Health Researcher – Cancer Patients’ Access to Medical Care

Terms of Reference

Research on the Intensified Challenges Faced by Cancer Patients in the Occupied Palestinian Territory Since October 2023 (In Gaza and West Bank)

Scope of work

Duration: 4.5 months (1 August – mid December)

The production of comparative research with firsthand data on how the escalation of Israeli military violence and restrictions since October 2023 has impacted access to and continuity of cancer care for Palestinian patients in Gaza and the West Bank.

This study aims to fill that gap by documenting the lived experiences of Palestinian cancer patients and identifying the specific barriers they now encounter. Given the heightened vulnerability of the study population, the research will adhere to the highest ethical standards to ensure participants’ dignity, safety, and informed consent. A mixed-methods approach will be employed to assess the impact and develop recommendations to support affected patients, their families, and healthcare providers.

Introduction

Medical Aid for Palestinians (MAP) is a British registered charity that has been reaching out to the Palestinian communities, striving to deliver health and medical care to those worst affected by conflict, occupation and displacement. MAP provides immediate medical aid to those in need at times of crisis, while also developing local capacity and skills to ensure the long-term development of the Palestinian healthcare system. Part of MAP’s work is to advocate for Palestinian right to health and demand accountability and an end to the Israeli violations.

The escalation of Israeli violence since October 2023 across the occupied Palestinian territory (oPt) has exacerbated the challenges faced by Palestinian cancer patients.  

In Gaza, the Israeli military has been systematically dismantling the healthcare system since the onset of what human rights experts have identified as crimes of extermination and genocide. Gaza’s estimated 10,000 cancer patients, like the rest of the population, have been severely affected by starvation, forced displacement orders, and the siege imposed, denying the entry of vital medical supplies.  

Moreover, Israeli forces have systematically attacked Palestinian healthcare infrastructure, including hospitals, crippling essential, life-saving services. For example, the Turkish-Palestinian Friendship Hospital, the only facility providing cancer treatment in Gaza, was struck by an Israeli airstrike 30 October 2023, damaging its third floor. The Hospital was subsequently forced to shut down on 1 November 2023 due to a fuel shortage. In March 2025, the Hospital was targeted and completely destroyed by the Israeli military.  

Between 7 October 2023 and 8 July 2024, 436 cancer patients have ‘died’ in Gaza, mostly without adequate medication and treatment since October 2023. On 1 June 2025, the Director of Al Shifa Hospital said that five cancer patients die every day at home due to a lack of medical care. 

In the West Bank, the situation has also deteriorated due to intensified Israeli military incursions—especially in the northern governorates—resulting in the displacement of approximately 40,000 Palestinians and widespread destruction of infrastructure. Increased checkpoint closures, movement restrictions, and a further tightening of Israel’s permit system have severely limited access to care. According to WHO, 44% of patient permit applications were either denied or delayed for West Bank residents between October 2023 and December 2024, representing a significant increase compared to previous periods. 

Moreover, on 7 October 2023, around 400 Palestinian residents of Gaza were receiving treatment in the West Bank or Israel, including around 100 cancer patients. As of June 2024, all remain stranded in the West Bank. 

Critically, the struggles faced by cancer patients began long before October 2023. For decades, the healthcare system in the oPt has been systematically undermined, primarily due to Israel’s unlawful occupation and entrenched policies of apartheid, racial segregation, systematic discrimination and the fragmentation of the Palestinian people. These structural forms of oppression are exacerbated by the 17-year-long illegal blockade of the Gaza Strip, repeated military assaults, and the intentional de-development of the Palestinian health sector. Across the oPt, the movement of patients and medical personnel is routinely obstructed, and the entry of essential medical supplies and life-saving equipment is tightly restricted under Israeli control. 

These systemic barriers have had a profound impact on Palestinian cancer patients, who often face significant obstacles in accessing necessary care. In 2022, cancer was the second leading cause of death in the oPt, with a mortality rate of 42.6 per 100,000 people.1 Furthermore, cancer treatment represents the highest number of referrals outside the Ministry of Health system—an indication of the urgent, unmet needs created by the systematic denial of Palestinians’ right to health. 

