In March 2018, the Great March of Return demonstrations began along the Gaza Strip perimeter fence, protesting against Israel’s siege and calling for the realization of the right of return. As documented by B’Tselem previously, the unlawful open-fire policy Israel is using against these demonstrations, allowing soldiers to shoot live fire at unarmed protesters who endanger no one, has led to horrific results: in addition to more than 200 Palestinians who were killed, by the end of January 2020, some 8,000 demonstrators were wounded by live ammunition, including 1,500 minors and 150 women. According to World Health Organization (WHO) figures, by the end of 2019, physicians had to perform limb amputations on 155 protesters, including 30 minors. Twenty-seven demonstrators are paralyzed as a result of spinal injuries.
The severe injuries are only the beginning of a torturous journey which includes treatments, tests, surgeries, and adjusting to a new reality. In the Gaza Strip the situation is even more complicated: any health system would be hard-pressed to cope with such a scope of injuries, but Gaza’s was already crippled by a shortage of medications, physicians, equipment, and professional training, because of the Israeli siege policy. As a result, many of the injured do not manage to receive the medical treatment they need, which in some cases exacerbates their condition, especially considering the shortage of rehabilitation centers in the Gaza Strip.
A small number of those injured manage to receive the medical care they need outside the Gaza Strip – in hospitals in the West Bank (including East Jerusalem), but only in the rare cases that they manage to receive Israeli entry permits, which Israel declared, at the outset of the demonstrations, would be given sparingly. According to WHO figures, from the start of the demonstrations through January 2019, 604 applications to exit Gaza via Erez Crossing for medical treatment in the West Bank (including East Jerusalem) or Israel had been submitted. Only 17% of the requests were approved, while 83% were rejected – directly or by delaying the issuance of a response. In other cases, the wounded are forced to travel to other countries, such as Egypt or Turkey, sometimes at their own expense.
Fathi Abu M’awad, from Jabalya Refugee Camp told B’Tselem field researcher Olfat al-Kurd about the day his 15-year-old grandson Muhammad was wounded:
When the doctor told me Muhammad was going to be paralyzed from the waist down, I was in shock. I went out to the hospital courtyard and burst out crying, especially because Muhammad is my first grandchild and very close to me. When they took him into surgery I cried and could barely say goodbye to him. I stood outside the door and waited for Muhammad to come out of surgery, with his father, my son Ramzi, who stood next to me and was deeply distressed about his son. It was one of the hardest days of my life.
Some of the wounded described how they were hurt, and the unbearable difficulties they have had to cope with since in testimonies they gave B’Tselem’s field researchers in Gaza:
Muhammad a-Za’im, 26, from Gaza City, wounded on 6 April 2018:
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Muhammad a-Za’im. Photo by Olfat al-Kurd, B'Tselem, 17 Dec. 2019
On 6 April 2018, the second Friday of demonstrations, Muhammad a-Za’im, owner of a stationery store, came to the demonstration that was held next to the perimeter fence east of Gaza City. At around 5 P.M., soldiers shot live ammunition and hit him in both legs. He was evacuated to the first aid tents and from there to a-Shifaa Hospital in Gaza City. After being treated for 10 days, a-Za’im was transferred to Istishari Arab Hospital in Ramallah, to which he was accompanied by his grandfather, and where physicians had to amputate his left leg.
In a testimony he gave B’Tselem field researcher Olfat al-Kurd on 17 December 2019, he spoke about his life since his injury:
When I found out my leg had been amputated, I was in shock. I am young, at the beginning of my life. How could my leg be amputated? After I got home, I also had to have a nerve implant in my right leg, nerve and bone implants in my left leg, and other treatments. I asked to exit for treatment at the hospital in Ramallah again, but I kept getting told that my request was under consideration. I was desperate and frustrated and refused to receive treatment in the Gaza Strip because I was afraid they would harm my leg. In October, I traveled to Egypt with my father for surgery and to receive a prosthetic for my left leg, and I stayed there for nine months. I had to pay by myself both for the trip and for the prosthesis. Now I need another surgery on my left leg.
Now I am in a bad mental state. I spend the day sleeping or in front of the computer. I don’t want to see people and don’t get together with my friends very much. I feel I’m a big burden on my family, and especially on my mother, who takes care of me and doesn’t leave the house very much to stay with me. Sometimes I have fits of rage, break things in the house, and feel like I’m suffocating.
I can’t ride my motorcycle or play soccer anymore, like I used to. I was offered to participate in swimming competitions and soccer games run by an association for the rehabilitation of people with disabilities, but I refused. I don’t want people to feel sorry for me. That’s why I also don’t leave the house too much with my crutches during the day, only at night, in the dark. Since my father has a heart condition and can’t work alone in the store, we had to close it. Maybe one day I will go to school, and I’m also thinking about marriage and starting a family.
