The Return Protests, which Palestinians in the Gaza Strip have been holding near the fence with Israel to demand realization of the right of return and an end to the blockade on Gaza, began nearly a year ago and are still taking place. According to the World Health Organization (WHO), by the end of January 2019, a total of 27,942 people had been injured in these demonstrations, 14,768 of whom were treated in hospitals in Gaza. More than 6,300 had been injured by live fire. According to B’Tselem’s figures, by the end of February 2019, 200 protesters had been killed, including 39 minors and two women. Most of the casualties – killed or injured – had posed no danger to Israeli security forces, who were deployed on the other side of the fence.
Any healthcare system would be hard put to treat such an immense number of casualties. All the more so for the healthcare system in Gaza, which is on the verge of collapsing. Israel has kept Gaza under blockade for more than a decade, imposing restrictions on bringing in drugs, advanced medical equipment and spare parts for broken equipment, and barring doctors from travelling abroad for further training. The restriction on bringing drugs into Gaza has severely depleted local stores of vital drugs and equipment. Gaza also suffers from an intermittent supply of power, largely due to Israeli policy, and routine power cuts damage medical equipment. This has forced hospitals to cut services to a minimum, postponing non-urgent operations and releasing patients home earlier than medically advised.
Given the failing healthcare system in Gaza, injured protesters cannot receive the medical attention they need and must seek vital treatment abroad.
Yet soon after the protests began, Israel declared that, as a rule, it would not allow persons injured while participating in them to leave Gaza for medical treatment in the West Bank (including East Jerusalem), Israel or Jordan. In April 2018, the NGOs Adalah and Al-Mezan Center petitioned Israel’s High Court of Justice on behalf of two wounded men, since amputation would be likely with the care available in Gaza. In response, the state told the court the applications had been rejected, “given the policy of the Minister of Defense on the issue, whereby, as a rule, entry into Israel shall not be granted to persons injured while taking part in the violent public disturbances organized by Hamas, where the concrete medical circumstances were not deemed to warrant considering a departure from said rule, as the petitioners are not in a life-threatening condition.” The state said it had “also warned Gaza residents against participating in the demonstrations,” as if this was a justification for denying them access to adequate medical treatment.
Despite the dire condition of both men, and the urgent treatment it called for, the justices refused to schedule an urgent hearing. The doctors had no choice but to amputate a leg on each patient. Only more than a week after the petition was filed, the High Court ordered the state to allow one of them, Yusef al-Kurunaz, 19, to travel to a hospital in Ramallah, where doctors were able to save his other leg. The justices did state, however, that this was an exceptional case and that they were not taking a stand on Israel’s overall policy toward injured protestors. In doing so, they effectively permitted the state to continue its policy of barring most injured protestors from receiving medical treatment.
According to figures released by WHO, from the start of the demonstrations through January 2019, 493 applications to exit Gaza via Erez Crossing for medical treatment in the West Bank (including East Jerusalem) or Israel had been submitted. Only 85 (17%) of the requests were approved, while 408 (83%) were rejected – directly or by delaying the issuance of a response. Given the extent of injuries in the protests and Gaza’s failing healthcare system, the number of requests filed is most likely much smaller than the actual number of persons in need, and primarily reflects the realization that applications stand a very low chance of approval.
The proportion of approved requests by injured demonstrators is much lower than that of approved requests to leave Gaza for medical care under other circumstances. According to WHO figures for 2018, 25,808 people applied for a permit to leave Gaza for medical care in the West Bank (including East Jerusalem) and in Israel. Almost 40% of these requests were rejected – directly or by responding only after the scheduled appointment. Sixty percent of the requests were for care in hospitals in East Jerusalem, 23% for hospitals in the rest of the West Bank, and 17% for hospitals in Israel.
Requests submitted
Rejected
No response
Total number of requests directly or indirectly rejected
Total
25,808
1,962
8,014
9,976
East Jerusalem
15,285
1,258
4,688
5,946
Rest of West Bank
4,773
523
1,812
2,335
Israel
5,750
181
1,514
1,695
Some of the persons whose requests were rejected or who received no response are trying to leave Gaza for medical care in Jordan or Egypt, via Rafah Crossing. Yet this solution is only relevant to some patients, as not all of them can receive proper treatment in these countries and some cannot endure the long, exhausting and perilous journey through Sinai. Since May 2018, Rafah Crossing has been regularly open five days a week, but Egyptian authorities restrict the number of persons allowed through. From May through December 2018, 1,510 persons in need of medical care crossed it – an average of 189 a month.
This is a reality created by Israel. It is Israel that instituted an open-fire policy that allows live gunfire at protestors posing no danger, resulting in thousands of injuries – a policy it still refuses to change, a year in, although the horrific outcome has been commonly known for some time. It is Israel’s decade-long blockade on Gaza that has made it the major culprit in the collapse of the healthcare system there. It is Israel that is now denying the wounded passage, for just several dozen kilometers, through its territory to reach the treatment they desperately need. It follows that it is Israel’s duty to change this reality – to prohibit the use of live fire against persons posing no danger, to end the blockade on Gaza and to permit access to proper medical care.
The following testimonies were given to B’Tselem field researchers in Gaza by individuals wounded in the demonstrations, who were then refused requests to leave Gaza via Erez Crossing to seek medical treatment:
Hassan al-‘Issawi, 42, a husband and father of four from Khan Yunis
Al-‘Issawi volunteered with the Red Crescent’s medical teams at the protests. He was hit in the leg by a live bullet in a demonstration held on 19 October 2018 east of Khan Yunis. The bullet shattered a bone and he underwent several operations in different Gaza hospitals. Nevertheless, he needs more surgery that cannot be performed within Gaza, and the doctors have referred him to al-Makassed Hospital in East Jerusalem. Al-‘Issawi made an appointment there, but Israel rejected his requests to leave Gaza three times, and his doctors fear they will have to amputate his leg unless he receives the necessary treatment. Al-‘Issawi used to run projects for NGOs, but is currently unemployed as he cannot move around.
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Hassan al-‘Issawi at his home. Photo by Olfat al-Kurd, B'Tselem, 20 February 2019
In a testimony he gave B’Tselem field researcher Olfat al-Kurd on 20 February 2019, al-‘Issawi said:
Since the protests began east of Khan Yunis, I volunteered with the Red Crescent to give first aid. On Friday, 19 October 2018, I went as usual to the demonstration east of Khan Yunis with other volunteers. I was wearing a first-aid volunteer uniform and a Health Ministry name tag.
During the demonstration I was hit by a live bullet in the right leg, even though I was far from the fence. I was taken to the European Hospital and stayed there three days. The bone in my leg was shattered and the main nerve and tendon torn. They put a platinum implant in the leg. Then I was transferred to Nasser Hospital, where I stayed for 25 days. From there, I was transferred to other hospitals – Dar a-Salam and the state hospital in Khan Yunis – where I had three operations.
While I was still in hospital, the doctors referred me for further treatment to al-Makassed Hospital in East Jerusalem. I have to undergo another complicated procedure that can’t be performed in Gaza. I filled out the Palestinian Health Ministry’s form and scheduled an appointment at al-Mkassed for 12 November 2018. The day before, I got a text message saying my request was still under review. I couldn’t make the appointment and scheduled another one for 10 December 2018. Then my request was rejected. The third time, I set an appointment for 7 January 2019 and was rejected again. I have another appointment scheduled for 5 March and have filed a fourth request. I am now waiting for a reply, again.