In Gaza, the Israeli-imposed closure since 2007 has rendered the local health system unable to provide comprehensive cancer treatment. Essential services such as radiotherapy, PET scans, and certain chemotherapy drugs are completely unavailable, due to Israel’s ‘dual-use’ list. As a result, patients must seek treatment outside Gaza, primarily in hospitals in the West Bank, including East Jerusalem, but are subjected to a restrictive and discriminatory Israeli permit system. 

In 2022 alone, 20,295 permit applications were submitted for Palestinian patients in Gaza, with 35% being cancer patients. Of these, 33% of applications were either delayed or denied by Israeli authorities. Nearly one-third (29%) of applicants were minors needing companions, but 62% of companion permits were delayed or denied, and 25% had to seek treatment without them.2 Most denied or delayed applications received no explanation.3 A WHO survival analysis of Gaza cancer patients from 2008 to 2017 showed that permit delays or denials increased the likelihood of death from cancer by 1.5 times.4 

In the West Bank, cancer patients similarly face severe barriers to care due to limited local services and Israel’s restrictive permit system, as well as other movement restrictions mainly due to road obstacles, and the large number of fixed and ‘flying’ checkpoints. Most facilities lack advanced diagnostics and radiotherapy, forcing patients to seek treatment in East Jerusalem. Between 2019 and 2021, 15% of all permit requests for West Bank residents were either denied or delayed by the Israeli authorities.5  

جميع الحقوق محفوظة لموقع جوبس.

Requirements/experience

• Proven experience in conducting field-based qualitative and quantitative research in the Palestinian context.
• Proven experience in data collection and analysis.
• Background in public health, social sciences, human rights, or related fields, with a focus on health systems, access to care, or humanitarian crisis response.
• Demonstrated experience working with vulnerable populations, especially patients with chronic illnesses.
• Commitment to upholding high ethical research standards, especially related to informed consent, confidentiality, and participant well-being.
• Wrote or directly contributed to published research in the health sector, desirably in the area of cancer treatment and care.
• Fluent in Arabic and based in Palestine, with a strong understanding of the Palestinian context.

Problem statement

Cancer patients in the oPt face structural barriers to accessing timely and adequate care. These include the direct attacks on healthcare personnel and facilities, fragmentation of health services, shortages of medicines and equipment due to the blockade, and a discriminatory Israeli permit regime. Since October 2023, the Israeli military has intensified its campaign in both Gaza and the West Bank, decimating health infrastructure and severely restricting patient mobility. This has rendered cancer care nearly inaccessible for thousands of Palestinians.

Project rationale or justification

While the humanitarian and human rights community has rightly focused on the direct targeting of healthcare workers and infrastructure since October 2023, far less attention has been given to patients themselves, particularly those with chronic and life-threatening conditions like cancer. As the healthcare system collapses under siege, and as military raids and movement restrictions intensify, cancer patients face unique and urgent risks. This research aims to fill this gap by documenting their lived experiences and identifying the specific barriers they now face, to assess the impact on quality of life, or the impact on health and life expectancy for these patients due to these barriers.  It also seeks to identify key steps that stakeholders, both political and humanitarian, must take to uphold the right to health and dignity of cancer patients in the oPt.

Project goals and objectives

Specifically, the research seeks to: 

• Assess and analyse the impact of Israeli military actions (e.g., targeting of healthcare workers and infrastructure, dismantling of healthcare, movement restrictions) on cancer patients’ ability to access timely and life-saving care since October 2023.
• Examine how Israeli policies—particularly the blockade, permit regime, movement restrictions, destruction of hospitals and clinics, denial of services such as radiotherapy that can greatly impact treatment outcomes, and bureaucratic delays—have systematically undermined the quality, continuity, and timeliness of cancer care, demonstrating that the denial of care is not solely a result of military escalation but part of a broader, institutionalised policy violating Palestinians’ right to health.
• Analyse the differentiated impact on specific groups (and their families), including: 
  • Cancer patients in Gaza
  • Cancer patients in the West Bank
  • Palestinian prisoners/detainees with cancer in Israeli custody
  • Gaza cancer patients stranded in the West Bank
  • Gaza cancer patients who were medically evacuated
• Generate evidence-based recommendations for duty-bearers and humanitarian actors to uphold the right to health and medical access for Palestinian cancer patients.
• Identify priorities and guiding principles for rebuilding a resilient, inclusive cancer care system—including early diagnosis, treatment, and continuity of care—through stakeholder engagement such as focus group discussions.
• Center and capture the voices of Palestinian cancer patients and their families, and Palestinian medical professionals to ensure their perspectives shape the narrative.
• Contextualise the findings within the broader landscape of cancer care by drawing comparisons with the health services provided in Israel, using publicly available information, in order to highlight disparities and underscore the challenges faced within the Palestinian healthcare system.

