Gaza hospital
A nurse tends to four-year-old Palestinian girl Shayma Al-Masri, who hospital officials said was wounded in an Israeli air strike that killed her mother and two of her siblings, as she receives treatment at a hospital in Gaza City July 14, 2014. Reuters/Mohammed Salem

On the same day that more than 300 Palestinian-Americans were evacuated by the United Nations from Gaza, 35 people, mostly women and children who were injured in Israel’s bombardment of the territory and in need of immediate medical services, were denied approval by the Israeli government to leave, according to officials at the World Health Organization.

The 300 Americans were among more than 800 people with foreign passports living in Gaza who were expected to be evacuated by the UN. The World Health Organization (WHO) said on Monday that 55 people, including the 300 Americans, were evacuated on Sunday by bus. The Coordination of Government Activities in the Territories (COGAT), part of the Israeli Ministry of Defense, said the evacuation process could take up to three days. Meanwhile, Palestinians injured from the bombings by the Israeli Defense Force (IDF), which is seeking to halt rocket fire into Israel by the radical Muslim group Hamas, were not allowed to leave on Monday despite needing medical attention.

The Palestinians were unable to receive adequate treatment from doctors in Gaza, WHO officials said, and they wanted to cross into Israel to get the medical help they needed.

There are only two official ways to leave Gaza: Through the Erez border crossing with Israel or through the Rafah border crossing with Egypt, which was reopened recently during the bombings but then closed again. The crossing was closed indefinitely last summer because of attacks on Egyptian security forces in the Sinai after former Egyptian President Mohamed Morsi was overthrown. According to the COGAT website, the Erez border crossing is open for "urgent cases only." Evacuations are only available by car or bus.

After the Israeli occupation of Gaza began in 1967, there was freedom of movement between the West Bank, Gaza and Israel, which became increasingly restricted as Palestinians began to resist the occupation. In the 1990s, after the outbreak of the revolt known as the First Intifada and with the implementation of the Oslo Accords, Israel began to seal its border with Gaza, building a 26-feet-high barrier that encapsulates its entirety.

The Universal Declaration of Human Rights says that “everyone has the right to freedom of movement and residence within the borders of each state; and everyone has the right to leave any country, including his own, and to return to his country.” The freedom of movement is also covered in the International Covenant on Economic, Social and Cultural Rights (ICCPR). Israel has ratified both international agreements and is bound under international law to uphold them. But the ICCPR allows for restriction of movement if it is necessary to protect national security -- a clause Israel has used to defend its policy.

Palestinians are increasingly in need of aid, but international organizations, including the UN, are pulling many of their staff members out of the region for security purposes.

Some, mostly medical organizations, have remained inside the strip.

Three international aid organizations operating in Gaza confirmed Monday that the hospitals and medical centers there are not equipped to deal with the influx of people in need of medical attention. Medecins Sans Frontieres (MSF), also known as Doctors Without Borders, the WHO and the International Committee of the Red Cross said they were supplying local Palestinian doctors with equipment such as stretchers and mattresses but still working on getting essential medicines into the region. Both the ICRC and the WHO said they were working with the Palestinian Ministry of Health to get the medicines that surgeons in Gaza need to operate.

But, Mahmoud Daher, director of the WHO Gaza office, said the Ministry of Health in Gaza was stretched thin even before the current conflict began. According to a WHO document, 28 percent of essential medicines were at zero stock before two weeks ago.

In recent days, MSF donated supplies, including antibiotics, gloves, painkillers and infusions, to Nasser Hospital, located in Khan Younis in southern Gaza.

Tim Shenk, a spokesman for MSF, said his organization fields about 56 staff members in Gaza who work closely with Nasser Hospital and Al-Shifa Hospital in Gaza City. He said the organization has two surgical teams ready to enter Gaza to help Palestinian hospital staff.

According to the ministry of health, the death toll in Gaza reached 176 Monday. More than 1,200 have been wounded. All of those affected are Palestinian. There have been no reported deaths in Israel as a result of Hamas rockets, because they either landed in uninhabited areas or Israel's Iron Dome missile shield system intercepted them.