Abstract
This paper examines Gaza’s blockade, imposed in 2007, and the closure of the Egyptian Rafah Crossing since May 6, 2024, as an ongoing health and human rights crisis. It situates current conditions within a longitudinal comparison of publications from 2009 to the present (2026). An analysis of how this closure impinges on Gazan Palestinians’ right to healthcare and other basic survival needs, including food, water and shelter, is presented. Additionally, this essay examines efforts to break the siege by land (the Soumoud Convoy) and sea (Global Sumud Flotilla), as methods through which civilians from dozens of countries physically challenged the blockade. Between June 9 – 16, 2025, the Soumoud Convoy comprised approximately 1,250 participants from Tunisia, Algeria, Libya, Mauritania, and Morocco traveling in roughly 100 vehicles. The Global Sumud Flotilla sailed between August 31 and October 1, 2025, with approximately 462 activists from 44 countries aboard 42 vessels carrying humanitarian aid. The flotilla asserted their right to freedom of navigation. Last, scholars documenting Gazans’ right to freedom of movement and publishing on the occupation, along with civilians traveling by land or sea, are crucial acts of resistance. Collectively, these academic and grassroots efforts assert the rights of Gazans and all Palestinians, amplifying international attention and embodying the ethos of fighting for health, dignity, and survival for all.
Introduction
Health equity, human rights, and broader economic and social justice issues are under threat worldwide. Authoritarian rulers and misleading media narratives have fuelled mistrust and social division at local, national, and global levels. (1) This paper examines Gaza’s blockade, imposed in 2007, and the closure of the Egyptian Rafah Crossing since May 6, 2024, as an ongoing health and human rights crisis. (2) It situates current conditions within a longitudinal comparison of publications from 2009 to the present (2025). An analysis of how this closure impinges on Gazan Palestinians’ right to healthcare and other basic survival needs, including food, water and shelter, is presented. Additionally, this essay examines efforts to break the siege by land and sea, as methods through which civilians have continued to Fight for the Rights of Gazans.
The 17-Year Siege on Gaza
Border closures and the 17-year siege on Gaza threaten the health and human rights of Gazans. In October 2009, HHR Journal published a three-part “Patients with Borders” series detailing Israeli-imposed border restrictions in Gaza, particularly at Rafah Crossing. (3, 4, 5) Physicians for Human Rights-Israel presented three case studies highlighting the severe limitations on medical aid entering Gaza. The primary purpose of publishing these cases was to raise awareness of the harms caused by denying severely ill Gazans permission to leave the Strip for critical healthcare.
More than 16 years after the publication of this series, the siege on Gaza continues. Amid the ongoing conflict, the scale and severity of illnesses and injuries requiring medical transport have increased exponentially. There is a grave need for medical aid, as well as basic necessities such as food, water, hygiene products, clothing and shelter. (6) Despite the ceasefire agreement of October 10, 2025, which stipulated reopening the Rafah Crossing during the first phase of the truce, the border has remained closed and humanitarian access restricted into late 2025. (7)
Rafah Crossing Closure as a Health and Human Rights Crisis
The effects of border restrictions on Gaza’s healthcare system are compounded by severe infrastructural limitations. Despite international humanitarian law mandating the protection of patients, providers, facilities and transportation, Israel has an extensive history of targeting these resources. (2) Direct military attacks on hospitals, ambulances, and medical education institutions, as well as the killing and arrest of healthcare personnel, are only some of many forms of destruction that have contributed to the system’s collapse. (6) As of November 2025, more than 60% of all health facilities remain nonfunctional. (8)
Border crossings such as Rafah are indispensable to Gaza’s healthcare system, allowing the entry of medical supplies and support staff, as well as the evacuation of patients requiring treatment. By imposing extremely restrictive policies or completely blocking movement through these passages, Israel deliberately obstructs healthcare for Gaza’s entire population–an obstruction that constitutes a war crime. (2) The World Health Organization called for an immediate and sustained reopening of all borders into Gaza in November 2025 because over 16,500 patients remain on waiting lists for evacuation outside the Strip for urgent specialized care, and 55% of essential medications are at zero-stock. (8)
Gaza has seen an exponential increase in diseases, while common conditions remain untreated, resulting in higher rates of severe complications and death. (9) Shortages of medical supplies, from surgical equipment to menstrual products, mean that even basic health needs cannot be met without substantial risk. (6) Vulnerable populations, such as patients with cancer or disabilities, are especially endangered by the lack of accessible treatment. (8) These conditions represent only the beginning of the consequences facing Gaza’s healthcare system, driven largely by its inaccessible borders.
