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Israel has restricted movement in and out of Gaza, where only limited health care is available, since the militant Islamic group Hamas took over last June, but says it makes exceptions for humanitarian cases daily.

In 2007, more than 7,000 patients received permits to enter Israel for care, many more than the 4,900 in 2006, said the W.H.O. and the Israeli Coordination and Liaison Administration, which manages movement at the Gaza border crossings. But 18.5 percent of permit applications were denied in 2007, compared with fewer than 10 percent in 2006.

Gaza’s border with Egypt was closed in June 2007, after the Hamas takeover, leaving Israel as the only option for most patients seeking advanced care. The liaison administration says that more than 2,300 patients entered Israel in the first quarter of 2008.

The report details five case studies, including that of Amir al-Yazji, 9, who contracted meningoencephalitis and died in a Gaza hospital on Nov. 19. Amir fell ill on Nov. 5, the report says his family reported, and his condition was diagnosed days later. Shaher Yazji, his father, described a desperate race against time from Nov. 14, when he got an urgent referral from Gaza for an Israeli hospital, until the Israelis processed the entry permit on Nov. 18, the report says.

Mr. Yazji says in the report that when full approval came through that afternoon for the boy and the medics who would accompany him to the Erez crossing, they were told they would have to arrive within 15 minutes, before the liaison office closed. But transferring Amir to an ambulance and the trip to the checkpoint took at least an hour, so it was put off a day, the report says. Amir died the next morning, it says.

In a written statement on Wednesday, Col. Nir Press, who leads the Israeli Coordination and Liaison Administration for the Gaza crossings, said that his office received the request for Amir on Nov. 18 and gave final approval that day. He said the boy’s departure from Gaza had been delayed a day at the Palestinians’ request because his condition had deteriorated and needed to be stabilized before he could travel. A spokesman for Colonel Press denied that Amir had been given 15 minutes to arrive.

Colonel Press added that among the other 31 deaths the report listed were patients who were unknown to the Israelis, with no request having been received on their behalf.