At night I have a hard time sleeping because of the pain, and all I think about is my injury and treatments. I can only fall asleep after taking painkillers. The pain gets worse in the winter because of the cold. Sometimes I can hardly stand to look at my artificial leg and it depresses me. Israel destroyed my life physically and mentally.
Jalal Abu Hayah, 39, father of five, from ‘Abasan al-Kabirah, wounded on 14 May 2018:
Jalal Abu Hayah, a civil defense employee who used to provide first aid in the demonstrations, arrived on Monday, 14 May 2018, at around 8 A.M., to a demonstration next to the perimeter fence east of the town of ‘Abasan al-Jadidah. At around 11 A.M., a soldier shot him in the back with live ammunition. He was evacuated to Nasser Hospital in Khan Yunis, where it was determined that the bullet had hit him in the spine. He was then transferred to the European Hospital south of Khan Yunis to have the bullet extracted. After the surgery he stayed in the hospital for eight days and then was transferred to the Red Crescent rehabilitation hospital in Khan Yunis, from which he was discharged four weeks later, paralyzed from the waist down.
In a testimony he gave B’Tselem field researcher Khaled al-’Azayzeh on 22 December 2019 he said:
After I got out of the hospital I was in very bad shape. The doctors said I had to be turned over in the bed every two hours to avoid bedsores, and my wife had to get up all the time to turn me over. It was very painful. I was paralyzed and I became a burden on my wife, and my mental state was very bad. All I could think about was how to make it easier for her, and I decided to build a bed where I could turn myself over with levers. I built it with my son Muhammad, 17. It took us seven months and I bought all the parts and tools at my expense. When I started using the bed I calmed down. I didn’t need my wife’s help anymore, just an alarm clock. I have very strong pain in the paralyzed part of my body, and I take painkillers that I have to buy myself because they are not available at the public clinics.
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Jalal Abu Hayah. Photo by Khaled al-’Azayzeh, B'Tselem, 22 Dec. 2019
After a month in bed, I started to get around in a wheelchair. My hobby is to make knives and swords, and after my injury I decided to make swords at home and sell them to make a living. Since I can’t use a circular saw for metal, I designed a metalworking tool. It gives me a lot of satisfaction at work and really helps me make good products.
Since I’m in a wheelchair I have a lot of mobility difficulties. We have steps at the entrance to the house, so I built a special passage to get in and out, but I still depend on somebody pushing me up the ramp to the door. Because it is hard to get around, I do not get out of the house much. Every time I want to visit somebody at home, I ask first if there are stairs in the building. I don’t go to a lot of social encounters so as not to be a burden on people, and also because moving from place to place causes me pain.
I still receive part of my salary from the civil defense and also get help from a Qatari NGO. Before I was wounded, I sometimes worked as a plasterer, but now I can’t anymore. My condition obviously harms my income and my family’s livelihood.
Ahmad al-Khudari 21, from Gaza City, wounded on 1 March 2019:
Ahmad al-Khudari, who was a construction worker, arrived on Friday, 1 March 2019, at around 3:30 P.M., at a demonstration near the fence east of Gaza City. About an hour later, a soldier shot him in the right leg with live ammunition. He was evacuated to the first aid tent and from there to a-Shifaa Hospital in Gaza City. Two days later, the doctors amputated his leg below the knee, and he was discharged a week later.
In a testimony he gave B’Tselem field researcher Olfat al-Kurd on 16 December 2019, he spoke about his life since his injury:
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Ahmad al-Khudari. Photo by Olfat al-Kurd , B'Tselem, 16 Dec. 2019
After the amputation I went through a difficult period mentally. I felt deep sadness and helplessness. People looked at me with pity because of my condition and I would look at people walking normally and cry. I felt like my spirit was shattered.
Before the amputation I worked as a construction worker and helped my father support the family. I played soccer and swam in the sea. Now I use crutches and can’t work in construction anymore. About eight months ago I joined a mental rehabilitation group and we go on excursions and play sports together. I go there almost every day of the week. I’m trying to get back to myself by going back to my hobbies but it’s difficult: I’m an amputee playing soccer, and it can’t be at the level of somebody who has two legs. I also tried to swim in the sea, and I succeeded. I don’t want people to feel sorry for me and I challenge my disability. I try to manage without help in the shower and to make my own food. It’s hard, but I don’t give up.
I feel like the children in the street and the neighborhood are afraid of me because of my amputated leg and it bothers me. When my two sisters, Layan, 7, and Lama, 6, saw my stump for the first time, they got scared and ran away. That hurt me deeply. Little by little I got close to them again and helped them not be afraid of me.
I’m a young man at the beginning of my life, and I’m afraid I won’t find anyone who will marry me. I think about that all the time. I loved to work and now I can’t. Lately, I’ve been going to the hospital to get used to the prosthetic limb I’m supposed to get next week. I hope it fits and isn’t a problem. Even though the idea of getting a prosthesis is very hard for me, I hope I will get it and people will stop feeling sorry for me.
