Leon , I really salute your contributions, you have actually hit the hammer on the head, I don't think , there is any option left for the Gaza man that the ones stated, however, I will choose the option that shows his/her effort to travel out of Gaza to do ielts and the explanations giving by ielts coordinator in Gaza rather than doing TOEFL which, I personally think is more difficult than ielts. Whichever way, I think he could be considered for interview, alternatively he could also claim moderate proficiency and may be just fine.