KHAN YOUNIS, Gaza (Reuters) - Born last week with a heart defect, Salem al-Masri needs life-saving surgery. But like hundreds in the Gaza Strip, he and his parents have no permit from Israel to exit the enclave to a suitably equipped hospital.
Palestinians suffering serious illnesses have long traveled from Gaza to nearby Israeli hospitals for treatments unavailable at facilities in the territory, which is home to 1.5 million people and was occupied by Israel for 38 years until 2005.
However Israel has tightened border restrictions since Hamas Islamists seized control of the coastal enclave in June. It also prevents access to Gaza by sea or air and has ensured a border crossing into Egypt is mostly shut -- so hundreds like baby Salem cannot get the care that could save lives.
Gaza's Hamas-run health ministry said 29 patients had died in the past six months because they had not managed to secure a permit to travel into Israel. Some 900 other sick Gazans were seeking permission to travel -- 350 of which were gravely ill.
Jamal al-Khudary, a member of parliament and former cabinet minister who heads the Palestinian Popular Campaign to Counter the Siege, said about 1,500 patients needed care outside Gaza.
"Among them there are 350 cases who are just waiting for death," Khudary told Reuters, referring to patients suffering illnesses such as cancer or chronic kidney failure.
Shortages of medicine, equipment and trained personnel, which local officials blame on the long occupation, prevent hospitals in the enclave from matching care available in Israel.
The Jewish state has labeled Gaza an "enemy entity" and has stepped up raids into the territory in the past week to try to curb rocket salvoes on Israeli towns. It shuns Hamas, which does not recognize Israel and refuses to renounce violence.
After pulling out troops and settlers, Israel kept full control of Gaza's borders -- a situation which Palestinians say means Israel must still observe Geneva Convention obligations as an occupying power to provide services for Gaza's people.
Israeli government spokesman Mark Regev said that in "life and death situations," the Jewish state allowed patients into Israel on a "case by case basis," acknowledging border restrictions had been stiffened because of the rocket salvoes.
"The extremists are holding civilian populations, both Israeli and Palestinian, hostage to their agenda," he said. He said he had no figures for the number of Gazans who have been treated in Israel.
Muawiyeh Hassanein, a senior official in Gaza's health ministry, said that in general at least half of those patients seeking permission to leave were turned down.
"The Israelis either refuse to give people permits or delay them until the disease spreads and causes death," said Hassanein, head of the ambulance and emergency department.
Egypt effectively closed its border after Hamas seized Gaza in violent clashes with Palestinian President Mahmoud Abbas's Fatah faction. With no independent air or sea access, that means Gazans' only exit to the world is via Israel.
Even if a patient gets a permit, family members are often refused, Hassanein said.
Masri's mother and grandmother stood by the baby's hospital bed while his father, Mohammad, stood outside in the corridor.
"I am a helpless father," said the 30-year-old construction worker, who is currently out of work due to an embargo on building materials. "I feel disabled as I see my son struggle with death before my eyes without being able to do anything."
Editing by Sophie Walker