Muhammad Abu M’awad, 15, from Jabalya refugee camp, wounded on 3 May 2019:
Muhammad Abu M’awad, a student at a vocational tailoring school, arrived on Friday, 3 May 2019, at around 2:30 P.M., at a demonstration near the fence east of the refugee camp, and at around 7 P.M. was shot in the chest by a soldier. He was evacuated to the Indonesian Hospital next to the refugee camp, and from there, because of the severity of his injury, to a-Shifaa Hospital in Gaza City, where he underwent surgery to remove the bullet and was diagnosed as a paraplegic. Ten days later, Abu M’awad was moved to the Hamad rehabilitation hospital in Gaza City, from which he was discharged a month later.
In a testimony he gave on 12 December 2019 to B’Tselem field researcher Olfat al-Kurd, he described what he went through:
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Muhammad Abu Ma'awad. Photo by Olfat al-Kurd , B'Tselem, 26 Dec. 2019
Before my injury, I was studying tailoring at a vocational school and I was barely at home: I rode my bike, played soccer with my friends, went to play computer games, and shopped in the market for my family. My life was full, and I was happy. Now I’m confined to the house and to a special nursing bed, and all I do is play on my phone or watch videos. I don’t go to school anymore, don’t ride my bike, and don’t play with my friends. All that was taken away from me.
When I see the children of the camp playing, and hear them happy and screaming at each other, I miss being with them. I feel sorry for myself, have fits, break things, and cry.
We are a poor family: my father doesn’t work and there are eight of us. We rent an apartment in public housing in Jabalya Refugee Camp. I had hopes of working as a tailor and helping my father raise my siblings, but now I’m paralyzed and can’t do anything.
I have bedsores that are very painful, and twice a week somebody comes over from an organization to change my dressings. I also have anemia, so I go to the Indonesian Hospital to receive blood units.
I really want to have surgery outside the Gaza Strip so I can go back to walking on my feet, to the normal life I used to have, and to the games I used to play.
Muhammad’s grandfather, Fathi Abu M’awad, 62, married and father of nine, described his grandson’s condition in a testimony he gave on 15 January 2020 to B’Tselem field researcher Olfat al-Kurd:
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Fathi Abu M’awad. Photo by Olfat al-Kurd , B'Tselem, 15 Jan. 2019
When the doctor told me Muhammad was going to be paralyzed from the waist down I was in shock. I went out to the hospital courtyard and burst out crying, especially because Muhammad is my first grandchild and very close to me. When they took him into surgery I cried and could barely say goodbye to him. I stood outside the door and waited for Muhammad to come out of surgery, with his father, my son Ramzi, who stood next to me and was deeply distressed about his son. It was one of the hardest days of my life.
During his hospitalization, Muhammad kept asking me: “Will I be able to walk?” And I kept saying: “Yes, but you’re going to have to take medicine.” I couldn't tell him the truth about his condition. I kept telling him he would be fine. But when I helped him move his body right and left, or diapered him because he was incontinent, Muhammad would tell me: “I can’t feel the bottom half of my body.”
Sometimes Muhammad would try to get out of bed and suddenly realize he couldn’t. It would make him very sad and depressed. At those moments I would go out of his room and burst out crying.
After ten days Muhammad was transferred to the Hamad Hospital in Gaza for a month of rehabilitation, alone. We could only come during visiting hours. At night he would call me and say: “I’m scared. Why did they put me in this hospital?” And I would reassure him and say: “You have to get treatment and get better, Muhammad, so you can walk.” But he would say: “You’re lying, Grandpa. Nobody wants me, nobody loves me. If you loved me, you wouldn’t have left me alone at the hospital. I’ve had it, I hate the hospital."
Since Muhammad was injured, he has been suffering from fits of rage, throwing and breaking objects when he is in severe pain. He stays in bed, and only occasionally goes out in his wheelchair to the camp to meet friends. I see the sadness in his eyes when his friends are playing while he is sitting in his wheelchair.
His parents and I are at his side all the time. Muhammad’s mother is mentally ill, suffering from PTSD since the war in 2014. In order to function and take care of her family, she takes pills. My son, Ramzi, doesn’t work and receives a 1,800-shekel allowance from the Ministry of Welfare every five or six months. They are a family of eight and the situation is very difficult. Especially since Muhammad’s injury, because he needs medications, diapers, and food. In the winter they suffer a lot because the rain goes into their house through the roof.
I pray to God for Muhammad to get better. He needs a lot of treatment and care. The health ministry refused to let him go abroad for an operation as he wanted to, because they think there’s no point. I do what I can, and I will stay at his side, give him whatever I can, and try to make him happy.
Nazih Qdeih, 39, from ‘Abasan al-Kabirah, wounded on 14 May 2018:
Nazih Qdeih, a farmer, arrived on Monday, 14 May 2018, at around 10 A.M., to a demonstration near the fence east of the town of Khuza’ah. Six hours later, at around 4 P.M., Qdeih was shot with a live bullet in her right leg and evacuated to the first aid tents, and from there to the European Hospital south of Khan Yunis, where physicians amputated her leg.
