Dr Nafiz Abu Shaban says he has been working for 24 years at Gaza City’s Shifa Hospital, 15 of them as the head of plastic surgery and the Burns Unit. But he has never seen such burns before.
During Israel’s 22-day offensive in Gaza, patients arrived at his hospital with wounds that continued burning long after the explosion in which they were injured.
The wounds gradually become whiter and then toxic. Even small burns continue to expand. In some cases, the patient’s condition deteriorates and results in death.
”Some of these patients burn for hours. One of the patients, after two hours we opened the wound and noticed smoke came out of the wound!”
Dr Abu Shaban says he removed some of the particles from the wound and when he held them up and they came into contact with the air ”a flame came out”.
At first, he would treat the wounds as regular burns, washing them with water and saline. But that only made it worse.
It then dawned on him and his staff that the burns could be caused by white phosphorus, a highly-flammable powder used by armies to create smokescreens covering their troops when in danger. It ignites spontaneously when exposed to the air and will continue to smoulder either until it is completely burnt up or when deprived of oxygen. It cannot be put out by water, only by sand or mud.
The Shifa doctors began trying a different approach, covering the patients’ wounds with sodium bicarbonate — a soluble white powder used in fire extinguishers — and blankets, before quickly moving them to the operating theatre, where they cut out the burnt areas.
”We cut until we reach healthy tissue,” says Dr Abu Shaban.
He can only hope this is the best way to proceed, pleading for international organisations to send experts who can confirm the type of weapons used and experienced specialists who know how to treat the wounds.
”I’m not a weapons expert, so we don’t know,” he says, and wonders: ”Are we treating them correctly or not? And what are the long-term consequences?”
All of the injured in his hospital are civilians, he insists. ”We don’t have any militants in our hospital.” Many of them are children.
”I’ve seen patients from one year old. Complete families come to us — the mother, the father, the grandmother …”
He says it is difficult to estimate the number of casualties affected, because many have multiple injuries.
Amnesty International has sent a fact-finding team to Gaza, which arrived on Saturday, hours before a fragile truce took effect, and has since found ”indisputable” evidence that Israel did use white phosphorus, fired by 155 millimetre artillery shells each filled with 116 wedges impregnated with the material.
When the shells explode in the air, they create a flash of light.
Bright fragments then rain down to the ground, drawing lines in the sky.
Christopher Cobb-Smith, a member of the team and a former British Army officer who also worked as a United Nations weapons inspector, says white phosphorus is a legal munition used by most modern armies. It was also used by the United States in Iraq.
Its advantage is that it creates an instant smoke screen, which can hide troops when they are in immediate trouble. Smoke discharged from cannisters, by contrast, takes a few minutes to disperse. ”You fire that between yourself and the enemy, not at the enemy itself,” explains Cobb-Smith.
But when used in populated areas, the weapon becomes illegal because –with the fragments of one shell spreading out over an area of 200 by 200 metres — it causes disproportionate and indiscriminate harm to civilians, human rights groups say. Many of them advocate reclassifying the weapon from a conventional to a chemical one, because of the horrific burns it causes.
Cobb-Smith’s team says it has come across both the empty shells that carry the white phosphorus wedges, and the wedges themselves, many of them still burning.
”We found them all over the place, really, in between residential buildings where people live and children play,” says fellow team member Donatella Rovera. ”We’ve seen plenty no longer burning covered with sand. At the moment kids start kicking it around, it starts burning again.”
She says they found the shells in those Gaza City suburbs where much of the ground fighting was concentrated, including Tal el-Hawa and Zaytoun, as well as in Jabaliya and Beit Lahia.
Among the places where the shells were found were: Tal el-Hawa’s al-Quds Hospital, where they caused a major fire in the administrative building; the UN’s main Gaza City compound, where they set ablaze a warehouse and destroyed tons of humanitarian aid; and a UN school in Beit Lahia where one empty 50kg carrier shell broke through the roof and landed in a classroom, killing two small siblings who had taken refuge in the shelter.
Asked how widely the smokescreen weapon was used by the Israeli ground troops, Cobb-Smith says: ”I’ve been here for three days and I’ve probably seen 30 or 40 shells.”
The Israel Defence Forces (IDF) announced on Wednesday it had established an investigative team, which would look into the allegations that its troops used white phosphorus illegally.
”It must be noted that international law does not prohibit the use of weaponry containing phosphorus to create smokescreens and for marking purposes. The IDF only uses weapons permitted by law,” said a statement sent to Deutche Presse-Agentur dpa. — Sapa-dpa