Palestinian-American doctor Jiab Suleiman arrived in Jordan last month ahead of an emergency medical mission into Gaza, which he was due to oversee. The Ohio-born orthopedic surgeon had already led two trips into the besieged strip since the Israel-Hamas war broke out in October and was finalizing details for his third.

But his preparation would ultimately be for nothing. The day before the team was set to cross into Gaza, Suleiman received notice that he had been denied entry by Israel’s Coordinator of Government Activities in the Territories, or COGAT, the Israeli agency that manages policy for the Palestinian territories and the flow of aid into the strip.

“We have to actually tell people of Palestinian origin or Palestinian dual nationals that it is not possible for them to go in,” said Sameer Sah, director of programs at Medical Aid for Palestinians, an aid organization based in the United Kingdom. “We have to distinguish between Palestinians and non-Palestinians which is not ethically right, which is not right in terms of humanitarian laws, and it is not humane.”

“They said ‘you’re denied because of your Palestinian ID,’” said Suleiman, the medical mission lead at Rahma, a US-based humanitarian organization, referring to COGAT. “It’s very upsetting, annoying and disturbing to deny someone entry to a war zone to do a mission just because of the fact that they’re by genetics Palestinian.”

“I stopped recruiting or encouraging any Palestinian physician worldwide to come help, I just can’t recruit them because I lose a slot,” Suleiman added. “Even if it’s just one doctor or one nurse, I lose a slot knowing that they’re going to be denied and I need every single body, every physician to go into Gaza.”

The change in policy came after Israel launched a deadly ground offensive into Rafah in May, during which it seized control of the Rafah crossing between Egypt and Gaza and destroyed the Palestinian side. Medical aid groups that relied on the Rafah crossing for entry into Gaza have been forced instead to use Kerem Shalom – a crossing previously used for commercial goods – to get from Israel into southern Gaza.

Before the war, Palestinian medics and medics of Palestinian heritage who held other passports could apply to Israel for entry into Gaza and have no issues getting approval. They would enter the strip through the Erez crossing, between Israel and northern Gaza, which has been closed since it was destroyed in the Hamas-led attacks on October 7.

International aid organizations are demanding that Israel drop the new restrictions affecting medical missions, pointing to the dire need for their teams to enter Gaza, which has had its healthcare system decimated by Israel’s war, launched in response to the Hamas-led attacks of October 7. Since then, more than 500 healthcare workers have been killed and 32 out of 36 hospitals have been damaged or destroyed, according to the UN.

In an email sent by a WHO regional office, teams were told that the new COGAT policy stated that anyone with Palestinian background or roots would be denied border crossing through Kerem Shalom.

“We reiterate that we STRONGLY advice (sic) against any attempt of entering Gaza with a Palestinian background/roots,” the email stated.

Another WHO email sent a few days later explained that rejections could also be simply due to ancestry, such as having “parents or grandparents who were born or formerly established in Palestine, with or even without Palestinian ID.”

“We are having HUGE problems with this, as COGAT keeps rejecting many people for this reason,” the email said.

In one WHO document from early June detailing updated guidance, aid groups were told that “it is not recommended that staff with dual citizenship (Palestinian) enter Gaza due to issues with permits.”

Thaer Ahmad, a Palestinian-American doctor from Chicago who went on a medical trip to Gaza in January, was in Cairo preparing for another trip in May when Israel seized the Rafah crossing, blocking humanitarian and medical aid groups from entering.

“I find it so heartbreaking and tragic that any connection to the land is used against healthcare workers trying to help,” said Ahmad, who walked out of a White House meeting with Muslim community leaders in April in protest of the Biden administration’s support of the war. “To be deprived of being able to put my skills to use for my people, at the height of their suffering and pain is especially cruel.”

“Because of the limited amount of seats that we have, we can’t risk it,” said Dr. Mustafa Musleh, the president of PAMA. “It is not necessarily something that we want, and we really prefer not to do that. But I don’t think we have a choice at this point.”

Another organization posted a recruiting ad on Instagram calling for surgeons to apply for its upcoming medical mission trip to Gaza. The ad disclosed that “applicants with a Palestinian ID or Palestinian roots are not allowed into Gaza.” The post has since been deleted.

Musleh emphasized that there are significant advantages to including medical workers with the same background and roots as the populations they are treating in mission teams, since it means they can understand the language and culture.

Palestinians have faced decades of tight restrictions on their movement by Israel, imposed through a complex system of permits, walls, checkpoints and border crossings. Unlike Israeli settlers – who can generally move freely without restriction – Palestinians in the West Bank and Gaza are required to obtain special permits from the Israeli government.

According to B’Tselem, an Israeli human rights organization, Palestinians face “an arbitrary, entirely non-transparent bureaucratic system” in which many permits are denied or revoked without explanation.

For Palestinian doctors hoping to provide care for their people, Israel’s decision to deny them entry to Gaza has left them in despair.

“Your hands are tied, and you feel hopeless,” Suleiman lamented. “I don’t understand these people, how they decide to do this to someone that’s just going in for two weeks to serve the purpose of helping people.”

“It does not feel right being denied just because of the place you were born and being treated different than other US citizens,” Musleh said.