Meanwhile, I’ve also filed a request for treatment in Egypt, in case I can’t get to East Jerusalem, because my leg is in bad shape. There are complications from infections in the bone. It’s a dangerous condition and if I don’t get proper treatment, they may have to amputate. In the meantime, I’m having physiotherapy sessions with Doctors Without Borders. I go to their clinic every two days. They also provide transport to and from the clinic, because I can’t drive my car. I use crutches and only leave home to go for treatment.
Since the injury, my life has been on hold. I used to do weightlifting at a sports club. We live on the fourth floor, with no elevator, so I had to move out of the house, leaving my wife and kids, and go to my mother, who lives on the first floor. It’s easier to go to hospital and treatments from there. Sometimes I spend one day a week at home, with my wife and kids. I’m stressed all the time and it’s had a bad effect on my relationships with my family. Since the injury, I also haven’t worked. I used to run projects for NGOs, but my career is over. I spend most of my time on social media and undergoing treatments.
* Update: Al-‘Issawi’s fourth request to leave Gaza via Erez Crossing for medical treatment was also denied.
Muhammad Saleh, 12, from Jabalya Refugee Camp
Muhammad Saleh was wounded in his right leg by a live bullet on 5 October 2018, at a protest held east of Jabalya Refugee Camp. He was taken to the Indonesian Hospital, where he underwent surgery twice and stayed until 18 October 2018. During his time in hospital and after he was sent home, his parents submitted three requests for a permit to leave Gaza via Erez Crossing, so he could undergo surgery at al-Makassed Hospital in East Jerusalem. Two of the requests were denied. The third time, they were asked to find someone other than his mother to go with him. The family is now waiting for al-Makassed to schedule a new appointment so they can file a new request. Saleh can currently walk only with the help of crutches.
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Muhammad Saleh at his home. Photo by Olfat al-Kurd, B'Tselem, 21 February 2019
In a testimony he gave B’Tselem field researcher Olfat al-Kurd on 21 February 2019, Saleh described the injury and his life since that day:
On Friday, 5 October 2018, I took part in a protest east of Jabalya R.C. I got very close to the fence and was hit in the right leg by a live bullet. At first, I felt nothing, but then I looked down and saw that my leg was bleeding badly. I blacked out. The paramedics carried me to an ambulance that took me to the Indonesian Hospital. My leg kept bleeding in the ambulance and I felt like there were electric shocks going through it. I was taken into an operating room immediately and kept in intensive care for a few days. I stayed in hospital until 18 October 2018. I had two surgeries. After I was released, I went back to the hospital every few days because my temperature rose. After about a month, I started physiotherapy with Doctors Without Borders.
Before the injury I loved playing soccer and riding my bike. I can’t do that now. When I see my friends playing soccer, my heart aches and I feel sorry for myself. I feel like crying but I hold the tears back. I spend most of my time at home, in bed. I can only walk with crutches.
I missed school during the first half of grade 7. The principal gave me permission to attend only twice a week, because it’s hard for me to get there every day. My brother Jihad, 30, carries me on his back a kilometer or more to school, because we don’t have a car or money for a taxi. The principal said he’d switch classrooms so that my class studies on the second floor and not on the third, to make it easier for me to reach. My friends help me with homework and carry my bag. My grades used to be excellent but now I’m down to C’s and D’s, because I miss a lot of lessons.
Since the injury I’ve been sad. I cry a lot and yell sometimes. I’ve become very short-tempered and I’ve lost my appetite. Sometimes, I go along with my mom to visit relatives, but I don’t enjoy it. I want to play like the other kids, to run and play soccer. I really hope I can have the surgery that will make it possible for me to walk again without pain.
Muhammad’s mother, Nuha Saleh, 45, a wife and mother of seven, told al-Kurd on 21 February what it is like living with her son’s injury:
After Muhammad was wounded and had two operations, the doctors told us he had to have another operation that can’t be performed in Gaza, because it’s very difficult and complicated. They said the chances of such surgery succeeding were very slim.
The Palestinian Health Ministry referred us to al-Makassed Hospital in East Jerusalem, where they set Muhammad an appointment for 12 November 2018. A day before the appointment, I received a text saying that Muhammad’s request had been denied. We made a new appointment, for 18 December 2018, and were denied again. The third appointment was set for 18 February 2019, but the day before, we were told that my request to accompany him was still under review, so Muhammad had to file a new request. We’re now waiting for the hospital to schedule a new appointment so we can file another request for a permit to leave Gaza.
Since the injury, Muhammad has been suffering a lot. He and I are both stressed, all the time. He shouts in pain all night and can’t sleep. I sit by his bedside all night and don’t sleep, either.
For a while, he lost feeling in his leg altogether – so much so that he was severely burned by the stove because he didn’t feel he was right up against it. His brother Iyad noticed and yelled that his leg was on fire. We took him to a-Shifaa Hospital and he had to go there every day for 40 days to change bandages, in addition to suffering from the original injury.
Mahmoud al-Hawajri, 19, single, from a-Nuseirat Refugee Camp
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Mahmoud al-Hawajri at his home. Photo by Khaled al-‘Azayzeh, B'Tselem, 27 January 2019
Al-Hawajri was injured in both legs by live fire on 31 March 2018, the first day of the Return Protests, at a demonstration held east of al-Bureij R.C. He was treated at the ICU in Shuhadaa al-Aqsa Hospital in Deir al-Balah. After three days, he was transferred to a-Shifaa Hospital in Gaza City, were a platinum implant was surgically fitted in one of his legs. Since then, al-Hawajri has submitted six requests to leave Gaza through Erez Crossing for surgery in al-Makassed Hospital, East Jerusalem. All the requests were denied. His leg deteriorated and in April, the doctors were forced to amputate it. He filed yet again for a permit to leave to have a prosthetic fitted at al-Makassed, but was refused.
In a testimony he gave B’Tselem field researcher Khaled al-‘Azayzeh on 27 January 2019, al-Hawajri described the injury and his life today:
On the first day of the Return Protests, I took part in activities east of al-Bureij R.C .after noon prayers. When I got there, I saw thousands of people near the border.
At about 5:00 P.M., I was about fifty meters from the fence. I was just about to draw back when a sniper fired at me. The bullet went through my right calf to my left calf. I fell and blacked out from the pain. I woke up at ICU in Shuhadaa al-Aqsa Hospital, Deir al-Balah. Three days later, I was transferred to a-Shifaa Hospital in Gaza City.
At a-Shifaa, the doctors wanted to amputate my right leg but I refused. They fitted me with a platinum implant. I stayed in intensive care for a week, and then I was transferred to the surgical ward, where I stayed for another month. During that month, I submitted several requests to receive further treatment at al-Makassed Hospital in East Jerusalem, because the treatment I need isn’t available in Gaza. Israel denied all my requests. I suffered a lot from increasing pain. I started getting black gangrene spots on my right leg.
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Mahmoud al-Hawajri in his Yard. Photo by Khaled al-‘Azayzeh, B'Tselem, 27 January 2019
Every day that passed brought the amputation of my right leg closer, because the veins were ruptured. After my last request was rejected, in April, the doctors at a-Shifaa decided to amputate. They were afraid the gangrene would spread to other parts of my body and kill me.
