The iron gates of Rafah have creaked open, offering a desperate lifeline to a handful of Gaza’s dying, but for thousands left behind, the gesture is a drop in an ocean of suffering.

After nearly two years of hermetic sealing, the first convoy of ambulances has crossed into Egypt, carrying the broken bodies of 150 Palestinians. This limited reopening, brokered through fragile diplomatic backchannels, marks the first significant movement across the border since Israeli forces seized the crossing in May 2024. For the families watching their loved ones leave, it is a moment of salvation; for the 20,000 others still waiting for medical evacuation, it is a cruel lottery of life and death.

A System in Ruins

The backdrop to this evacuation is a healthcare system that has been systematically obliterated. Israeli airstrikes have reduced Gaza’s hospitals to rubble, with the destruction of the territory’s only specialized cancer hospital in March 2025 serving as the final blow to oncological care. Now, doctors operate in tents, without diagnostics, without drugs, and often without hope. The 11,000 cancer patients trapped in the strip are fighting a war on two fronts: against the bombs falling from the sky and the disease consuming them from within.

"This is not a humanitarian corridor; it is a trickle," stated a Médecins Sans Frontières representative. "One in five of the wounded are children. To let out 150 people when 20,000 are in critical need is a moral failure of the highest order."

• Security Stranglehold: Israel has imposed a draconian screening regime on the crossing. Every patient, every ambulance, and every companion is subject to joint Israeli-Egyptian vetting, a process that slows the evacuation to a crawl and leaves the most vulnerable waiting in agony.
• The Smuggling Pretext: The closure was originally justified by Israel as a necessity to stop Hamas weapons smuggling. Today, that policy has resulted in the total isolation of two million people, turning Gaza into what aid agencies are calling a "death trap."

The Egyptian Dilemma

For Egypt, the reopening is a calculated risk. Cairo is under immense pressure to alleviate the humanitarian catastrophe on its doorstep while maintaining its peace treaty with Israel and preventing a mass exodus of refugees into the Sinai. The sight of ambulances crossing at sunset provides a media-friendly image of cooperation, but it does little to address the structural strangulation of the Gaza Strip.

As the gates close again for the night, the 150 lucky ones speed towards hospitals in Cairo. Behind them, in the dark and the ruins, thousands more wait, praying that the world’s attention—and the border—will remain open long enough to save them too.