The Ministry of Health in Occupied Gaza, Palestine is appealing to South African specialist medical personnel and NGOs to pitch in to help alleviate an unprecedented crisis that could see hundreds of young Palestinians at risk of limb amputation.

Since Palestinians began mobilising in protest at the fence separating Gaza from the State of Israel last March, Israeli forces have killed over 200 Palestinians in the territory and injured thousands of others. The
protests have sought to raise awareness of living conditions in Gaza under an 11 year-long Israeli blockade and an ongoing occupation, and to highlight the right of Palestinians to return to homes and lands they were expelled from when the State of Israel was created in 1948.

During the ten months of protest to present, Israeli snipers have targeted one part of the body more than any other – the legs. Of the over 10 000 protesters treated at hospitals and field clinics in Gaza so far, roughly 60 percent have been struck in the lower limbs, according to statistics compiled by Gaza’s Health Ministry.

“We did not face any situation like this, any trauma like this, any injuries like this before,” Dr Abdullatif Alhaj, General Director of Hospitals at the Gaza Ministry of Health said.

“The bullets being used are fragmented explosives. They destroy a big part of the lower limb including the bone, making for a devastating injury along with the muscles and nerves.”

Due to the extent of injuries incurred, hospitals in Gaza have carried out 120 amputations of legs thus far during the affected period. Most of the victims have been youth below the age of 30.

“If we had followed normal medical guidelines we would have to carry out hundreds more of primary amputations on legs upon arrival to hospital,” Alhaj said.

Orthopedic surgeons in Gaza have instead largely opted for the difficult alternative of attempting to save affected limbs by using devices such as external fixators, provided injuries are not life threatening.

The deluge of injuries has put Gaza’s already beleaguered health sector under severe strain, with hospitals being forced to discharge other recovering patients prematurely almost every week to make space for new arrivals. At times, several limb-related operations have had to be carried out simultaneously, and there have been shortages of external fixator components and consumables such as IV solutions and antiseptics. Gaza’s hospitals have also seen the onset of a superbug epidemic.

Alhaj suggests the targeting of limbs is part of a deliberate strategy from the Israeli army, especially since the protestors have posed no direct threat to the lives of Israeli forces, and given the availability
of other less lethal control measures to the army.

“If their aim was just to stop them or prevent them from coming to their side [of the fence], a very simple measure can control his movement and send him to the hospital preventing him from continuing his protest, but they want to make this destructive trauma and injury to the lower limbs in order either to make him lose his limb or leave him in permanent disability.

“They want to achieve the most painful effect not only for the victim but also for his family and the whole society. When there is a man with an injury like this, it is not only his problem, but a problem for his family, for the society and for the health system in Gaza even. It is a big burden for the society completely. They want to give a lesson for others not to demonstrate again.”

In line with the wider focus of the upcoming global Israeli Apartheid Week, Alhaj has urged the international community to hold Israel responsible for the usage of so-called butterfly bullets responsible for the majority of such injuries.

“These weapons are internationally banned even in conventional warfare, so imagine using them against peaceful civilians. These bullets, we have not seen the entire bullet, we just see the fragments – tens and hundreds of fragments were seen by the x-rays on their lower limbs or wherever they penetrated the bodies of the victims. They fragmented and exploded, destroying the whole tissues and the whole muscle, blood vessels, bones – everything – and they leave a gaping hole in that lower limb,” Alhaj said.

A special appeal is being made to South African NGOs and medical personnel to work towards alleviating a backlog of 1200 cases within the Gaza health system awaiting limb reconstruction surgery due to such injuries. Carrying out these operations requires specialist surgeons, of which there is a shortage in Gaza.

There is also a need to shore up Gaza’s supplies of medical consumables, instruments and equipment necessary for such procedures.

“We are calling for specialist medical missions that can deal with surgery in regard to limb reconstruction. We are also calling for providing instruments and consumables that are needed for such cases,” said Alhaj.

“If progress is not forthcoming immediately there are a number of cases where victims will lose their limbs or have permanent disabilities.”

Ebrahim Moosa of the South African based Palestine Information Network (PIN) said, “This is an issue of youth and the future. Being robbed of a limb is psychologically a very damaging experience and the effects of such a phenomenon going unchecked are going to be devastating for Palestine’s public health, economy and dignity.”

Dr Malik Abou-Rageila, General Manager of Partners International Medical Aid South Africa (PIMA-SA) added, “We regularly receive scores of requests from patients who lost limbs or have been paralyzed due to their injuries in Gaza. The impact goes beyond the immediate patient to his wider family and support structure. It is thus not simply a health issue but an economic and social problem which will take a long time to be solved.

“A specific appeal is being made to South African NGOs and donors to prioritise support to existing projects for these patients or to initiate new ones in co-ordination with our partners on the ground.”