When I woke up after surgery without my leg, I went into extreme shock. How did I lose my leg? What sort of life can I lead now? I haven’t been able to lead a normal life since then. I get around on crutches. I can’t play soccer or ride a motorbike any more. My only hobby now is pets: dogs, birds and bees. Most of the day, I keep myself busy in the yard with my pets.
I prefer to hole up at home and try to forget about my injury, but can’t really do it. I very much hope to get to hospital in East Jerusalem to have a prosthetic leg fitted that will help me walk, even a bit. The last appointment I had scheduled at al-Makassed was for 7 June 2018, but my request for a permit was denied. In the meantime, I hobble around on one leg with crutches. It makes my left leg hurt a lot, because it carries the entire weight of my body. When it’s cold it especially hurts, and then I get really blue and very short-tempered and lose patience with everyone in my family.
Muhammad Mas’ud, 18, from Jabalya Refugee Camp:
Mas’ud was wounded in the chest by live fire at a demonstration held east of Jabalya R.C. on 13 April 2018. He was taken to a-Shifaa Hospital, where doctors found that the bullet, which had penetrated his chest and exited through the lungs, had caused hemorrhaging in the chest. Mas’ud underwent surgery and was referred to East Jerusalem for further treatment, but the two first requests he filed went unanswered and the third was denied.
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Muhammad Mas’ud at his home. Photo by Olfat al-Kurd, B'Tselem, 21 February 2019
In a testimony he gave B’Tselem field researcher Olfat al-Kurd on 18 February 2019, Mas’ud related:
When I was injured, the paramedics drove me in an ambulance to the Indonesian Hospital near Jabalya R.C. and gave me first aid on the way. When I got to the hospital, I blacked out. I was so badly injured that they transferred me to a-Shifaa Hospital in Gaza City, were I stayed in intensive care for a week. I was unconscious the whole time. I had an operation in which the doctors suctioned the blood clots from my chest, but there is still shrapnel in my lungs that the doctors said they can’t get out because its too dangerous. Since then, it’s felt as though something is moving around in my chest.
The condition led to complications such as choking and bad pain in my chest. I can’t exert myself at all and can’t walk more than a few meters. I can’t lift anything with my left hand. When I feel like I’m choking, I use an inhaler. It’s especially hard to climb stairs, but we live on the second floor. In the shower, the water on my head makes me suffocate.
I’m in grade 12 but have hardly attended school since the injury. I tried to go for almost a month, but stopped because the school is far away and it was hard to walk there with the bad pain.
The doctors told me I have to learn to live with my condition and adjust. I tried to, for a long time, but it’s unbearable. I submitted a request for treatment in East Jerusalem and got an appointment for 10 November 2018. We wrote my father down as my escort. A day before the appointment, my mother got a text saying my request was still under review. I asked for a new referral and was scheduled a new appointment for 10 December 2018. My mother got the same message again. I asked for a third referral and was given an appointment for 21 January 2019. My mother got a text saying the request for my dad and me was denied.
Since 30 March 2018, Gazans have been holding a series of protests along the Gaza perimeter fence, with anywhere between hundreds to tens of thousands of people participating. To date, scores of people, including at least 12 minors, have been killed by live ammunition Israel security forces fired; more than 3,600 have been wounded by live gunfire. According to figures published by the World Health Organization (WHO), as of 22 May 2018, Gaza doctors had performed 32 amputations, 27 of them of lower limbs. Testimonies collected from Palestinians injured during the protests indicate they were shot while posing no mortal danger to anyone, including some who were shot when they were hundreds of meters away from the fence. In at least some cases, Israeli security forces fired at persons who were trying to reach the wounded to help them. This mindboggling number of casualties at protests is virtually unprecedented. It is the result of the manifestly unlawful orders given to security forces, allowing the use of live fire against unarmed protestors who pose no danger to anyone and are on the other side of the fence, inside Gaza. All relevant Israeli officials refuse to change these orders, even in the face of their predictable outcome. They continue to argue that the orders are legal and even defend them in court, where the justices of the Supreme Court have given this reality their seal of approval. The serious injuries are merely the tip of the iceberg in this saga. Even an advanced, functioning healthcare system would have been sorely tried when faced such a large number of casualties. However, even before the protests began, Gaza’s healthcare system was already on the verge of collapse. As a result, many of the wounded do not receive the care they need. According to figures released by the World Health Organization (WHO), as of 22 May 2018, 257 essential drugs and 247 types of disposable medical equipment were out of stock and needed immediately. Gaza physicians told Physicians for Human Rights – Israel that they reuse disposable equipment over and over again and that there is a shortage of antiseptics, disinfectants and anesthetics. The collapse of Gaza’s health care system is largely the result of the Israel-imposed blockade on Gaza. The blockade includes restrictions on replacing broken medical equipment, importing advanced medical equipment and drugs, and travel by physicians for professional training outside Gaza. In addition, Gaza’s intermittent power supply, again largely Israel’s doing, also disrupts the work of hospitals. Israel’s unlawful policy has caused the injuries and its blockade keeps the wounded from receiving the medical care they need. Israel also refuses, as a general rule, to allow these individuals to travel just a few kilometers through Israeli territory in order to get to hospitals in the West Bank, where at least some of them would be able to receive the care they need. Since the demonstrations began, B’Tselem field researchers have collected scores of testimonies from people who sustained live fire injuries and from eyewitnesses, including teenagers who were shot by Israeli security forces at various distances from the fence. In their testimonies, the boys describe how they were wounded, the difficulties they faced obtaining the medical care they desperately need and the long and costly rehabilitation facing them. We bring you the stories of three of these boys: Muhammad al-‘Ajuri, 16, was injured east of Jabalya Refugee Camp on 30 March 2018 Muhammad al-‘Ajuri is 16 years old. An eleventh grader from Jabalya R.C., he is also a member of the Palestinian Athletics Association. On Friday, 30 March 2018, at around 11:00 A.M., al-‘Ajuri arrived with several friends at the protest that was taking place near the perimeter fence, east of Jabalya R.C. They advanced to a distance of a few dozen meters from the fence, in order to hand out onions to protestors to relieve symptoms of teargas inhalation. After security forces fired a great deal of teargas at the area he was in, al-‘Ajuri moved back. When he was about 300 meters away from the fence, a member of the Israeli security forces fired a live bullet at his right leg. In a testimony he gave B’Tselem field researcher Olfat al-Kurd on 17 April 2018, he described how he was injured: I went up to a distance of about 50 meters from the fence to hand out onions to the protestors. I saw a few people who’d been injured, including an older man who’d been hit in the left leg. The bone in his leg was showing and he was bleeding badly. Most of the injuries I saw were to the legs. The soldiers were firing a barrage of tear gas canisters and I nearly choked, so I turned around and started moving away. When I was about 300 meters away from the fence, I was shot from behind and hit in the right leg. I didn’t fall down. I stayed standing where I was, and my leg was bleeding. My father came to help me, and then a few young guys came and gave me first aid. They tied a strip of cloth around my leg to stop the bleeding and took me