In a testimony she gave B’Tselem field researcher Olfat al-Kurd on 12 January 2020 she said:
After I graduated from high school I went to work on my family and our neighbors’ land. I grew some vegetables, plowed the land, and harvested the wheat. I also help my family with the olive harvest every year. I liked farming. I would go out of my house in the morning and come back in the evening. I was happy to support myself and my family. My parents are elderly, and my brother, Suhayb, 34, was also injured in the March of Return and had his leg amputated. He is married and has four boys and two girls.
Since I was injured my life has been ruined. I’m unemployed, and I’m home all day and can hardly do anything. I spend most of the time sleeping. My spirit is tired. I cry all the time, my head and my leg hurt. I got a prosthetic leg, but it irritates me, and I don’t use it. Since I live alone with my elderly parents, when I want to do something, like clean the house, I have to crawl on the floor, but it’s very tiring. Sometimes, for instance when I wash the dishes, I stand on my left foot, but that is also very tiring.
When I see my friends and neighbors go to their fields, or my family going to harvest olives, I wish I could be with them, plow the land and grow crops. I cry and feel overcome with sorrow. I miss the get-togethers and the joy and the good atmosphere of the wheat and barley harvest in our fields.
When I see the girls walking in the street in high heels, wearing nice clothes, it breaks my heart. I cut off my social ties with family and neighbors, and I don’t attend a lot of family events. When I go out of the house it tires me and I don’t like people to see me this way. My life turned dark. Every day it gets harder. I have no future.
I think I’m the only woman who had her leg amputated in the March of Return. I really hope I get a wheelchair, because now I can’t go out of the house and support myself.
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).
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. 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. 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 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. 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. 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 the protests by the Gaza perimeter fence began on 30 March 2018, Israeli security forces have fatally shot over 180 demonstrators – including 31 minors – and injured over 5,800 demonstrators with live gunfire. The vast majority of casualties were unarmed, and were fatally shot from a distance while in the Gaza Strip itself. As a general rule, the protectively clad troops sniping at them from other side of the fence were not in any real danger. Some protesters threw stones, some damaged the fence, and a small number crossed it or threw hand grenades, IEDs and Molotov cocktails at the troops. According to figures by the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) and the World Health Organization (WHO), over 12,700 casualties have required treatment in Gaza hospitals. This number includes the over 5,800 who suffered live gunshot wounds as well as some 1,900 who suffered teargas inhalation injuries, and some 480 who were hit by rubber-coated metal bullets. Approximately 2,300 of the casualties are minors. Doctors have had to perform amputations on 90 protesters, including 17 minors and one woman. In the majority of cases (82), the amputations were of lower limbs. Over the past few months, B’Tselem field researchers in the Gaza Strip have conducted an extensive survey, canvassing 406 protesters who suffered live gunshot wounds; including 63 (15%) minors under the age of 18. The survey is not a representative sample; it consists of a detailed compilation of data regarding approx. 7% of gunshot casualties. An attempt was made to incorporate various protests sites and dates in order to achieve as diverse, comprehensive and reliable a picture as possible, given the complex setting of protests that have been taking place over a long period of time and at many sites along the perimeter fence. An analysis of the completed questionnaires found the following regarding the injuries surveyed: 85% – 348 (including 48 minors) – reported lower limbs injuries; 8% – 33 (including 10 minors) – reported upper limb injuries; and 3% – 12 (including 3 minors) – reported being hit in the head. 41% – 167 (including 29 minors) – reported being hit when they were in the immediate vicinity of the fence (up to 10 meters from it); 35% – 145 (including 24 minors) reported being hit at a spot further away from the fence, up to a distance of 150 meters from it; 22% – 92 (including 9 minors) – reported being injured at a distance greater than 150 meters from the fence. Of the 58% (237) who were not in the immediate vicinity of the fence (i.e., more than 10 meters away) when injured, 84% (200) were shot in the leg; and 13% (30) were shot in the arm or head. Two-thirds of the minors surveyed (41) reported being injured while they were watching the protest, waving a flag, photographing or filming the protest, moving away from the protest, or treating the wounded. 83% (339) required prolonged, ongoing medical treatment, and 57% (233) also required rehabilitation and physical therapy. 