A small number of sick and wounded Palestinians have begun crossing into Egypt to seek medical treatment after Israel permitted a limited reopening of the Palestinian territory’s Rafah border post as fragile diplomatic efforts to stabilise the conflict inch forward.

About 150 people were due to leave the territory on Monday, and 50 to enter it, according to Egyptian officials, more than 20 months after Israeli forces closed the crossing.

However, by nightfall, Reuters reported that Israel had permitted 12 Palestinians to re-enter the territory, according to Palestinian and Egyptian sources.

A further 38 had not cleared security and would wait on the Egyptian side of the crossing overnight, it said.

In terms of those exiting, Israel permitted five patients escorted by two relatives each to cross to the Egyptian side, the sources said.

That brought the total number entering and exiting to 27.

Palestinian officials blamed delays on Israeli security checks.

Israel’s military had no immediate comment.

Ambulances waited for hours at the border before ferrying patients across after sunset, footage from Egyptian state-run television showed.

The crossing had been closed since Israeli troops seized it in May 2024, only briefly opening during a ceasefire in early 2025 for the evacuation of medical patients.

About 20,000 Palestinian children and adults needing medical care hope to leave the devastated territory via the crossing, according to Gaza health officials.

Thousands of other Palestinians outside the territory hope to enter and return home.

When Israel took control of the Rafah crossing – Gaza’s only crossing not shared with Israel – it described it as necessary to prevent weapons smuggling by Hamas.

The move isolated the territory, cutting off a critical lifeline for Palestinians seeking access to medical care, travel and trade.

View image in fullscreen Palestinian patients at hospital in Khan Younis.

Photograph: Haitham Imad/EPA Israel has made clear that all movement through the crossing after the partial reopening will be subject to joint Israeli-Egyptian security screening and that, for now, only a small number of Gaza’s tens of thousands of wounded and ill Palestinians will be permitted to leave each day.

Thousands of civilians have registered with the World Health Organization for medical evacuation.

According to Médecins Sans Frontières more than one in five of them are children.

The sick include more than 11,000 cancer patients.

Israeli airstrikes on hospitals have reduced the Palestinian healthcare system to ruins.

In March 2025, Israel destroyed Gaza’s only specialised cancer treatment hospital, the territory’s sole provider of oncological care.

Since then, doctors have been pushed into makeshift clinics, operating with almost no resources, including the tools needed for diagnosis.

Gaza health officials said there were about 4,000 people with official referrals for treatment to third countries who had been unable to cross the border.

For some, the reopening came too late.

Dalia Abu Kashef, 28, died last week while waiting for permission to cross for a liver transplant.

“We found a volunteer – her brother – who was ready to donate part of his liver,” her husband, Muatasem El-Rass, told Reuters.

“We were waiting for the crossing to open so we could travel and do the surgery, hoping for a happy ending.

But she deteriorated badly and died.

” The WHO says 900 people, including children and cancer patients, have died while awaiting evacuation.

The limited reopening of the Rafah crossing also offers a rare opportunity for families torn apart by more than two years of war to reunite.

Many families who fled to Cairo early in the war never expected to remain for so long.

In the war’s early months before Israel shut the crossing, about 100,000 Palestinians exited to Egypt through Rafah.

“I love Gaza, and I don’t see any other place that feels like home,” said Mohammad Talal, 28, a currency trader whose home in Jabalia in northern Gaza was destroyed.

“Going back to live in a tent?

I don’t care,” he said.

“I can’t wait to take my father into my arms and place a kiss on his forehead.

” Israel had kept the Rafah crossing sealed as a bargaining chip, linking its reopening to the return of all hostages taken during the Hamas-led assault of 7 October 2023 – whether alive or dead.

That position shifted only last week, when the Israeli military announced it had recovered the remains of the final captive, Ran Gvili, a police sergeant killed during the initial attack that triggered the war.

9:33 Gaza: Rafah crossing reopens under Israeli restrictions - The Latest The reopening is seen as a key step as the US-brokered ceasefire agreement moves into its second phase.

Its first phase called for the exchange of all hostages held in Gaza for hundreds of Palestinians held by Israel, an increase in badly needed humanitarian aid and a partial pullback of Israeli troops.

The second phase of the ceasefire deal is more complicated.

It calls for the installation of a new Palestinian committee to govern Gaza, the deployment of an international security force, the disarmament of Hamas and taking steps to begin rebuilding.

The EU’s top diplomat, Kaja Kallas, said the opening of the Rafah crossing “marks a concrete and positive step in the peace plan”, for the wartorn territory.

“The EU’s civilian mission is on the ground to monitor crossing operations and support Palestinian border guards,” she wrote online.

The National Committee for the Administration of Gaza – a body of Palestinian technocrats tasked with helping govern the territory – welcomed the reopening of the crossing as a symbolic first step rather than a solution.

In a statement posted on social media on Monday, the committee described the move as “the beginning of a long process to reconnect what has been torn apart, and to open a genuine window of hope for our people in the Gaza Strip”.

The reopening of Rafah marks a tentative turning point after the fragile ceasefire agreed last October, a truce that has proved more nominal than real.

Four months on, it has failed to halt the bombardment of Gaza, offering pauses rather than peace.

Life in Gaza remains precarious.

While airstrikes and gunfire have slowed, they have not ceased.

At the same time, storms have compounded the crisis, causing deaths and flooding in displacement camps already stretched beyond their limits.

The ceasefire’s brittleness was once again laid bare on Saturday, when Israeli airstrikes killed at least 32 people, including several children, according to local health officials.

The Israeli military said the strikes targeted militants and weapons infrastructure.

Israeli forces have killed at least 509 Palestinians and wounded 1,405 more since the Gaza ceasefire took effect in early October, including hundreds of children.

Despite the reopening of Rafah, Israel is still refusing to allow the entry of foreign journalists, banned from Gaza since the start of the war.

Reporting from inside Gaza for international media, including the Guardian, is carried out solely by journalists who live there, hundreds of whom have been killed

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