Wounded in The Gaza Strip

The fact that the state refuses to let anyone leave for treatment merely on account of the circumstances of their injury, is an outrageously cruel act.

Gaza demonstrations | Photo: Activestills

In recent weeks, tens of thousands of Palestinians living in the Gaza Strip have demonstrated in several locations along the border fence. The demonstrations claimed the life of forty Palestinians, and 5,511 were injured, at least 138 severely. Out of this total, 1,704 were injured in their lower limbs, 21 of them lost a limb, and more in danger of losing one.

Despite the large number of injured and the severity of their injuries, and although the Gaza health system lacks the means and expertise to avoid amputations, only twenty of the injured, mostly children and journalists, asked for a permit to leave Gaza for medical treatment outside. Israel approved only nine of those applications. Even when the injured did leave the Gaza Strip for treatment, the time it took from the moment of their injury until their arrival at an advanced medical treatment foiled the efforts to avoid amputation, and even risked their lives.

Inside the Gaza Strip, it was decided not to transfer injured demonstrators, including those at life risk, to treatment outside. This decision was made probably because the injured and their families feared they would be arrested by the Israeli security forces, as had happened in several cases in the past.

According to the World Health Organization, the Israeli Coordination and Liaison Administration (CLA) at the Erez Crossing received 20 requests to leave Gaza for medical treatment, all urgent. However, four of the injured who eventually managed to get out received their permit only after human rights organizations appealed to the Israeli court on their behalf, after the CLA rejected their application or failed to respond within a reasonable time.

Hitherto, Physicians for Human Rights Israel (PHRI) have appealed in two cases, and we are now appealing in three additional cases of injured Palestinians denied treatment outside the Strip.

Two cases that demonstrate the absurdity of this tragedy are those of Abd-al-Rahman Nofal and Yusuf Al-Qatrawi

Abd al-Rahman Nofal, 12, was injured on Tuesday morning, April 17, 2018. Soldiers shot his left leg while he was taking part in demonstrations outside of Al-Bureij refugee camp. In Al-Shifa Hospital in Gaza City, the doctors decided to transfer him to a hospital in the West Bank, since they did not have means and expertise to treat him in a way that would prevent his foot from being amputated. The family’s request to approve his transfer to the Istishari Hospital in Ramallah was denied, and they turned to us for help. We made an urgent plea to the Gaza CLA, and after receiving no reply, we petitioned to the High Court of Justice (HCJ) that same evening demanding that the child be allowed to leave for treatment.

About an hour after we filed our petition, Abd al-Rahman Nofal received the permit, and was transferred that same night to the Ramallah hospital. His mother was not allowed accompany him. At the hospital, the doctors did not manage to save his leg, and had to amputate it that night.

Yusuf al-Qatrawi, 17, was injured in both his hips after soldiers shot him on Friday, April 6. He too asked to leave Gaza for treatment, and he too was refused. We made an urgent request to the Gaza CLA and the Coordinator of Government Activities in the Territories to allow the boy to be transferred for treatment. We attached an opinion by Dr. Dani Rozin, a PHRI volunteer: “Yusuf al-Qatrawi sustained gunshot wounds in both hips; in the left hip, the bone was damaged and an external fixation operation was required. The gunshot wound was debrided and closed, but subsequently became infected and despite dressing and antibiotics treatment, the severe infection continued. Such an infection, in the presence of fracture and a metal foreign object, can be very difficult to treat, to the point of resulting in failure to knit, chronic infection and even loss of limb. The presence of uncontrollable infection can also risk the patient’s life”. At the time of this writing, Al-Qatrawi’s request has met with no reply, despite the fact that time is of the essence in saving his hips. Therefore, we have made an urgent appeal to the HCJ to approve his transfer.

The state’s position on this matter was made clear in its response to one of the petitions to the HCJ. In that petition, two Palestinian demonstrators whose legs had been injured demanded to leave for medical treatment in the West Bank, in an effort to save them from amputation. The state replied that the “respondents did not approve these requests because the appellants’ injuries had been caused as a result of participating in the said violent disruptions of public order organized by Hamas”. This means that the state considers the circumstances of a person’s injury a major consideration in deciding whether to let them leave Gaza for treatment.

A reality in which Israeli security forces shoot unarmed demonstrators is unacceptable in itself. Once shot, however, they must receive appropriate treatment as soon as possible. The fact that the state refuses to let anyone leave for treatment merely on account of the circumstances of their injury – in this case, taking part in a demonstration – rather than on account of their medical condition, including the fact that they may be in danger of losing life or limb, is an outrageously cruel act. All the more so, as medical ethics and the directives of all emergency response and healthcare organizations require appropriate treatment of all injured persons regardless of their actions prior to being injured.

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