10% (42) of the individuals surveyed have become handicapped. The grave injuries suffered are merely the first chapter in a prolonged ordeal. Even a superbly functioning healthcare system would be sorely tried when faced with such a large number of casualties. Yet in Gaza, even before the protests began, the healthcare system was already on the brink of collapse. As a result, many of the wounded do not receive the medical care they need. According to WHO figures published 3 November 2018, Gaza’s Central Drugstore ¬– which supplies the vast majority of medical equipment to hospitals – was completely out of 226 essential drugs, and had only a one-month supply left of another 241. In addition, as for medical disposables, 257 types had been completely depleted. The poor condition of Gaza’s health care system is largely the result of the Israeli-imposed blockade on Gaza. The blockade places restrictions on replacing worn-out, broken medical equipment, on importing advanced medical equipment and drugs, and on travel by physicians for professional training outside Gaza. In addition, Gaza’s intermittent power supply, again largely Israel’s doing, also disrupts hospital functions. Click to enlarge Israel’s unlawful open-fire policy has caused these injuries. The prolonged Israeli-imposed blockade denies hospitals in Gaza the facility to provide proper care to the wounded. On top of this, Israel refuses, as a general rule, to allow the wounded to travel just a few dozen kilometers through its territory so as to reach hospitals in the West Bank, where at least some of them would be able to receive the care they need. According to WHO figures valid for 7 October 2018, 283 injured protesters had filed for exit permits to leave Gaza via Erez Crossing for the purpose of medical care. Only 66 (23%) applications were granted. More than three quarters of the applications were denied to all in intents and purposes: either being denied outright (107 applications, 38%) or else a response was not given by the time of the scheduled appointment (110 applications, 39%). The high number of casualties at the protests is not an unavoidable fact of life. It is the result of a deliberate policy by the Israeli security establishment. As early 30 March 2018, the very first day of the Return Protests, then Defense Minister Avigdor Liberman threatened the residents of Gaza that “anyone who will come near the fence today is endangering themselves. I suggest that you carry on with your lives, and take no part in the provocation.” As B’Tselem has already written, the staggering number of casualties – at protests that have been taking place for over seven months – is virtually unprecedented and is the result of the manifestly unlawful orders given to security forces. The orders permit the use of live fire against unarmed protestors who pose no danger to anyone and are on the other side of the fence, inside the Gaza Strip. Coming near the perimeter fence, damaging it or crossing over it are not capital offenses. However, statements made in the media indicate that the military permits opening fire at Palestinians not only if they pose a mortal threat to troops, but also in cases of individuals it vaguely and unlawfully defines as “key agitators,” stone-throwers, protesters who damage the fence, protesters who try to cross over the fence, and protesters who simply come near the fence, still on its Gazan side. For example, in an 11 October 2018 television interview on Channel 20, Minister of Public Security Gilad Erdan said, “It’s no coincidence that hundreds of Hamas operatives have been killed in recent months […] Over 5,000 Palestinians in Gaza were shot, that is – were hit by gunfire or were injured in recent months, as part of a policy of not allowing coming close to the fence or planting explosives.” In practice, however, Israeli security forces go beyond the unlawful gunfire at individuals who get close to the fence, they also shoot at protesters who are hundreds of meters away from it and are doing nothing to jeopardize the troops. 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 before the Supreme Court, whose justices have given this reality their seal of approval. B’Tselem field researcher Olfat al-Kurd gathered testimonies from some of the wounded, their families and eyewitnesses. Muhammad Abu ‘Aker (26) injured north of the town of Khuza’ah, 6 April 2018 On Friday, 6 April 2018, at around 3:30 P.M., two 26-year-old cousins from Khan Yunis, Muhammad and Faiz Abu ‘Aker, met at a protest held north of the town of Khuza'ah. At around 3:00 P.M., Muhammad Abu ‘Aker approached the fence, set tires on fire and threw stones at Israeli security forces stationed on the other side of the fence. In a testimony he gave on 17 September 2018, Faiz Abu 'Aker described what he saw: The situation that day, which was dubbed Tire Friday, was hard. There were a lot of protestors and burning tires and smoke, and many casualties. I was near the fence, helping set tires on fire. At around 3:30 I ran into my cousin, Muhammad Abu ‘Aker. He was standing about 10 meters away from me and about 30 meters from the fence. There was massive fire at the protestors. Most of the injured people I saw were hit in the leg. Later, I tried to draw back because things were so bad. Muhammad was behind me. I heard shots and turned around to Muhammad. I saw him on the ground, waving to the protestors. Because of the massive fire, I couldn’t get to him for about 10 minutes after he was wounded. Then I crawled over to him quickly with some other guys. He was lying on the ground bleeding from a large wound in his back. I bandaged it with a kaffiyah and picked him up. I asked him to recite “there is no God but Allah, there is no God but Allah”, because I was sure he was about to die. I tried to get an ambulance but I couldn’t, because they don’t go near the fence. We took him to the medical tents. Later, my brothers told me that he was in very bad shape. In a testimony he gave on 17 September 2018, Muhammad Abu ‘Aker described what happened that day:: Several people were wounded and there was massive fire by the Israeli army. The soldiers sometimes got down from the dirt mounds and fired teargas at us. There were also drones, which sprayed teargas at us. A lot of the protestors fainted. Later, I started setting tires on fire and then I started throwing stones at