Palestinian child awaits Gaza evacuation as pacemaker battery nears depletion

LONDON -- As a 4-year-old Palestinian child waited on Sunday to cross into Jordan for a chance at a life-saving medical procedure, a gunman was crossing from the other side to attack Israeli border guards.

Accompanied by his mother and fiercest advocate, Huda, Ahmed Hammad had left Gaza a few hours earlier for an emergency surgery to change his pacemaker, a necessary device he had since he was just a baby that has a battery that is now days away from completely depleting.

As doctors first warned about the situation in March, the family soon organized to request an emergency evacuation, according to the humanitarian agents helping them. But Hammad's case was repeatedly rejected by Israeli officials who cited security concerns, they said.

Until Sunday, when he made it out of Gaza for the first time, traveling to the crossing in the West Bank, just to be returned to the war-torn Gaza Strip a few hours later. All crossings from Jordan were shut down after the gunman coming from Jordan killed three Israeli civilians at Allenby Bridge crossing, Israeli officials said.

It has been over 11 months since Hamas militants carried out a surprise attack that prompted a retaliatory war from Israel, which has left over 41,000 killed and 94,000 injured in Gaza, according to the Hamas-controlled Gaza Health Ministry. The health care system in the Strip collapsed as a direct result, leaving cases like Hammad's in a limbo of bureaucracy that quickly took most of the time he had left to save his life.

Humanitarian agencies, such as Save The Children and Doctors Without Borders, say there are thousands of other children like him waiting to evacuate for medical reasons.

Hammad, who is nonverbal, has people who raised their voice on his behalf, pleading his case to the relevant authorities more urgently as every day went by.

His mother, Huda, who said she already lost a daughter early in the war due to malnutrition and lack of health care, has been documenting Ahmed's journey on Instagram.

In posts shared with a growing number of supporters from all around the world, Huda uploaded photos of her son resting in a tent, as well as videos of the frequent, painful seizure-like activity that came with his pacemaker's battery dwindling.

Also fighting on behalf of Ahmed is Tareq Hailat, head of the Treatment Abroad Program at the Palestine Children's Relief Fund (PCRF), which provides free medical care to Palestinian children who lack access to it.

"He needs to get out, or that battery runs out and he's going to die," Hailat told ABC News.

He added that surgeries like the one Hammad needs were ordinary in Gaza before Oct.7 but are now impossible in what humanitarian agencies, such as Doctors Without Borders, call a destroyed health care system.

Hailat said that the situation with medical evacuations for children of Gaza deteriorated after the Israeli military took over the Philadelphi Corridor, a strategic ribbon of land running 9 miles at the border with Egypt that includes the Rafah crossing, a main evacuation point.

"Since the Rafah border has been closed, there's only been about maybe a hundred children that have been pulled out. Before, we would pull out almost 50 every single day," Hailat said.

When asked about the system in place and why emergency cases like Hammad's can wait for months without updates, Hailat said there is no system in place and the permission appears to be given arbitrarily.

"We ask the same question every single day: why is this particular child not being able to be pulled out? And it really has to do with the fact that it's all in the hands of COGAT and no one else," Hailat told ABC News, referring to the Israeli military's Coordinator of Government Activities in the Territories. "So we have to wait and plead until they approve, and we have to exert as much pressure as possible."

Hammad's peacemaker will soon lose power, which would leave him to face likely cardiac arrest, according to his doctor and advocates.

ABC News has reached out to COGAT for comment.

Dr. Oday Sallout, a cardiac and pediatric surgeon at the European Hospital in Gaza who has been following Hammad's case, said he has a "complete heart block" condition, with his heart's upper and lower chambers disassociated and not working in combination.

"This creates a mess, with complications including sudden loss of consciousness and ultimately the risk of cardiac arrest," Sallout said in an interview. "With a pacemaker he can sustain a good life, but it must be changed. I've learned he was first approved to evacuate without his mother, which is like a death sentence for someone like Ahmed."

He’s dependent on his mother, so separating them could be catastrophic, Sallout said.

After the Palestinian Ministry of Health flagged the case, Hammad was approved through the World Health Organization to be welcomed for treatment in multiple countries, including Spain and the United Arab Emirates.

But he needs to leave Gaza first.