by motorcycle to an ambulance, which was about 250 meters away. Muhammad’s father, Hani al-‘Ajuri, 39, also went to the demonstration. He was a volunteer providing first aid. When his son was shot, Hani al-‘Ajuri was standing about 300 meters away from the fence. In a testimony he gave B’Tselem field researcher Olfat al-Kurd on 3 May 2018, he described seeing his son being hit: When I saw my three sons at the protest, I had them move back to the tent area, which was about 700 meters away from the perimeter fence, because I was worried they’d get hit by live fire or teargas canisters. Later, a young man I know told me Muhammad had gone very close to the fence to give first aid and hand out onions to some young guys who had passed out from the teargas. When I looked over toward the fence, I saw soldiers were firing a heavy barrage of teargas at the protestors near the fence. I saw my son Muhammad running towards me. When he was a few meters away, a sniper stationed on a sand mound on the other side of the fence shot him. I went up to him and put my arms around him. I saw he’d been hit in the back of his right leg. It had a big hole in it and he was bleeding. His leg looked terrible, and I was afraid they’d have to amputate. I managed to bandage his leg with a strip of cloth and tied it up to stop the bleeding. After that, I couldn’t take it any longer, I completely broke down. I couldn’t help him any more. A few young guys arrived, put him on a motorcycle and took him to an ambulance. I went to the Indonesian Hospital near Jabalya R.C., but I didn’t find him there. I went to al-‘Awda Hospital, which is in Beit Lahiya. The doctors told me he had been brought there, but because of his serious condition, he had then transferred been to a-Shifa’a Hospital in Gaza City. I went there, looking for Muhammad, but I couldn’t find him. I looked for him in the operating rooms, but no one knew anything about him. I saw a doctor coming out of an OR and asked him about my son. He said there was no one by that name, but that there was one young man that hadn’t yet been identified. He was unconscious and didn’t have an ID on him. The doctor had a picture of him on his phone. He showed it to me. It was Muhammad. At the hospital the doctors found that an artery in his leg had been hit and the leg was broken and he underwent surgery. However, the doctors determined there was a risk his leg would be lost and that in order to save it he would have to undergo further surgery at a Ramallah hospital. Israel refused to let him out of the Gaza Strip. On 8 April 2018, human rights NGOs Adalah and Al-Mezan filed a High Court petition on behalf of al-‘Ajuri and another injured man. The justices dismissed the petitioners’ motion for an urgent hearing. In the meantime, al-‘Ajuri’s condition took a turn for the worse, and on 9 April 2018, the doctors had to amputate his leg. He was discharged from hospital three days later. The other petitioner also had a leg amputated. Hani al-‘Ajuri recounted in his testimony: When the doctors told me they would have to amputate Muhammad’s leg I wouldn’t consent. I was worried about him living as a disabled man for the rest of his life. I couldn’t deal with it. Finally, the doctors convinced me there was no other choice because if they didn’t amputate the leg, the infection would spread to the rest of his body. I became resigned to this fate and consented. I was heartbroken about the future he faced. It’s very painful for me to see my son without a leg. Muhammad was my right hand man. He was an athlete and loved soccer. He was on the Palestinian sprinting team and won first place at school. Muhammad Musbah, 17, was injured north of the town of Khuza’ah on 5 April 2018 On Thursday, 5 April 2018, at around 4:30 in the afternoon, Muhammad Musbah, 17, a twelfth-grade student, from ‘Abasan al-Kabirah, and his uncle, Wasim Musbah, 22, went to the protest area north of the town of Khuza’ah. After spending a short while in the tent area, about 400 meters from the fence, Muhammad and another young man went up to an older woman who was standing near a coiled barbed-wire fence the military had laid on the ground. She was carrying a Palestinian flag. The two took the flag from her and walked toward the coiled fence, which is about ten meters away from the perimeter fence. In a testimony he gave B’Tselem field researcher Khaled al-‘Azayzeh on 2 May 2018, Muhammad Musbah related: We went to the coiled barbed-wire fence, which was about ten meters away from the perimeter fence, and I hung the flag on the coiled fence. Suddenly, a soldier who was on a dirt mound on the other side of the fence shot me. I was hit by a bullet in the right leg and fell to the ground. The young man who was with me, whom I don’t really know, sat down beside me. I lay there on my back for about twenty minutes. The young men who were standing in the back couldn’t get to us, because every time they tried to, soldiers fired at them. That whole time, I felt like an electrical current was running through my body, and I was bleeding badly. It was only about twenty minutes later that some young guys managed to get to me. They put me on a tuk-tuk [a three-wheeled vehicle], which took me about 600 meters away from there, to the eastern edge of Khuza’ah, because they couldn’t find an ambulance any nearer. Wiam Musbah, 23, from ‘Abasan al-Kabirah, is volunteer paramedic who was working in the tent area of the Return March. At the time, he was standing with some other paramedics a few dozen meters away from the fence. In a testimony he gave B’Tselem field researcher Khaled al-‘Azayzeh on 2 May 2018, he recalled: At around 4:30 P.M., I saw two young guys take a Palestinian flag from an older woman who was close to the coiled fence that was on the ground. They went up to that fence, which was about ten meters away from the perimeter fence. They put the flag on the barbed wire fence, and then I heard a few shots and saw one of them fall down. The other guy lay flat on the ground beside him. A few young men tried to reach them to give them first aid but the soldiers fired live rounds and teargas canisters around them. I advanced toward the spot with the first-aid team. The soldiers fired live rounds near us to warn us not to approach. One of the women on the emergency team put up her hands to set the soldiers minds at ease and let them know we were a medical crew, and we kept advancing, but the shooting continued near us and over our heads. The soldiers also fired teargas canisters behind us. Despite this, we managed to get to the two guys. I found that the guy who was injured is a relative of mine, Muhammad Musbah. He had been hit by a live bullet in the right leg and was lying on his back. His leg was completely torn up below the knee and he was bleeding badly. I bandaged the wound with medical gauze and Wasim Musbah, who was with us, brought the stick the Palestinian flag had been tied to, broke it in two and tied it to the injured leg as a splint for support. The entire time we were caring for him, the soldiers kept firing above us. A few young guys moved forward till they reached us, and together we lifted Muhammad and got him away from the barbed wire fence and on to a tuk-tuk, because there was no ambulance there. Muhammad Musbah was taken from the tuk-tuk and put into a Red Crescent ambulance, which took him to the European Hospital south of Khan Yunis, where his right leg was amputated below the knee. He was discharged after being hospitalized for more than three weeks. In his testimony he recounted: When I came to after the surgery, I found my father beside me. He said the doctor had had to amputate my right leg below the knee because it had taken in a lot of shrapnel that severed the arteries and nerves and shattered the shin bone. I was very sad. I felt I couldn’t breathe. I realized I would never play soccer again. I love playing so much. Before my injury I’d play every day. There’s a special field near us, and I played defense for the neighborhood team. I’m still getting treatment, and go back to the hospital every few days for checkups. I’m taking three different kinds of antibiotics. I’m also on painkillers because my leg still hurts. I can hardly sleep, and only with sleeping pills. The pain gets worse in the afternoon and at night. All the kids in my grade are getting ready for final exams, but I can hardly read because the pain is so bad. I couldn’t study at the hospital either because of the injury. I don’t know