the Israeli army, from a distance of about 30 meters from the fence. When I turned around, I was hit in the back by a bullet. I fell over and felt terrible pain in my belly. My cousin Faiz Abu ‘Aker was about 10-15 meters away from me. After about 10 minutes, he came with some other guys to give me first aid. They couldn’t make it earlier because of the massive fire and teargas. They carried me to the tent area and kept saying “martyr, martyr”. When I got to the medical tent, they gave me first aid. The doctor said: “Try to stay awake.” Then I was taken to Nasser Hospital in Khan Yunis. I was very badly injured. I heard people saying “martyr, martyr”. I was bleeding heavily and then I blacked out. I came to seven days later and discovered I was hooked up to a lot of tubes from my stomach, nose and mouth. I was in ICU and couldn’t move or talk to my family when they came to visit me. When I saw them, all I did was cry. I stayed that way for about a week. Then the doctors started taking some of the tubes out of my mouth and nose and I was able to talk. I asked the doctors how I was doing and they said they’d operated on me for three hours, stopped the bleeding and repaired ruptures in my intestines. I also had shrapnel in my pelvis. It was hard to walk and I could only swallow liquid. I stayed at Nasser Hospital for about a month, until 14 May 2018. Now I have a colostomy bag and infections in the wound and in my stomach stitches. I live on painkillers and have a hard time sitting or walking. I got a referral for treatment in Egypt, but I didn’t go for financial reasons. I pray to get well and hope I can get a referral for treatment so I can get rid of this colostomy bag, which I loathe. ‘Abdallah Qassem (16) injured east of Gaza City, 14 May 2018: On Monday, 14 May 2018, at around 9:30 A.M., 'Abdallah Qassem (16) and his friend 'Umran Zaghrah (18), both from Gaza City, went to the protest area east of the city. Thousands of Palestinians were there, demonstrating against the transfer of the American embassy to Jerusalem. At around noon, the two friends drew back and sat down on a dirt mound about 100 meters from the fence. In a testimony he gave on 6 August 2018, Zaghrah described what happened next: At around noon, ‘Abdallah and I moved back because there was lots of teargas and we felt like we were choking. We climbed a small dirt mound about 100 meters from the fence and sat there, looking down at the protestors. I told ‘Abdallah we had to say noon prayers and he said: “Wait. Let’s see what happens to the protestors near the fence first.” A few minutes later, while we were still sitting on the mound, we were fired at. I didn’t hear the shots. At first, I thought I’d been hurt because I saw blood on my legs, but then ‘Abdallah started screaming. I looked at him and saw he was holding his legs, which were bleeding heavily. I tried to lift him up but I couldn’t. I yelled to the medics and they came and took him away. In a testimony he gave on 5 August 2018, ‘Abdallah Qassem related: There were a lot of people at the march. Near the fence there were protestors throwing stones at the Israeli army and a lot of burning tires. I saw about 30 soldiers stationed on the dirt mounds and behind them, several army vehicles and jeeps that were firing teargas canisters at the protestors, and drones that dropped teargas canisters on them. A lot of people got hurt - some were injured and many choked or fainted because of the gas. Several people were killed. Most of the hits I saw were to the lower limbs. At noon, while I was sitting next to my friend ‘Umran on a small dirt mound about 100 meters from the fence, the Israeli army fired at us. I was hit by a bullet that entered my right leg, exited and hit my left leg. I tried to stand up but couldn’t. I fell over. My friend tried to help me, but he couldn’t. He asked the medics for help. I was immediately taken to an ambulance that was in the tent area. I stayed in the field clinic for about an hour and was given first aid. They bandaged my legs. Then they transferred me to a-Shifaa Hospital in Gaza. There were a lot of injured people at the hospital. Because it was so busy they transferred me to al-Quds Hospital, which is also in Gaza, after four hours. Qassem underwent surgery at al-Quds Hospital, but the doctors were not able to save his legs. He was sent back to a-Shifaa Hospital, where doctors had to amputate his legs after about two and a half weeks. Qassem’s right leg was amputated below the knee and his left leg above the knee. In his testimony, he related: On Tuesday, 22 May 2018, before they took me into surgery, my father told me the doctors were going to amputate both my legs, because I was getting worse. I was very sad to lose parts of my body, but that’s what fate had in store for me. I put my trust in God and went into the operating room. I was under anesthesia until 30 May 2018. When I woke up, I discovered that they’d amputated my right leg under the knee and my left leg above the knee. The pain was excruciating and I kept crying and shouting. They gave me painkillers, but it didn’t help. I was hospitalized for a month and a week. I left the hospital in a wheelchair. I can’t walk anymore. I used to really love swimming and playing soccer, but I can’t do that any more. The school year is about to begin. I’ll have to go to school in a wheelchair instead of on foot. I’ve hardly moved since the amputation. No walking, no playing. I’m even thinking about quitting school soon, because I can’t see myself going there in a wheelchair. It makes me very sad. I’m still in shock. What crime did I commit going to the March of Return? I was just sitting watching the protestors. I went there on my feet and came home without them. The Israeli army shot me for no reason. It cost me my legs. Now I’m waiting to have prosthetics fitted