Wastewater treatment services are in desperate need of repair and lack the energy supply to operate properly after the 2014 war on Gaza. The 90 m3 of raw or partially treated sewage that previously flowed into the Mediterranean Sea on a daily basis is now completely untreated, increasing pollution and health risks. Sewage pumping stations have also begun to fail. In November 2015, one of the main sewage pumping stations in Gaza City expelled over 35,000 m3 of untreated sewage into the neighborhood of az-Zeitoun, posing significant health risks to around 3,000 people. 215 Lack of power has also severely affected the provision of medical services in Gaza. Power outages have caused essential equipment such as lab machines and incubators to malfunction and hospitals have had to prioritize emergency surgeries, making the waiting list for elective surgeries up to 18 months long.216 Additional healthcare problems have been created by the wars on Gaza and the closure of the Strip. There is an acute shortage of medicines and medical equipment, with Gaza’s Ministry of Health reporting insufficient supplies of 149 medicines.217 The Ministry has been unable to afford or to import enough to combat this shortage due to closure restrictions.218 This has been hugely detrimental to the delivery of medical services, particularly to the most vulnerable groups like pregnant women and babies. Injections to stimulate development in premature babies and induce labor are in short supply, and technology like infant heart monitors and incubators are not enough to meet demand.219 Subsequently, the number of referrals by Gaza’s Ministry of Health to hospitals in the West Bank and Israel has climbed significantly, as patients are unable to access sufficient care in Gaza. However, approximately one third of exit permit applications for medical treatment were rejected or delayed by Israeli authorities, causing these patients to miss their 215 OCHA oPt, “Gaza: water and sanitation services severely disrupted due to the energy crisis,” 24 November 2015, available at: https://www.ochaopt.org/content/gaza-water-and-sanitation-servicesseverely-disrupted-due-energy-crisis [accessed 22 August 2017]. 216 OCHA, Impact of Gaza’s Electricity Crisis, supra note 106. 217 Isra Saleh el-Namey, “Gaza’s sick pay price of blockade,” The Electronic Intifada, 27 July 2016, available at: https://electronicintifada.net/content/gazas-sick-pay-price-blockade/17501?platform=hootsuite [accessed 22 August 2017] [hereinafter Saleh el-Namey, “Gaza’s sick”]. 218 Health Cluster in the occupied Palestinian territory, “Gaza Strip: Joint Health Sector Assessment Report,” September 2014, available at: http://www.emro.who.int/images/stories/palestine/ documents/Joint_Health_Sector_Assessment_Report_Gaza_Sept_2014-final.pdf; Saleh el-Namey, “Gaza’s sick,” supra note 217. 219 Saleh el-Namey, “Gaza’s sick,” supra note 217. 60