Border closures have also contributed to Gaza’s broader humanitarian crisis. Most acutely, following October 2023, nearly all of the region’s infrastructure has been destroyed or heavily damaged, including agricultural land, water networks, housing, transportation, roads, and factories. (10) As of 2025, the situation is dire with three-quarters of Gazans face “emergency” or “famine” levels of food insecurity, the Integrated Food Security Phase Classification’s (IPC) most severe categories. (11) Ninety-seven percent of Gaza’s water supply has been deemed unsafe for drinking. (10) Eighty-five percent of Gazans have been internally displaced following the demolition of over 360,000 homes. (6) External aid is not supplemental; the population’s survival is now entirely dependent upon it.
In 2007, the Israeli government designated Gaza a “hostile entity” and imposed a blockade on land, air, and sea. Gaza’s border crossings have since remained under Israeli control. (10) Consequently, and in violation of international humanitarian law, Israeli authorities have made the entry of aid into the Strip nearly impossible: the inaccessibility of travel permits, lack of protection afforded to organizations from attack, and politicization of aid as a means to “support terrorism” have deterred and directly prevented local and expatriated staff from delivering essential supplies. According to United Nations (UN) World Food Programme Executive Director Cindy McCain, “Families in Gaza are starving while the food they need is sitting at the border.” (12)
Today, over 50% of the Strip remains under Israeli military deployment and faces restricted or blocked access to humanitarian resources. (8) Since October 2023, the entry of thousands of metric tonnes of UN-coordinated aid has been rejected, including shelter, water and sanitation supplies.
Many international organizations remain unable to obtain the Israeli-mandated registration required to operate at scale, while others, like the UN Relief and Works Agency, are banned from entry altogether. Gaza’s borders no longer mark territory; they determine the conditions of Gazans’ survival itself.
Civil Resistance and Advocacy: Land and Sea Efforts to Break the Siege on Gaza, 2025
As detailed in Table 1, (13) notable civil resistance efforts by land and sea sought to break the siege. Civilians from dozens of countries physically challenged the blockade. Between June 9 – 16, 2025, (14) the Soumoud Convoy comprised approximately 1,250 participants from Tunisia, Algeria, Libya, Mauritania, and Morocco traveling in roughly 100 vehicles. Around 15 participants were arrested; the convoy was denied entry and subsequently cancelled. Nonetheless, this effort amplified worldwide media attention to Gaza’s border policies.
The Global Sumud Flotilla sailed between August 31 and October 1, 2025, with approximately 462 activists from 44 countries aboard 42 vessels carrying humanitarian aid. (15) The flotilla asserted their right to freedom of navigation. All vessels were intercepted, and activists were deported, imprisoned, beaten, or threatened. This act of international solidarity demonstrated civil society operationalizing the “Fight for Rights” for Gazans by asserting their right to humanitarian access.
Conclusion
Scholars documenting Gazans’ right to freedom of movement and publishing on the occupation, (16) along with civilians traveling by land or sea, are crucial acts of resistance. Collectively, these efforts raise awareness of underlying health and human rights violations. While the scale of these convoys and flotillas remains small relative to humanitarian need, their visibility and organization provide a critical metric of the power of lay-driven advocacy. Such academic and grassroots advocacy assert the rights of Gazans and all Palestinians, amplifying international attention and embodying the ethos of fighting for health, dignity, and survival for all. The authors urge the continuation of the decades-long Fight for Gazan and Palestinian’s Health and Human Rights–by ending the occupation and lifting the siege.
Funding:
None
Competing interests:
None declared.
References
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