so I can walk, go back to school and live like other kids my age. They took away my ability to hang out with my friends on the street. I can’t use the stairs. When I have to go somewhere, my brothers help me and carry me. Qassem gave another testimony on 1 November 2018, after he returned to school: At first, I refused to go to school. I wanted to put it off because I couldn’t go up the stairs there. My parents didn’t let me and said they’d support me and help me. For the first three weeks of the school year, I didn’t go to school because my class was on the third floor and I couldn’t make it there. Then the school administration decided to move the class to the ground floor so I could come back. Now I need prosthetics to walk and live normally. I asked several organizations to help me go abroad to have prosthetics fitted, so far with no success. Mentally, things are worse. I just hope I’ll be able to get prosthetics, get back to normal, finish high school and fulfill my dream of becoming a journalist. Muhammad Abu Hussein, 13, injured east of Jabalya R.C., 29 June 2018 On Friday, 29 June 2018, at around 5:00 P.M., Muhammad Abu Hussein (13), an eighth-grader from Jabalya Refugee Camp, arrived at a demonstration held east of the camp. Abu Hussein moved towards the fence until he was about 30 meters from it. There, at approximately 6:00 P.M., he was shot in the leg. His friend, Ahmad a-Sakhar (17), a twelfth-grader from the camp, related what he saw of the incident in a testimony he gave on 5 August 2018: After half past four, lots of people began arriving and the demonstration picked up. A lot of protesters moved towards the fence. Some of them threw stones at the Israeli army, and there were a few burning tires. I got up to about 10 meters from the fence. On the other side of it there were several soldiers on sand mounds. They were shooting at the protesters. There were also several jeeps there, firing teargas canisters. Some protesters were hit by the fire, but a lot choked on the teargas. I stayed put and later met my friend, Muhammad Abu Hussein, there. I was surprised to see him, because he's a little boy. I grabbed him and took him back to the tents a few hundred meters from the fence, so he wouldn't be hit by a bullet or inhale teargas. I went back towards the fence. About 15 minutes later, I suddenly saw that Muhammad was really close to the fence again. The Israeli army was firing heavily. At around six o'clock, there was heavy fire at the protesters and Muhammad was several meters away from me. I decided to move back and was going to take Muhammad with me, because I was worried about him. But then the army fired and hit the leg of a guy standing next to us. The soldiers fired at us, too, and Muhammad was hit in the leg. I looked over and saw that his leg had almost come off. He was bleeding heavily. I started shouting and crying and calling for medics. They carried him to an ambulance on a stretcher. In a testimony he gave on 2 August 2018, Muhammad Abu Hussein described the incident: At six o'clock, I was standing with my friend Ahmad a-Sakhar. The Israeli army fired at us when I was just standing and watching what was going on by the fence. The bullet hit me in the right leg and I fell down. My leg was almost completely crushed and I was bleeding a lot. I cried and shouted, it was so painful. Ahmad called the medics, who carried me to an ambulance and bandaged my leg. I was taken to the Indonesian hospital. About an hour later, I was transferred to a-Shifaa Hospital in Gaza, because I was seriously wounded. I was still bleeding a lot, and then I blacked out. Because my leg was so badly injured, the doctors at a-Shifaa decided to amputate it. I was taken into an operating room and amputated above the knee. When I woke up from the anesthetic, at four in the morning, I asked my brother 'Abd a-Rahman whether they'd cut off my leg. He told me they hadn't. After that, every time I tried to stand up, my brother would say "keep still". That's how I understood they'd cut off my leg. I was very sad. I asked my brother to have my leg buried in a grave near my dad, who died about two years ago. I was in a lot of mental and physical pain, and also suffered from the medication. After about three weeks, I was released. Now I need crutches to walk. Sometimes I get very tired from walking with the crutches, because I'm not used to them yet. Obviously, I'll never be able to ride my bike again or play with my friends the way I used to. I love soccer, and I won't ever be able to play again. Sometimes I try to play, but it doesn't work. When I see my friends playing and I can't join them, it breaks my heart and makes me very sad. School is starting again soon, and I don't know whether I'll be able to go back. How will I get there with the crutches? How will I play with my friends? I really hope I get a prosthetic leg - so I can play again, ride my bike, go back to school and play soccer again. They shot me for no reason. I was just standing there and didn't do anything. Because of them, I lost my leg and became crippled. Muhammad's mother, Amneh Abu Hussein (44), described that day in a testimony she gave on 28 October 2018: When Muhammad's leg was amputated, that was the worst day of my life. The news hit me like a bolt of thunder. I went to the hospital thinking he'd been lightly injured. When I saw his leg and learned they were going to cut it off, I burst out crying and screaming. He's only thirteen. I was afraid his entire future would be ruined and his studies and dreams come to nothing. What can a little boy do when he finds out he's missing a leg? What did my little Muhammad even do wrong? He wasn't carrying any weapon! And even if he had been holding a rock, that doesn't really affect the Israeli army. Now I'm very sad. Muhammad is no longer independent. I