Research methodology

The research will use a qualitative, comparative case study approach, combining desk research, interviews, and focus group discussions, to compare the situation before and after October 2023: 

• Desk Research: A review of peer-reviewed, existing studies, reports, and verified news articles on cancer-related issues in the oPt, with a focus on the exacerbated challenges since October 2023.
• Focus groups: With patients, caregivers, and healthcare workers to discuss collective experiences.
• Interviews: In-depth semi-structured interviews with cancer patients and their caregivers and family members and doctors in the West Bank and Gaza to gather firsthand accounts of their lived reality. A total of at least20 interviews will be conducted with key informants, including:
  • Palestinian cancer patients or family members in the West Bank
  • Palestinian cancer patients or family members in Gaza
  • Palestinian cancer patients who are currently or formerly incarcerated in Israeli prisons 
  • Gaza cancer patients or companions currently stranded in the West Bank
  • Gaza cancer patients who were medically evacuated to receive cancer care
  • Healthcare workers in Gaza and the West Bank
  • People with cancer symptoms referred for testing but unable to access testing

Expected Deliverables:

Phase one

• Detailed action plan and budget for the research including methodology
• Researcher to conclude the MAP online safeguarding training and sign MAP code of conduct

Phase two

• Providing full transcripts of interviews and focus groups conducted
• Providing all the information from the desk review on cancer patients and access to health in oPt and in Israel
• Full report with data collection and data analysis

Phase three

• Submitting a full report that includes data collection, comparative analysis, desk review, recommendations, and further research gaps.

Budget

1. Transportation
2. Transportation fees (for both the researcher and patients/interviewees) to and from different regions of West Bank
3. Reserve space to conduct focus groups
4. Reserve space to conduct in-depth individual interviews
5. Data Collection 
6. Data Analysis and transcription of in-depth interviews & focus groups
7. Data interpretation, Discussion, & Findings
8. Submission of full report with recommendation and further research gaps

Ethical considerations for this research

This research involves cancer patients in Gaza and the West Bank, conducted in the context of trauma from military  occupation, and systemic barriers to healthcare. Given the heightened vulnerability of participants, the research will adhere to the highest ethical standards to ensure dignity, safety,  confidentiality and anonymity when needed, and informed participation.

Participants will be fully informed about the purpose, risks, and voluntary nature of the research through clear informed consent processes in Arabic, with options for verbal consent when needed.

A trauma-sensitive approach will be applied throughout, with interviewers trained to recognise signs of distress and referral pathways established for psychosocial support where needed. MAP will provide the researcher(s) with a clear list of referrals pathways that they can use. 

Data will be anonymised and securely stored to protect participants.

The research will avoid any framing that neutralises or depoliticises the context of Israeli occupation and blockade. Recognising that the research takes place within a context of military  occupation and apartheid, and what was described by human rights experts as genocide, Israeli policies (checkpoints, permits, siege on Gaza, medical refusals) directly shape patients' health outcomes and failing to name occupation or power structures can reinforce injustice.

Interested candidates are invited to submit the following documents:

• A detailed price offer in USD, inclusive of tax

• An updated CV

• A sample of previous relevant work

All documents must be submitted no later than July 17th, 2025 at 1:00 PM to [email protected].

Please note that 10% income tax will be deducted from the total amount if the applicant does not hold a deduction at source certificate.

Late or incomplete submissions will not be considered.