It is an open secret in the Middle East, and a source of great pride among Jews, that Israeli hospitals provide life-saving medical care to citizens of neighboring countries, even enemy states. A crucial part of this effort is the NGOs who locate sick Arab and Kurdish patients and tend to their needs while they undergo treatment in Israel.

But, despite the determined efforts of individuals and organizations in Israel to secure medical care for its neighbors, new blocks in the already formidable wall of Israeli bureaucracy might prevent from them receiving the medical care that could save their lives.

According to one NGO involved in bringing Muslim children to Israeli hospitals, new Interior Ministry regulations are interfering with the work between the organization and the Israeli government. For some sick children, the subsequent delays may be the difference between death and life.

For almost two decades, Shevet Achim, a Jerusalem-based Christian organization, has been arranging for Palestinian, Jordanian, Kurdish and now Syrian children to come to Israel to undergo life-saving heart surgery.

Shevet Achim staffers, led by founder Jonathan Miles, recently returned from a weeklong trip to Syrian refugee camps in Iraqi Kurdistan in order to find dying children whose lives depend on them reaching Israeli hospitals. Muslims, Jews and Christians — Americans, Iraqis, Jordanians, and Israelis — worked together to locate the ailing refugees, document their conditions, and find the appropriate Israeli hospitals to treat them.

But though they have medical reports, UN identification papers, funding for the surgery, and the go-ahead from Israeli hospitals, the NGO’s staff is currently stuck waiting weeks for the Interior Ministry to approve entry permits for the dying children. The process, until recently, was much quicker and more efficient.

Shevet Achim staff told The Times of Israel that, despite a desire to help on the part of the Israeli Embassy in Jordan and staff in the Immigration and Border Authority (PIBA), new rules in the Interior Ministry have drastically slowed down the approval process for entry permits. This leaves the children with no guarantee that they’ll be allowed into the country in time for their surgeries. Sick children wait weeks for permits, while requests are moved from one government office to another, and Israeli hospitals, eager to treat Israel’s needy neighbors, never receive their scheduled patients.

The organization saw one of its young patients die during a complicated procedure in an Israeli hospital in December after he had spent weeks waiting for approval.

In December, after waiting months for entry permits, Miles decided to simply head for the Israeli border from Amman, bringing along 2-year-old Yousif, who has Down’s syndrome in addition to a heart defect, and 8-year-old Payveen, who has a rare genetic disorder called Williams syndrome. He hoped that the Israeli border guards would let him through with only written assurances from the Interior Ministry that it intended to grant permits — and not the actual documents themselves. In this case, the children were allowed through, but there is no guarantee that similar tactics would work again.

The recent bureaucratic difficulties stand in stark contrast to a decade of well-oiled collaboration between Israel and the NGO. Because of the delays, several families in Iraqi Kurdistan gave up on Israel and turned instead to Turkey and Iran, countries whose health care systems can’t provide the same level of care.

“We have been bringing children to Israel for ten years, and have always really had support and encouragement from the Israeli government,” said Miles. He remembered a case in 2003, while the embassy in Jordan was closed for a national holiday, in which Israel even sent a staffer back to the office in Amman just to handle the paperwork of a child whose life depended on urgent treatment.

For the next nine years, Shevet Achim worked closely with the embassy in Amman, who waived processing fees to enable sick Muslim children into the country. During that period, visas requests would take no longer than a week to be approved, including the security check.

When Interior Minister Gideon Saar came into office in early 2013, he continued in the spirit of his predecessors, even easing the process for Syrian refugee children to come into the country. But Saar insisted that he personally sign off on all applications from enemy countries, a break from previous policy.

Fuad Jamal (L), Hiwa Sherzad, and Jonathan Miles inspect the ID papers of a Syrian Kurdish refugee family whose baby is a candidate for heart surgery in Israel (photo credit: Times of Israel/Lazar Berman)

Fuad Jamal (L), Hiwa Sherzad, and Jonathan Miles inspect the ID papers of a Syrian Kurdish refugee family whose baby is a candidate for heart surgery in Israel (photo credit: Times of Israel/Lazar Berman)

The increased scrutiny meant that instead of working directly with the consulate in Jordan, Shevet staff had to go through PIBA in Jerusalem, a wing of the Interior Ministry. Since that office handles visas extensions and the like for the many tourists, students, and workers in Jerusalem, just getting an appointment in order to file the paperwork took 5-6 weeks.

“We found that even after getting in there and submitting the applications, it was taking a month and a half to two months just to get a reply,” Miles lamented. Most of that time was spent on the security checks, which previously took only days. “It’s even less comprehensive now,” he noted, “because they ask for less information than we used to give the consulate.”

“When those applications go in,” he related, “ they seem to sit in the regional office for a week, then they make their way over to someone else’s desk, and then they disappear into the security checks, and no one seems to know what happened to them, and finally , a month and a half later, I’m in desperation, and I’m calling and emailing day after day, and finally someone finds the thing, and says, ‘OK, it’s approved.’”

The PIBA spokesperson’s office did not respond to repeated requests for comment. However, in response to Miles’ entreaties to allow the experienced embassy staff in Jordan to handle the cases once again, a PIBA staffer wrote to him in early January emphasizing that “entry permits for foreigners from enemy countries are under the exclusive authority of the interior minister. Therefore, it has been decided that the matter will be handled by PIBA, and the request must be filed at the PIBA office, who will weigh it with the relevant parties and pass it to the interior minister for his signature.”

“We give preference for these requests because of their sensitive and humanitarian nature,” the message continued. “To this day, no request has ever stayed on our table without being handled.”

“People want to help,” Miles emphasized, “and they seem to be full of good intentions. They are as happy as we are when a visa gets approved.”

But it seems that the problem persists. On Wednesday, Miles wrote to PIBA to remind them that only 4 of 16 requests for life-and-death cases he submitted at the Jerusalem office more than a week ago had even reached the appropriate office in PIBA.

Besides the lost chance to fulfill Jewish and Israeli values and save children’s lives, Miles contends that Israel is missing a major opportunity to build bridges with its neighbors. “The news is going all through the Arab world about people getting treatment here. What’s going on with the Syrians up in the Golan Heights, everyone knows about that. One of the Syrian parents said to me, ‘When I was still back in Syria, I heard that Syrians were getting treatment in Israel, and I wished my son could do that.’ He said he even had the feeling it was going to happen.”

“That message is getting through that there’s help,” he continued, “that there’s a caring neighbor over here. Let’s grab that moment, it’s an opportunity that doesn’t come so often to really send a message that, we see you, our neighbors, as valuable -your lives matter, your children matter. That’s such a healing message for our neighbors.”