A/HRC/34/70 out of Gaza has in the past year become increasingly difficult as the number of permits revoked or denied has steadily increased. In addition, the infrastructure is under increasing strain and while some import restrictions have been lifted, that has not been enough to allow for the adequate maintenance and development of the public utilities needed to serve a densely populated area of nearly 2 million. Permit denials 19. Movement restrictions have been a permanent fixture of the blockade, with exit permits granted only to a small fraction of the population, usually patients seeking medical treatment, business people and the staff of humanitarian agencies. Even among those groups, permits have often been arbitrarily denied. 20. Indeed, a large majority of residents face the prospect of never being permitted to leave. Movement restrictions undermine the rights to health care, work, education and family life, and negatively affect the right of Palestinians to self-determination (see A/HRC/31/44, para. 11). 21. With the near-continuous closure of the Rafah crossing into Egypt since mid-2013, the Erez crossing has become the main entry and exit point for Palestinians in Gaza. 28 While travel out of Gaza through Erez has not been an impossibility since the imposition of the blockade and in fact the number of permits granted has seen a relative increase since 2013,29 the second half of 2016 saw a high rate of permit denials and revocations for all classes of Gaza residents (merchants, patients and others). 30 According to figures provided to the Gisha Legal Center for Freedom of Movement by the Coordinator of Government Activities in the Territories (the Israeli agency that regulates movement of goods and people into and out of Gaza), in 2016 only 46 per cent of exit permit requests were granted, compared to 80 per cent in 2013. 22. The World Health Organization reported that as of October 2016, the approval rate for health permit applications had dropped to 44 per cent. In 2012 it had been as high as 92 per cent. Since then, there has been a steady decline in the approval rate, with the most dramatic drop seen between 2015 (77.5 per cent) and 2016 (44 per cent).31 Physicians for Human Rights — Israel receives a steady stream of requests from patients seeking support in the event of their being denied a permit. In 2015, in 61.7 per cent of such cases the denials were successfully revoked.32 In the first half of 2016, that rate was only 25 per cent. 23. Those seeking permits to accompany family members traveling for medical treatment have also been subject to greater rates of denial and increasing scrutiny. According to Physicians for Human Rights — Israel, after seeing an increase in denials of permit requests for medical escorts they inquired with the Israeli authorities as to whether the process had changed. At that time, the Coordinator of Government Activities in the Territories confirmed that it had implemented increased restrictions on those under the age of 55 seeking escort permits. In one case, a breastfeeding mother was prohibited from escorting her infant daughter for follow-up treatment to lifesaving surgery. The baby had to be escorted instead by her 74-year-old grandfather. This was a long and difficult journey for the grandfather, as well as for mother and daughter, owing to the age of the child and her dependence on breast milk.33 28 29 30 31 32 33 6 Between October 2014 and the end of 2016, the Rafah crossing was open for a total of 83 days, see www.ochaopt.org/sites/default/files/crossing_december_2016.pdf. See www.gisha.org/UserFiles/File/publications/Inside_look_at_gaza/Gaza_in_no.en.pdf. See Gisha factsheet “Security blocks restricting travel through Erez Crossing”, September 2016, available from www.gisha.org/publication/5551. WHO, “Right to health: crossing barriers to access health in the occupied Palestinian territory, 20142015” (2016). Physicians for Human Rights — Israel, submission to the Special Rapporteur, 7 November 2016. Note: these figures represent cases from both the West Bank and Gaza, with a majority of the cases coming from Gaza. Ibid.