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TEL AVIV — Family members bid tearful goodbyes to 21 critically ill children who were evacuated from the Gaza Strip as part of a secret mission to get them the badly needed medical help that’s been in short supply since the Israelis invaded the Palestinian territory.

The deal to allow the children to leave was brokered by the World Health Organization and American charities, according to a doctor involved with the operation. And it was put into motion with the help of the U.S. government, Israel, Egypt and other nations in the region.

“A lot of effort went in to getting these young kids, many of them in desperate medical need, get them to safety, get into some hospitals where they can get the care that they need,” White House National Security Communications Advisor John Kirby told NBC News.

Sixteen of the children are cancer patients, Kirby added.

“They’re obviously at critical stages of their treatment and they weren’t able to get that lifesaving, that critical medical attention that they needed for their care,” he said. “And now they will. They’re there. Safely out.”

Before the Rafah crossing into Egypt was closed, the U.S. in partnership with hospitals, various nongovernmental organizations and local officials in Gaza were able to quietly move more than 150 patients, mostly children, out of the embattled territory to get to critical lifesaving care in the region.

But when Israeli military operations near Rafah forced the closure of the crossing in May, getting the sickest children out became almost impossible.

Faced with a heartbreaking bottleneck, the rescuers regrouped and found another way out.

Kirby declined to go into detail about what was done, but he said they hope to continue evacuating sick children in need of urgent care in the coming months.

“It is very dangerous, as you can imagine, and that’s why we needed so much help,” Kirby said. “These children are in critical need.”

He went on to explain how moving the children is not a simple process because they’ll require medical care as they make the journey.

COGAT, the Israeli military body that oversees aid distribution in Gaza, said in a statement that it had helped to facilitate the evacuation “in coordination with officials of the U.S. government, Egypt and the international community.”

An NBC News crew spoke with relatives of the ailing youngsters at Nasser Hospital in the southern city of Khan Younis just before four ambulances and two buses transported them across the border to Egypt via Israel’s southern Kerem Shalom border crossing.

Ahmed Shalha told NBC News his 5-year-old daughter, Rawand, had a cyst on her brain and she was going to be treated in Egypt. He said her mother and four sisters were traveling with her.

“It is very difficult,” he said while taking pictures as they boarded a bus.

Another parent, Nazila Zaroud, said her 7-year-old daughter, Razan, was living with one kidney and needs treatment because she gets sick every time she eats.

“She suffers from inflammation in lymphatic system, she has swelling, she’s always sick,” she said.

Mohammad Zaqout, the director of hospitals in the Gaza Strip, confirmed to reporters that the 21 children traveling to Egypt were leukemia and cancer patients.

“They are manageable if the treatment is there,” he said, referring to their conditions.

But if they stayed in Gaza, he said they were “going to die.”

In all, Zaqout said, there are 250 children who required urgent treatment for life-threatening ailments in the territory. Another 25,000 children are being treated for a variety of illnesses and war-related injuries.

Travel in and out of Gaza has long been difficult, but it became all but impossible after Hamas’ Oct. 7 attack on Israel. The Rafah border crossing between Gaza and Egypt — the only one available for people to travel in or out — shut down after Israeli forces captured it during their operation in the enclave’s southernmost city early last month. Egypt has refused to reopen its side of the crossing until the Gaza side is returned to Palestinian control.

Eight of the evacuated children had been transferred Monday to Nasser Hospital from Mamadani Hospital in northern Gaza City, Palestinian health officials told NBC News shortly after they arrived.

Aouatif Azam told NBC News she had brought her two grandsons Amjad and Ahmad Al Qanou for treatment.

Humanitarian Efforts At The Kerem Shalom Crossing
The Kerem Shalom crossing between Israel and southern Gaza.Amir Levy / Getty Images

“One has cancer,” she said, adding that the other was suffering from kidney disease because of low potassium.

After the siege started in northern Gaza, she said “there was no food at all” and the family was forced to live “on some broad beans or chickpeas.”

She added that she was thankful to the people and organizations that helped them get treated.

Another six of the children transferred from Nasser Hospital on Thursday arrived from al-Ahli Hospital in Gaza City earlier this week, according to The Associated Press. Five of them had malignant cases of cancer and one suffers from a metabolic syndrome, the AP reported.

Severely Ill Palestinian Children Leave Gaza
A man carries a seriously ill child at Nasser Hospital in Khan Younis on Monday.Bashar Taleb / AFP – Getty Images

News of the evacuation was welcomed by Hanan Balkhy, the WHO’s regional director for the Eastern Mediterranean. But in a post on X she said: “More than 10,000 patients still require medical care outside the Strip. Of the 13,872 people who have applied for medical evacuation since 7 October, only 35% have been evacuated.”

“Medical evacuation corridors must be urgently established for the sustained, organized, safe, and timely passage of critically ill patients from Gaza via all possible routes,” Balkhy posted.

Henry Austin reported from Tel Aviv and Andrea Mitchell from Washington, D.C.

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