gaza march of return casualties Israel targeting of civilians


One year after the Great March of Return protests began, health workers in Gaza are facing an unprecedented challenge: salvaging the limbs of protestors that Israeli forces have targeted.

These injuries are inflicted on protestors in response to their weekly protests calling for a return to their land and an end to the siege on Gaza that has lasted for more than a decade

The United Nations reports that more than 29 000 people have been injured, with over 7 000 of the injured shot using military ammunition, many by army snipers. Around 90% of those shot were injured in the lower limbs, Gaza’s health ministry has reported

Sniper bullets, designed to kill at distances of 1 000m, are being fired at targets from a much shorter range. The devastating injuries that this causes means that on average each patient needs between five and nine surgeries before their wounds can heal. This treatment journey will last for a minimum of two years.

There is something distinctly cynical about targeting people’slimbs as a response to them walking to the fence of their prison to protest.

Last week, Doctors without Borders (MSF) held a meeting of medical experts in Brussels to discuss the challenge of providing reconstructive surgery to these patients.

Between 800 and 1 200 young Palestinians are still awaiting reconstructive surgeries for their legs, according to data provided by Palestinian surgeons and international organisations working in Gaza. Palestinian surgeons from Gaza’s largest health facility, Shifa Hospital, described how the majority of those shot in the lower limbs were targeted in the lower thigh and back of knee where a single bullet can find its way to nerves, arteries and the knee joint all at once.

The devastating nature of the injuries means that around 20 to 40% of patients will sustain bacterial bone infections, further complicating the clinical management of their wounds and burdening an already struggling health system. The presence of multidrug-resistant bacteria makes treating these infections both difficult and costly. If not promptly treated, patients with these infections risk joining the 124 Palestinians who have already had a limb removed in what can be described as an epidemic of amputations. Almost 1 000 more people have already suffered permanent nerve injury leading to more disability.

The people of Gaza are being debilitated for their demonstrations against the siege and for the right of return. This is the epitome of disproportionality. The act of salvaging those limbs targeted by Israeli forces is a medical act of humanitarian defiance.

In response to the need for specialised limb reconstruction surgery, MSF has tripled its capacity to provide medical activities in the Gaza strip. One project is partnering with the Union of Health Work Committees to set up a specialist limb salvage unit at Al-Awdah Hospital in Jabalya Camp in the northern Gaza Strip. Palestinian and international health professionals of all specialities and disciplines work together in providing complex medical care that aims to reduce the disabling effect of these injuries on such a large number of previously able young people.

These activities occur within a health system already under strain. Electricity shortages, stock ruptures of medical supplies, severe overcrowding, vast infrastructural damage and unemployment are all force multipliers of the Israeli occupation. These conditions make the bullet wounds far more dangerous.

For the abandoned people of Gaza, there is no such thing as an ‘international community’ that will address this crisis. There are a collection of political interests, with the most powerful of them entirely backing the occupation. Bilateral aid is channelled at an unprecedented level to Israel, while Gaza is entirely cut off from the humanitarian mechanisms needed to deal with the consequences of never-ending occupation and siege.

What health professionals can do is to defy these policies by continuing to save lives and alleviate suffering. In the case of Gaza, that means salvaging the arms and legs that are being targeted with the intention to debilitate.

Jonathan Whittall is the director of MSF’s analysis department. Follow him on Twitter @ @offyourrecord. Ghassan Abu-Sitta is the co-director of the conflict medicine program at the American University of Beirut in Lebanon. Follow him on twitter @GhassanAbuSitt1.

These are unprecedented times, and the role of media to tell and record the story of South Africa as it develops is more important than ever. But it comes at a cost. Advertisers are cancelling campaigns, and our live events have come to an abrupt halt. Our income has been slashed.

The Mail & Guardian is a proud news publisher with roots stretching back 35 years. We’ve survived thanks to the support of our readers, we will need you to help us get through this.

To help us ensure another 35 future years of fiercely independent journalism, please subscribe.

Jonathan Whittall
Jonathan Whittall 2
Jonathan Whittall is the director of the analysis department at Doctors Without Borders. These are his own views. He is based between Johannesburg and Beirut.
Ghassan Abu Sitta
Ghassan Abu Sitta is founder of the Conflict Medicine Program at the American University of Beirut, and has been a war surgeon throughout Europe and the Middle East. His research interests include cleft and craniofacial surgery, e-learning in plastic surgery, and conflict surgery.
Bhekisisa team
Bhekisisa Team
Health features and news from across Africa by Bhekisisa, the Mail & Guardian's health journalism centre.

Nehawu launches urgent court bid over protective gear for health...

The health workers’ union says the government has rebuffed its attempts to meet about mitigating risks to workers

Stay at home, Cyril said. But what about the homeless?

In Tshwane, forcing homeless people off the street resulted in chaos and the abuse of a vulnerable population. In Durban, a smooth, well-planned operation fared far better

Press Releases

New energy mix on the cards

REI4P already has and will continue to yield thousands of employment opportunities

The online value of executive education in a Covid-19 world

Executive education courses further develop the skills of leaders in the workplace

Sisa Ntshona urges everyone to stay home, and consider travelling later

Sisa Ntshona has urged everyone to limit their movements in line with government’s request

SAB Zenzele’s special AGM postponed until further notice

An arrangement has been announced for shareholders and retailers to receive a 77.5% cash payout

20th Edition of the National Teaching Awards

Teachers are seldom recognised but they are indispensable to the country's education system

Awards affirm the vital work that teachers do

Government is committed to empowering South Africa’s teachers with skills, knowledge and techniques for a changing world

SAB Zenzele special AGM rescheduled to March 25 2020

New voting arrangements are being made to safeguard the health of shareholders