if I’ll be able to handle the exams this year, or how long rehabilitation will take before I can go back to normal life. It never occurred to me that a day would come that I would be a disabled person. I’m still in shock over what happened to me. Mustafa Dhaher, 15, was injured east of Jabalya R.C. on 2 May 2018 On the afternoon of Wednesday, 2 May 2018, Mustafa Dhaher, 15, his cousin Mahmoud Dhaher, 14 and Yusef Abu Mansur, 17, all from Jabalya Refugee Camp went to the tent area east of the camp to attend a memorial service for people who died during the “Return Protests.” A short while later, the three boys advanced to a spot a few hundred meters away from the fence. Mustafa Dhaher advanced even farther, up to a few dozen meters from it. At around seven o’clock in the evening, the boys decided to go home. In a testimony he gave on 6 May 2018 to B’Tselem field researcher Olfat al-Kurd, Mustafa Dhaher recounted: There were soldiers on dirt mounds on the other side of the fence. The air was completely filled with teargas that had been fired from military jeeps. There was also heavy live gunfire. At around seven o’clock I called out to my friends: “Mahmoud, Yusef, we have to go home. Enough, I’ve had enough”, and I was going to leave. As soon as I turned around, the soldiers shot my left leg, in the thigh. The bullet wen through my left leg and hit the right. I felt like there was an electric current running through my whole body, and I fell down. Yusef and Mahmoud came to me. I was bleeding heavily and I put my hands on the wounds to stop the bleeding, but it didn’t help. Yusef bandaged my legs, one with a kaffiyeh and one with his shirt, and that did help. A few minutes later, Mustafa Dhaher’s friends and some young men who were in the area evacuated him on a stretcher to an ambulance which took him to the Indonesian Hospital, near Jabalya R.C. He underwent surgery on his right leg and needs another operation on his left. In his testimony he said: I’m still in hospital and have to have another surgery, after my hemoglobin level goes up. I’m in pain a;; day long now. I cry and scream and then they give me painkillers. It hurts especially when they change the bandages. All I did was go to a memorial service for the martyrs. I didn’t do anything that threatened the lives of the Israeli soldiers. I didn’t even wave a flag. I didn’t throw stones. I was just watching the young guys protesting near the fence, and still the soldiers shot me.
B'Tselem issued a position paper detailing the guidelines of the necessary Israeli investigation of its conduct during the operation in Gaza. B'Tselem's initial survey of the military operation calls into question Israeli statements that the military acted according to International Humanitarian Law and that responsibility for the harm to the civilian population rests exclusively with Hamas.
About 15 months after the round of fighting that took place in Gaza in May 2021 (operation “Guardian of the Walls”), Israel rained fire on the Gaza Strip once again, launching a new “round” of fighting (Breaking Dawn). The fighting in August 2022 lasted three days and claimed the lives of 49 Palestinians. Over the past few months, B’Tselem has spoken to several of the wounded in the May 2021 fighting, who are still struggling to rehabilitate themselves. In that round, 233 Palestinians were killed, including 38 women and 54 children. More than half took no part in the fighting. According to the UN Office for the Coordination of Humanitarian Affairs, tens of thousands lost their homes and dozens of health care, and infrastructure facilities were damaged. The wreckage of buildings and fallen utility poles blocked streets and roads, impeding the passage of ambulances and other vehicles evacuating casualties. The damage to the electricity grid and the water infrastructure also made it difficult for hospitals to operate. In their testimonies, the wounded give their personal perspective on how they and their families are coping with the challenges of rehabilitation. In addition to the personal stories, the testimonies shed light on the wider context in which the wounded from this round of fighting, and previous ones, live as they desperately try to rehabilitate. Rehabilitation after a serious injury is a tough process under any circumstances, with complex physical and mental health aspects. In Gaza, however, it is tougher still, as the number of wounded keeps growing from one round of fighting to the next, while Gaza’s health infrastructure continues to crumble as a result of the Israeli blockade. According to the World Health Organization, two out of 30 hospitals in Gaza stopped functioning during the May 2021 fighting due to damage, and the others functioned on a partial basis only. In addition, 57 out of 93 primary care clinics stopped functioning, while the rest functioned partially. Gaza’s health care system is grappling with a dire shortage of medicine, equipment and physicians, particularly doctors with up-to-date training. Despite this, as part of its blockade on Gaza, Israel continues to restrict the entry of medicine and advanced medical equipment into Gaza and denies physicians exit for training, further harming the wounded and denying them proper rehabilitation. Israel also denies many of the wounded access to medical institutions in the West Bank, just a few dozen kilometers away, to receive medical treatments they need and are not available in the Gaza Strip. According to Handicap International, there are currently about 50 non-governmental rehabilitation centers in Gaza that rely on funding from foreign foundations. They suffer from staff shortages, have trouble training staff, and are only able to offer physiotherapy and psychosocial support. Occupational rehabilitation with assistive devices, for instance, is rarely available. When it comes to prosthetic limbs, Gaza currently has only two orthopedic rehabilitation facilities, one run by the Red Cross and the other, established in March 2022, operating with Qatari funding. Israel eschews responsibility and has absolved itself of any payment of compensation for almost all injuries, citing “warfare action” through legislative enactments, leaving Palestinian claimants with infinitesimal odds of receiving monetary compensation for the harm and suffering Israel caused them. Victims of the fighting in Gaza suffer extreme financial hardship and have no access to the kind of support that can enable rehabilitation. They live in constant fear and terror of more rounds of fighting, with the feeling that at any given moment, they could once again become targets for Israeli fire. We spoke with young adults and students who were severely injured, as well as parents of severely injured children, some of whom have lost family members and some have sustained permanent disabilities. They described their daily struggles, as they cope with debilitating physical and psychological injuries. Testimonies collected by B’Tselem field researchers in the Gaza Strip: Testimony of Muhammad Abu Sakran (17) from a-Shuja’iyeh neighborhood in Gaza City, who was severely wounded by a missile that landed in the doorway of his home and killed his grandfather and his father’s cousin. He still has a motor disability in his legs and in one hand, and life-threatening shrapnel lodged in his head. He gave his testimony to B'Tselem field researcher Olfat al-Kurd on 1 August 2022. I was badly injured in the war last year. On the last day of Ramadan, 12 May 2021, at around 8:30 P.M., I was at home with my grandfather and my father’s cousin when suddenly, a missile was fired at our house. I spent a week in the ICU at a-Shifaa Hospital. Over the past year I’ve been treated at the El Wafa Rehabilitation Hospital, on the Doctors Without Borders wing. I’ve undergone surgery on my left leg and have had physiotherapy, occupational therapy and psychotherapy. Before the injury, I had a normal life. I went to a vocational school every day from 7:00 A.M. to 2:00 P.M. I liked carpentry class and gym class, and hung out with friends a lot. After school, I’d have lunch at home and then work a little at repairing bikes, which was a hobby of mine. I also helped my grandfather plow land and tend to his crops. Since the injury, I’ve stopped going to school and stay home most of the time. I have unbearable headaches and can’t use my right hand because of a neurological problem. When I do go outside, I use crutches. I hate them and the way my body looks, deformed by