dress and bathe him. I worry about him and am afraid to leave him alone for a second. When I see that he can't play or go to school, it breaks my heart, because all his friends walk normally and he can't. Muhammad is being treated by Doctors without Borders. He's doing exercises to prepare for having a prosthetic leg put in. This week he's going to travel to the United States thanks to the Palestine Children’s Relief Fund to have a prosthetic installed. He'll be away for several months. I wanted to go along and be with him during the treatments, but the organization can't arrange it. It will be a difficult time both for me and for Muhammad, who needs me with him. It will be his first time away from me. He very much wanted me there with him during the treatments, but it isn't possible. I hope he recovers and comes back to me walking on two legs, without the crutches. Yusef a-Dush, 18, injured near Erez Crossing on 4 September 2018 On Tuesday, 4 September 2018, during a demonstration near Erez Crossing east of Beit Hanoun, some of the protesters broke through the checkpoint gate. At around 3:30 P.M., Yusef a-Dush (18) from Beit Lahiya and his cousin 'Abdallah Salman (16) from Jabalya Refugee Camp joined the demonstration. The two teens approached the checkpoint, throwing stones at Israeli security forces who were stationed on the other side of the fence and the wall behind it. At around 5:20 P.M., after a-Dush had crossed through the checkpoint gate and thrown stones at security forces from about 15 meters way, soldiers shot him in the leg. In a testimony he gave on 12 September 2018, 'Abdallah Salman described how his cousin was shot: When we got there, at around three-thirty, there were a lot of protesters. They were throwing stones at the Israeli army at Erez crossing. We went forward and crossed through the checkpoint gate. We made our way towards the Israeli soldiers, who were behind the concrete wall. The army fired a massive amount of teargas canisters at the demonstrators, as well as live bullets. Some people were hit. Yusef and I threw stones. Yusef went towards the soldiers and I stayed behind him, about 15 meters away. We continued to throw stones. I looked over at Yusef and he said to me: “Come on, 'Abdallah". Then they opened live fire at us and hit Yusef in the leg. I tried to go over and help him, but I couldn't get close because of the massive shooting of teargas canisters in our direction. He was bleeding and tried to draw back. When he got close to us, some medics came, bandaged his leg and put him in an ambulance. I got in with him. His right leg had been hit by live fire and was bleeding heavily. He shouted in pain while the medics tended to him. By the time we got to al-'Awdah Hospital, he was in a terrible state. In a testimony he gave on 12 September 2018, a-Dush recounted that day: I threw stones at the Israeli army along with other protesters, while getting closer to the soldiers. There were soldiers on top of the concrete wall, as well as jeeps and massive tear gas fire. People passed out from the gas. A few people were hit by the live fire, and most of them were badly injured. I went through the checkpoint gate and got closer to the Israeli army and the inspection point. I got up to about 15 meters from the army and threw stones. At about 5:20, I felt something in my right leg. I looked down and saw a spurt of blood. I tried to go back, but there was so much teargas that no one helped me. I kept drawing back until I met some medics who bandaged my leg and put me in an ambulance. My cousin 'Abdallah was with me. The medics took me to al-'Awdah Hospital in Jabalya, while I kept bleeding. Because I was so badly injured, they transferred me to a-Shifaa Hospital in Gaza and took me into surgery immediately. During the operation I was given a lot of blood units because the bullet penetrated my right knee, destroyed tissue and cut the main artery. The surgery lasted three and a half hours. I woke up in the ICU and spent about two days there. I'm still hospitalized at a-Shifaa. The doctors told me that I’m in good shape and that there’s been an improvement, but I still need to stay in hospital. I'll have to undergo plastic surgery, too, because I lost some of the tissue in my right leg. A-Dush was released after about three weeks in hospital, but his leg grew steadily worse. When he returned for a checkup, doctors told him an amputation could not be avoided. His father refused to give his consent and tried to arrange for his son to receive treatment abroad. In another testimony he gave on 29 October 2018, Yusef a-Dush discussed his condition: My father got in touch with a private doctor, who examined me. He said my leg was in a terrible state. A CT scan showed severe blockage of the arteries. I got shots and treatments, and then a relative of mine who is a doctor with the Ministry of Health took me to his home in a-Nuseirat Refugee Camp. I've been living with him for two weeks, while he treats my leg. He changes my bandages every day and cleans the wound. Right now, the leg is doing better. The injury has caused me a lot of suffering. I can't walk on my leg and have to use crutches. I lie in bed all the time, day and night. I'm in very intense pain and my leg feels like it's burning. Sometimes it hurts so bad that I hit myself in the head. My father is a simple public employee and can't pay for the care I need. I have no appetite and have lost weight. It's very hard to even make it to the bathroom, and I have headaches all the time. Because of the injury, I lost my job at a baking goods factory. I can't play soccer any more at the club I used to belong to, or race my friends along the beach the way I loved to do. I lost all that. I'm physically and mentally exhausted and never leave the house. I pray to God to get better and be able to walk again.
