The reopening of the Rafah border crossing between Gaza and Egypt after nearly two years was supposed to offer a glimmer of hope for Palestinians wanting to leave the war-ravaged strip — and those wishing to return.
For weeks, officials have hailed the reopening as a major ceasefire milestone, with the Rafah crossing expected to make it easier for Gazans to seek medical treatment, reunite with family and undertake education abroad.
But strict limits on people entering and exiting, long delays, security concerns and bureaucratic hurdles have quickly cooled expectations.
Israeli authorities said 50 sick and wounded Palestinian patients, along with two family members escorting them, would be allowed to leave through the Rafah border each day.
But only five patients, along with their family members, exited through Rafah on the first day of its reopening, ABC staff inside Gaza said.
Doctors in Gaza have told the ABC that does not scratch the surface of the thousands of Palestinians who desperately need medical evacuation.
"We have more than 20,000 sick and wounded patients who need urgent medical treatment outside Gaza," doctor Khalil Al-Daqqran, spokesperson for Al-Aqsa Hospital, told the ABC.
"Only 50 patients being allowed to leave a day means it could take more than two years to evacuate them.
"This would result in many deaths and place patients in grave danger."
The process for entering and exiting Gaza
Before the war, Rafah was a key crossing point for people and goods.
Now that it is reopened, only a limited number of pedestrians will be allowed to enter and exit the crossing and no aid will be allowed through.
After pressure from Egypt, the crossing will also be opened to allow Palestinians who have left Gaza to return to reunite with family.
More than 30,000 Gazans have registered with the Palestinian embassy in Cairo to be allowed to return to Gaza.
Egyptian authorities must submit a daily list of people who are to be allowed through.
But Palestinian officials say dozens of people waiting to come back to the strip did not clear security and blamed the delays on Israeli security checks.
Israel's miliary has been contacted for comment.
Entry and exit are supervised from the European Union Border Assistance Mission in Rafah, but Israel is carrying out stringent security checks.
Those who want to leave Gaza must have approval from Israel and Egypt, before travellers enter a check point run by the Palestinian authority and EU representatives.
From a command centre, Israeli officials use facial recognition software to open a gate at the crossing and allow travellers to pass.
Coming into the strip, people must also have approval from Israel and Egypt where they pass through an Israeli checkpoint for searches, X-ray screening and biometric verifications.
Then they are permitted to cross the "yellow line" territory Israel controls inside Gaza and past the demarcation line, which the Israel Defense Forces (IDF) withdrew to under phase one of the ceasefire.
There have been several deadly incidents around the "yellow line", which are essentially concrete yellow blocks that act as dividers.
The World Health Organisation oversees the transfer of patients from territory under Hamas control, transporting them by bus to the crossing over the "yellow line" and into territory controlled by the Israeli military.
Patients waiting for medical evacuation
Dr Al-Daqqran said the facilities needed to treat many patients did not exist inside Gaza.
"Many cancer patients and many people injured by Israeli attacks need complex surgeries," he said.
"More than 1,300 sick people have lost their life as a result of waiting to get medical treatment outside the strip."
Everyone who wants to leave the strip must apply for a permit that has to be approved by Israeli authorities.
Islam Nasr, 12, said she lost three of her siblings in September during an Israeli strike and was facing the risk of leg amputation as she waited for medical evacuation.
"After the shelling my mother and I were trapped under the rubble for three hours," she told the ABC.
"My injury was extremely serious, all the bones in my foot were shattered, there was no flesh, no skin, nothing, just exposed bone."
She told the ABC her doctors had requested a transfer to leave for medical care five months ago.
"I begged the doctors not to amputate my leg, they submitted a referral for me to get medical treatment outside Gaza but I have been waiting five months," she said.
"I beg anyone who can to help take me abroad to help my leg so I will be able to walk again like the other children."
What has happened at Rafah so far?
The reopening of the Rafah crossing was supposed to happen during the first phase of US President Donald Trump's ceasefire plan between Israel and Hamas, which began in October.
But Israel delayed that until it received the last hostage taken by Hamas in the October 7 attack.
Ran Gvili was returned last week.
The head of the Palestinian technocratic committee appointed by Mr Trump, who will take over day-to-day running of Gaza, has lauded the reopening of Rafah.
"This step ... marks the beginning of a long process that will reconnect what has been severed and open a genuine window of hope for our people in the Gaza Strip," Ali Shaath said.
But its reopening for a limited number of pedestrians is a multi-stage process and bureaucratic challenge.
On the first day of the reopening there were long delays with some disagreements over luggage and security, some returnees told AP.
"They didn't let us cross with anything," Rotana Al-Regeb said as she returned around midnight on Monday to Khan Younis.
"They emptied everything before letting us through. We were only allowed to take the clothes on our backs and one bag per person."
Gazans hope crossings will increase
Officials say the number of crossings could gradually increase if the system works.
Gazan Dima Shoukani is hoping to be one of them.
The 16-year-old said she was waiting for treatment with three pieces of shrapnel in her head and burns on her leg after she was injured in the war.
"I have a referral," she told the ABC.
"All I wanted is to be treated, so I can return to my normal life.
"I have been in this condition for five months and it keeps getting worse.
"I want the shrapnel removed to recover my vision and to regain the use of my legs."
