AMMAN, Jordan — Dr. Mimi Syed, an emergency medicine physician from Washington state, is in an Amman hotel room, surrounded by infant formula and devices used for resuscitation that she had hoped to take into the Gaza Strip.
Syed, who had been planning her third volunteer mission to Gaza with a U.S. medical aid group, was told by the organization after she landed in Jordan for the trip that the Israeli military had rejected her and had given no reason.
She believes the reason is because of what she has described publicly after her previous missions. She has spoken — including in testimony to a United Nations commission — about treating minors who'd been shot in the head, an increase in child malnutrition and patients dying due to a lack of basic medical supplies.
With an unprecedented number of Gaza-based Palestinian journalists killed by Israel, which is barring almost all foreign reporters from the enclave, doctors and nurses have been among the last remaining international witnesses to the war's catastrophic toll on civilians.
"It just seems like this is a targeting of certain people who are going to be exposing the truth of what's happening in Gaza, another way to prevent that," says Syed, referring to Israel's decision to stop her and other foreign doctors from working in Gaza.
The U.N.'s World Health Organization says what it calls Israel's "arbitrary denial" of emergency medical staff is leading to more deaths in Gaza — where health authorities say Israeli strikes have killed about 1,500 local medical staff since the start of the war in October 2023. Many others have been repeatedly displaced by Israeli attacks.
Organizations sending international medical staff on volunteer missions to Gaza submit their applications weeks in advance to the WHO, which liaises with the aid groups sending in emergency medical teams, confirms physician qualifications and coordinates the missions to Gaza with the Israeli government, according to medical aid groups.
Israel requires doctors applying for the missions to be physically present in Israel or Jordan — a crossing point for many to Israel and Gaza — just before the mission starts, but notifies them only hours in advance if they are approved, says Syed.
Syed says a French doctor due to go in with her, who has also been vocal about the suffering in Gaza, was also rejected. A third member of their team, a nurse, was approved — but because she was required to go in with physicians, none were able to go.
Syed said being refused was particularly heartbreaking as she had befriended on her previous missions a sixth-year medical student in Gaza.
"I speak with her daily. She is like my sister," she says. "When I had to tell her the news I was denied, it was devastating."
The medical student, who does not want NPR to use her name because she fears being targeted by Israel, sent back to her mentor a voice message that sounded like a goodbye.
"I no longer have any hope, everything feels over, Mimi," she said, the sound of drones in the background. "I don't even want anything from life except death. Because I truly believe I will find peace in it."
Syed was left in tears by the message. "I feel hopeless that I can't provide anything for her," she says. "She's been displaced multiple times. They're exhausted. They don't have food. There's no place to live."
The World Health Organization says denial rates have risen by 50% since March
It's unlikely Syed would have been able to take into Gaza the donated infant formula, laryngoscopes and other supplies she'd crammed into a huge suitcase. Israel bans medical personnel from taking in anything but personal medication or supplies and allows only a small amount of cash, according to medical groups.
It also, according to U.N. and nongovernmental aid groups, severely restricts medical supplies entering Gaza by truck. According to medical aid groups and Israel's Physicians for Human Rights, Israel argues that items including hospital beds, anesthesia and water disinfectant tablets could have military use.
In response to NPR questions, Israel's military declined to provide a list of banned items and said it facilitates entry of medical equipment and supplies while "taking every possible measure" to prevent the militant group Hamas from seizing aid and using it for military purposes.
"I hear of people, like, hiding baby formula and stuff like that, trying to smuggle it in sometimes, but we discourage our staff to take anything besides their personal items," says Dr. Mustafa Musleh, head of the Palestinian American Medical Association (PAMA) in the U.S. "We don't want to risk them getting denied because of that."
Musleh estimates that more than 50% of the doctors for whom PAMA submits applications to Gaza are rejected by Israel, with rejections increasing sharply starting three months ago.
He and others say that Israel never provides an explanation for the denials. Musleh has gone through the rejections trying to find a pattern, and found that doctors who had previously served on missions in Gaza were more likely to be rejected than first-timers.
"We're facing a lot of challenges to get people in and get aid in," he says. "You know there is no rhyme or reason. You can't find an explanation for it from a security standpoint."
The Israeli military responded to NPR questions about why it was increasingly rejecting qualified doctors at short notice and with no explanation by saying it coordinates entry of dozens of organizations each week in a process subject to prior security screening.
The World Health Organization, in a written response to NPR questions, said "complex entry requirements and the arbitrary denial of international medical teams" were leading to more Palestinian deaths. Since mid-March, denial rates have risen by about 50%, it said, with 102 surgeons and other specialized medical staff denied entry into the Gaza Strip.
PAMA and other medical aid organizations had previously been able to send more than a dozen doctors at a time through the Egyptian border, with hundreds of suitcases filled with medical supplies they would need in Gaza's shattered hospital system. Israel participated in those checks and approvals.
Egypt shut the Rafah crossing after the Israeli military took control of the Gaza side of that border in an offensive on Rafah city and surroundings in May 2024. This has left border crossings with Israel, with occasional exceptions, as the sole entry to Gaza.
Doctors who are denied entry to Gaza try to help in other ways
When foreign doctors do get into Gaza, the volunteer missions are grueling and require personal sacrifice. Each doctor has to take up to four weeks off work from their practice, volunteer their time and pay for their own airline tickets. Musleh says despite that, he has hundreds of doctors willing and able to go, if Israel would allow in more medical staff.
The last-minute rejections mean that seats on U.N.-run security convoys for volunteer personnel go unfilled, he says, and patients are left untreated when desperately needed specialists are rejected. Last week, an oncologist was among PAMA's doctors rejected by the Israeli military, he says.
"Those are specialties that are highly needed and if those doctors did not get in, those patients will not get treated," he says. "It's as simple as that."
The World Health Organization told NPR the entry denials of specialized foreign medical staff are putting at risk 4,500 consultations per week in Gaza.
Israel's increased rejections of doctors are in addition to restrictions it imposed last year, which included banning any volunteer medical staff with a Palestinian grandparent.
Dr. Yassar Arain, a pediatrician and neonatologist in Texas, was among the physicians rejected last week.
"I had obviously been planning for months on end and then on my way to Jordan, I got a text message saying I was denied," he says in Amman.
The message was from his medical aid group, showing a red line the Israeli military drew through his name. A Jordanian doctor due to go in at the same time was also denied, he said.
Arain decided he would go to visit Jerusalem as a tourist after being rejected. He says he was detained for three hours at the border crossing of the Israeli-occupied West Bank, as Israeli guards went through his phone and social media posts, reading his journal entries to one another. They sent him back to Jordan and gave no reason.
Arain says he was haunted by what he previously experienced in his time volunteering as a doctor in Gaza. He and other doctors and nurses who had volunteered there formed a group called Healthcare Workers for Humanity to raise public awareness about Gaza and other humanitarian crises.
"What helped me was realizing that, OK, I did a couple of weeks in Gaza and did what I could, but the real work was when I came home," he says. "As one of the few witnesses to what was going on in Gaza from the West, it was now time to engage in advocacy and community building."
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