the shrapnel. I get irritated easily and am aggressive with my brothers. It’s killing me mentally. My medical condition is not improving and I simply can’t do anything on my own – no sports, no cycling. Whenever I see our front door, it reminds me of the missile that hit our home and killed my grandfather and my father’s cousin, so I withdraw into myself and cry. I watch shows and movies on my phone most of the time, but nothing makes me happy anymore. I keep remembering my time in hospital after the injury and thinking about my grandfather, who would take me to work with him. My life has become a nightmare of memories and pain. Testimony of Muhammad’s father, Hisham Abu Sakran (44) That night, Muhammad was home with his grandfather, Ahmad Ibrahim Abu Sakran (64), and my paternal cousin Muhammad Nahed Abu Sakran (25). Suddenly, a missile was fired at the house and they were both killed. Muhammad, who was next to them, was severely injured. When the missile landed, I was on the second floor. I rushed downstairs and found my father dead. I saw Muhammad lying next to Muhammad Nahed, and there was a lot of blood. There was smoke and debris everywhere. I picked them both up and carried them out to a car that was there, which took us to a-Shifaa Hospital. Someone brought my father to the hospital, too, and the doctors told me he’d been killed. Later, my cousin Muhammad Nahed also died of his wounds at the hospital. I was told my son had been martyred. Someone else said he was in the ICU and needed a blood transfusion. At around 1:00 A.M., the doctors asked me for blood for Muhammad. I waited until 3:00 A.M. without knowing how he was, and then I was told he was still in a very serious condition. They told us to pray for him. When I went into the room to see him, he was lying in bed without moving, hooked up to tubes everywhere. I couldn’t process it. I left the hospital and went home to say goodbye to my father and bury him. Muhammad spent a week in the ICU, and then he lay in hospital for about two months. My son Tamer (38) stayed with him the whole time he was in hospital. He had trouble talking and couldn’t eat or drink. After two weeks on the ward, he was able to eat light food. From there, he was transferred to El Wafa Rehabilitation Hospital and put on the Doctors Without Borders wing for two months, where he had physiotherapy and occupational therapy. He was barely able to move at that point – he had trouble moving his right hand because of neurological damage, and had fractures in his left leg and shrapnel in the right. He got a lot of stitches and they put platinum in his legs. He was in constant pain and I was there most of the time, to help him as much as I could. After about two months at El Wafa Hospital, his platinum implants were corrected at a-Shifaa Hospital. Then I took him home, where his mental health just kept deteriorating. He stopped eating and drinking almost entirely again, and got angry and yelled most of the time. We went to Doctors Without Borders again, and they gave him mental health support. He also continued with physiotherapy there, and in May 2022 the outer platinum was removed from his left leg and the bone was treated. Now he uses crutches. Muhammad’s body is full of shrapnel and he’s still very weak. The doctors say he’s in danger because of a piece of shrapnel that’s stuck in his head, close to his brain. We’ve been warned he must never bang his head, because the shrapnel might move and damage his brain. Even sneezing could cause it. Until he was injured, Muhammad studied carpentry at the vocational school in Gaza. He hasn’t gone back to school since then and stays home most of the time. He’s very anxious. Testimony of ‘Abdallah Islim (23) from Gaza City, who was severely injured by a missile Israel fired at a car near which he was standing. Six people were killed in the attack, including a friend of his and a relative of the friend. He gave his testimony to B’Tselem field researcher Khaled al-’Azayzeh on 18 May 2022. On 12 May 2021, at around 10:30 A.M., I was walking with ‘Abed al-Ghazali (28) to the restaurant we worked at on al-Wihada Street, in order to open up despite the bombings. When we got to al-Mughrabi Street, we ran into ‘Abed’s cousin, Nader al-Ghazali (46), outside the sewing shop he works at and chatted with him for a while. Just then, a car stopped a few meters away from us. I caught a glimpse of three passengers inside and suddenly, there was a strong blast. ‘Abed flew up in the air and hit the steel door of a store near us. I stayed put. There was blood everywhere and I felt very dizzy. I moved a few meters away and I realized I’d been hit by shrapnel along the entire rightside of my body. I fell down and recited the Shahadatein [“There is no God but Allah, Muhammad is Allah’s prophet”]. About three minutes later, there was another bombing. I felt I’d been hit in the stomach. I got up and walked a few meters to a nearby drugstore, and asked the pharmacist to help me check on ‘Abed. I was bleeding from the right eye and my clothes were soaked in blood, so he got scared and called out for help. A few young guys who were there drove me to a-Shifaa Hospital in their car. After three days in hospital, I was told ‘Abed and his cousin Nader had been martyred. I stayed in hospital for 15 days. In July 2021, I had abdominal surgery, but they couldn’t get all the shrapnel out and I’m still in pain. I also had chest surgery and some of my bones were removed. Since then, I’ve also been suffering from shortness of breath and chest pain, and I have trouble sleeping at night. I’ve have hearing loss in my right ear and the retina in my right eye is damaged. I don’t go out of the house much. I couldn’t go back to the restaurant, so I’ve lost my livelihood. I was the sole provider for my family, and now the whole family is suffering. Before that, we wanted for nothing. We ate well and I provided for everyone’s needs. I also paid university tuition for my sister Hanadi (24) and my brother Shadi (19), but they only managed to finish one semester and then I couldn’t cover their tuition anymore because of the injury. Before my injury, I managed to save up about 2,000 USD to buy a transit car for extra income, but I’ve spent almost all my savings on my medical care. Ever since I’ve been out of work, our situation has been getting worse. I don’t know how we’ll be able to go on. Testimony of Mu’awiyah al-Wahidi (43), a father of two from a-Zeitun neighborhood in Gaza City, who lost his right leg when a missile fired by Israel landed near his workplace. He gave his testimony to B'Tselem field researcher Olfat al-Kurd on 18 May 2022. On 12 May 2021, at around 11:00 A.M., I was in my barbershop when suddenly, I heard a loud explosion outside. Right after that, Nader al-Ghazali (46) came into the barbershop in a panic, saying: “Help, Mu’awiyah! I can’t breathe!” He was in a terrible state. I took him outside and we walked about 30 meters from the barbershop. He was bleeding from the mouth, and then he fell down. I tried to give him first aid. I looked at the street and saw at least four martyrs lying near the car that had exploded. I recognized Sa’id al-Hittu and his wife Maysoun al-Hittu among the dead. Three minutes later, another missile landed right next to us and Nader was instantly killed. My right leg was severed and didn’t stop bleeding for 20 minutes. Everyone around me was in a panic – we were all scared there would be another airstrike. People gathered round me and called an ambulance. When it came, the paramedics took me and left all the martyrs on the street. I was taken to a-Shifaa Hospital and must have blacked out on the way. At the hospital, I was taken into surgery and my right leg was amputated. I later found out they’d planned to amputate my left leg, too. It was in a bad state, but they decided to treat afterwards. After a week in hospital, I was transferred to the care of Doctors Without Borders, which treats injured people and also operates at al-Awda Hospital in the northern Gaza Strip. I remember hearing the Israeli airstrikes on the way. I was discharged after about 40 days there, with an amputated leg and a lot of problems in the other leg. That was when my ordeal really started, and it’s been going on for a year now. To this day, my whole body is in pain. Twice a week, a team from the National Physiotherapy Authority visits me at home. My left leg is barely there and I need a hydraulic prosthetic, which should carry some of my body weight and make it easier for me to walk. But at Hamad Hospital in Gaza they told me they wouldn’t be able to help me get it, because Israel isn’t allowing prosthetic parts into Gaza. There’s a special wheelchair, too, that could make it easier for me to work, but it costs about 1,500 US dollars and I can’t afford it right now. One of the charities gave me an electric wheelchair that helps me move around outside, and sometimes I get donations from people. I live on the fourth floor without an elevator and it’s very difficult for me to go up and down the stairs, so I stay home most of the time. I feel like a burden to my family. Because I can’t help around the house anymore, my wife is also overworked and she’s started to suffer from a herniated disc in her back. My helplessness is affecting the entire household. My two sons, Sadim (8) and Siraj, (11), were top students. Since my injury, their grades have gone down. They see me so upset that I break things at home. It’s been a year since my injury and it’s still really hard to get out of this mental state. I became a victim of the Israeli army while I was at work, even though I was no threat to Israel in any way. Sometimes, when I go to the barbershop, I see the burning car and the martyrs lying on the ground in my mind’s eye. I remember how I picked up the martyr Nader al-Ghazali and ran from the other missile. It makes me cry and choke up every time. Once in a while, I try to go to the barbershop, but when a client comes in and asks for a haircut, I can’t always do it. All I want is to get the barbershop running well again and go back to work. I worked as a barber for 25 years and was the only breadwinner in our house. Despite my handicap, I get no disability pension from anyone. I feel like I’ve gone from business owner to beggar. Testimony of Ishaq Fayad (51), a father of six from Beit Hanoun in the northern Gaza Strip, who lost his right leg when a missile hit his home directly. He gave his testimony to B’Tselem field researcher Khaled al-’Azayzeh on 19 May 2022. On the night of 14 May 2021, we were hosting about 60 relatives, half of them children, in our house on al-Ba’ li Street in central Beit Hanoun because our area was considered safer. Shortly before midnight, we heard explosions that kept getting closer to us. When they grew louder, everyone started shouting in fear. I tried to reassure them and told them they were safe. I went up to the top floor. When I got there, while I was still in an open-air part of the stairwell, there was a big explosion that threw me at least three meters away. A few seconds later, there was another explosio n from a missile that hit the neighbors’ house. Rubble from the walls and roof of our building was scattered everywhere. Only the pillars stayed standing. My right leg was nearly cut off. It was still connected by a piece of skin and an artery, and I tried to pull it towards me. Shrapnel from the missile had hit my left leg and it didn’t stop bleeding. I crawled down the stairs to the ground floor. When I got to the street, I saw a lot of people running in a panic, looking for family members. I was dizzy. My son Ibrahim (22) and his wife Ghazal (22) carried me to the house of our neighbors, the a-Z’anin family, where they tied my leg to stop the bleeding. A few minutes later, they took me outside so an ambulance could take me to hospital. About 15 minutes later, an ambulance arrived and took me to hospital in Beit Hanoun. There, I was bandaged, and then I was transferred to the Indonesian Hospital in Beit Lahiya. My son Jasser (23) went with me. I must have blacked out along the way. I woke up the following afternoon in hospital. Four days later, I was transferred to Nasr Hospital in Cairo, where I had about ten operations on my legs. I was also fitted with a fixator on my right leg. I was in terrible pain and lost a lot of weight during that time. I looked like a skeleton and was barely recognizable. My mental health was very poor. I’m lucky my wife Warda was there with me the whole time, supporting me. I stayed in hospital in Cairo for nine months, and on 13 March 2022 went back to Gaza. I continued treatment with Doctors Without Borders at al-Awda Hospital. The doctor there told me my right leg had to be amputated. I was shocked the situation was so bad. About three weeks later, my leg was amputated. I had two more operations on my leg, and I’m still having physiotherapy. I’ve also developed diabetes and hypertension but unfortunately, government drug stores in the Gaza Strip don’t carry the medicine I need, so I have to pay for it out of pocket. For instance, the pill I take for leg infections, Flucoral, costs 13 shekels (~4 USD) a pill. Since my leg was amputated, I’ve barely left the house, because I live on the second floor without an elevator. I’ve already fallen down the stairs. Before the injury, I was always on the go because I trade in sheep and goats. I’m not used to being unemployed and sitting at home. At least close friends come over to keep me company sometimes. Testimony of Majd al-’Ajleh (21), a law student from a-Shuja’iyeh neighborhood in Gaza City, who was injured by a missile fired by Israel when he was standing near his home. Since then, he has had a motor disability and speech difficulties. He gave his testimony to B’Tselem field researcher Muhammad Sabah on 26 May 2022. On Sunday, 15 May 2021, I set out from my house in a-Shuja’iyeh neighborhood. When I was still close by, at around 1:00 P.M., a missile fired from an airplane landed near me. Three of my cousins were killed in the strike: Yihya al-'Ajleh (24), Seif a-Din Abu al-'Ata (18), who had fled from his home in the eastern part of the neighborhood and was killed near his uncle’s home, and Muhammad Bhar (17), who was killed in the doorway to his brother’s home. My brother Muhammad and I were severely injured. I woke up at a-Shifaa Hospital after I was unconscious for 25 days. During that time, I had head surgery because of a fracture in my skull and abdominal surgery because of shrapnel that entered it and caused hemorrhaging and damage to the intestine. On 11 June 2021, I received a permit to go to al-Ahali Hospital in Hebron, where I had surgery on my right leg and arm. I was discharged from there about six months later, on 5 December 2021, and returned to Gaza unable to walk or talk. The head injury paralyzed the right side of my body, which is why I couldn’t move my right leg and arm. They’re both still in a cast. I still need a bone transplant on the left side of my skull. I’ve had months of physiotherapy and speech therapy at the ICRC hospital in Gaza, but I still have a hard time talking and walking. I’m using crutches until I get a prosthetic fitted at Hamad Hospital. My life has changed since the injury. My arm and leg are paralyzed, and I hate being treated like a disabled person and seen as handicapped. I need help most of the time because of the paralysis, and I’ve come to realize my life won’t go back to what it was. I see a psychotherapist to help with the mental challenges. Until the injury, everything was normal – I was a third-year law student at al-Azhar University in Gaza. But I haven’t gone back to school because of my condition. My dream was to go into law so I could help people exercise their rights. My mother also wanted her eldest son to be educated and successful. I’m worn out asking my mother and brothers for help all the time. They help me get dressed, eat, drink and go to the bathroom, and also come with me to all the treatments. I can’t move around freely, or even just go outside or hang out with friends. I’ve lost some of my close friends, who feel I’ve become a burden. I go from one treatment to another, from one hospital to another, hoping this suffering won’t last too much longer. Testimony of Lina al-Matrabi’i (27), a mother of three from a-Sabra neighborhood in Gaza City, whose five-year-old daughter Sarah was severely injured when a missile fired by Israel penetrated the ceiling of her home. She gave her testimony to B'Tselem field researcher Olfat al-Kurd on 22 May 2022. On 14 May 2021, at around 8:30 P.M., my husband Zaher (43) was sitting in the living room and I was feeding five-year-old Sarah when suddenly, without any warning, a missile fell through the ceiling of the room. The apartment above us had been bombed. Sarah and I were covered in debris and I was afraid my husband had been killed, and that our house was marked as a target by the Israeli army. Sarah kept crying under the rubble. I managed to pull her towards me, and then my husband came and got her. I was about five months pregnant and shrapnel from the missile penetrated my belly, back and right arm. I put on my prayer clothes and we took Sarah outside to look for an ambulance or another car to evacuate her. She fainted several minutes later, and only then an ambulance came and took her to a-Shifaa Hospital. She was put in the ICU. She had damage to the skull that caused meningitis, an open fracture to the spine, and shrapnel that penetrated her spine and paralyzed both legs. The doctors told us her injuries were very dangerous and asked us to pray for her. Sarah woke up three days later, and they only let us see her after six days. Then she was transferred to the pediatric surgery ward at a-Shifaa Hospital for four days. She was in really bad shape and couldn’t see or talk. Ten days later, on 24 May 2021, we got permission to travel to Jordan, and we traveled through Erez Crossing to al-Hussein Hospital. There, she had more than ten operations on her back, which included rehabilitating her spinal cord and fixing it in place with screws. She also had skin graft surgery on her legs. She was in a terrible emotional state and barely ate. She kept bursting into tears or shouting, and had nightmares. She had psychotherapy there, too. About four months later, on 23 September 2021, I gave birth to my little boy, ‘Abdallah, in a C-section at the hospital in Jordan. It was one of the hardest times of my life, recovering from the C-section while Sarah was going through rehabilitation. About six months after Sarah’s injury, on 17 November 2021, we went back to Gaza. She was still in pretty bad shape. She couldn’t walk and was confined to a wheelchair. To this day, her condition hasn’t improved. The doctors at Hamad Hospital in Gaza referred her to physiotherapy and I take her every week or two. Sarah is also incontinent, so I drain her urine with a catheter and change her diapers regularly. Because my husband is out of work, we can’t give Sarah what she needs, so we sometimes get diapers donated by charities and aid organizations. We’re renting an apartment for 500 shekels (~USD 153) a month on the first floor of a building with an elevator, so it’s accessible for Sarah. Although Sarah’s condition isn’t stable yet and she’s tired most of the time, I take her to preschool when she’s not getting treatment. Thank God, she loves her friends and they help her and never leave her on her own. She doesn’t really understand the situation, and sometimes asks why the army bombed her and why she’s still sick. I reply that she’s strong. I have to hold her when she bathes, and I also dress her. It’s very hard and tiring, but even though it’s exhausting, I want her to stay as active as possible – so maybe it will take her mind off her disability for a little while. When she’s home, she crawls on the floor or sits on the couch or in the wheelchair. She’s still afraid all the time that something bad is about to happen, and she asks us not to mention the injury or the war. Sometimes, when she looks in the mirror, she asks me to cover her legs because it’s hard for her to see them. Every once in a while, I insist she let herself look at the injury, because maybe it will make it easier for her to accept the situation. She gets spooked by loud noises and is too afraid to stay home alone, so I take her a lot to the beach boardwalk, so she can let go and relax. What did Sarah do wrong? All she was doing was sitting at home having dinner. They bombed us without warning and robbed my daughter of every beautiful thing she had in her life. My heart is broken, but I try to stay strong around Sarah and hide my pain from her. Now she needs to be reassessed at a hospital outside Gaza, because the resources she needs aren’t available here. She’ll only be able to get better care outside Gaza, in hospitals in Arab countries, in Israel or in Europe. Testimony of Hibah al-Bahtiti (32), a mother of six from a-Shuja’iyeh neighborhood in Gaza City, whose six-year-old daughter Farah was severely wounded outside her house by a missile fired by Israel. She gave her testimony to B'Tselem field researcher Olfat al-Kurd on 19 May 2022. On 12.5.21, the last day of Ramadan, at around 2:00 P.M., I sent my youngest daughter, Farah, out of the house to buy some things nearby. My sister-in-law Siham (30) was cleaning the stairs at the time. She was worried about Farah and called out to her to come back. Suddenly, there was a strong explosion outside. All the glass from the windows and stones from the building flew through the air. Siham yelled: “Farah’s been martyred!” I ran outside and saw a car going up in flames. Inside it was a martyr I didn’t recognize. There were a lot of injured people scattered near the car. Farah was lying on the ground, unconscious, quite close to our house. She was bleeding all over. I went into shock and was afraid she’d been martyred. It crushed me. Her aunt Wafa (23) yelled that Farah was still alive and started looking for a car to get her out of there. She was taken to the ICU at a-Shifaa Hospital, where they said she was very severely injured. Half an hour after Farah was evacuated, another ambulance came and took away Siham, who’d been injured by shrapnel in her left foot. Farah was unconscious for 12 days. That’s a very long time, and I was afraid she wouldn’t wake up. They only allowed her one visitor in the ICU, so my husband Rif’at (39) went. He said she was in very bad shape and that her left leg and arm were completely shattered. I could do nothing for her but pray. Farah had several operations, including a colectomy, and was fitted with platinum implants in her arm and leg. When she came out of the ICU, she didn’t talk and couldn’t hear well. She didn’t recognize any of us and for two weeks, I thought she had gone deaf or lost the ability to speak. I brought her brothers, cousins and friends to see her, and she started responding a little more. We filed several applications for a permit to go to a hospital in Jordan. We only got a permit to leave via Erez Crossing on 3 June 2021. I took her through Erez Crossing to the rehabilitation hospital in Jordan. The back of her head was injured and she had shrapnel in her lungs, abdomen, left arm, feet, left eye and right ear. The shrapnel in her left hand caused neurological damage to the wrist, and the shrapnel that penetrated her feet damaged the tendons. She also lost a lot of skin, and had skin grafts in her abdomen and left leg. She had a lot of other testing and imaging done at the hospital. We returned to Gaza on 5 September 2021, after three months in Jordan, and continued Farah’s rehabilitation at the Jordanian Hospital in Gaza. When her condition improved, she started walking. Now, a physiotherapist from the National Rehabilitation Association comes to our house. She can hold light objects in her right hand, but she still can’t control the left one. Farah is supposed to wear compression bandages that compress the skin to prevent swelling but they’re very tight, so sometimes she takes them off. She needs a skin graft and tendon extension. At the end of the month, we’re going to see a limb specialist. Whenever Farah sees her body in the mirror, she cries and asks why the Israelis did this to her. To this day, whenever she hears airplanes, she’s worried they’re coming to bomb her. I try to reassure her, telling her the war is over and we’re all with her. She has nightmares all the time and is scared of little things, such as water in the shower or doctors and injections. Since the injury she’s had trouble controlling her bladder, so I keep her in a diaper. Until recently, she wasn’t prepared to sleep alone and I slept next to her. Now she sleeps next to her sister, though she’s still scared and can’t relax. When she’s not getting treatments or going for tests, she goes to preschool, but she finds it hard to deal with the kids’ questions about her condition. I keep worrying one of the kids will unintentionally hurt her feelings. We got help from a respectable lady, who took Farah under her wing and covered our trip to Jordan and all our expenses there. But now, our financial situation is very bad. We are crowded into one house with 28 family members. We live only off what my husband makes from his fruit stand, which isn’t enough to provide for our six children: the twins Follah and Fuad (15), Muhammad (13), Ahmad (11), Yusef (8) and Farah (6).
