May 29, 2018 "Information Clearing House" - Any healthcare system in the West would collapse if it had to treat as many gunshot wounds in a single day as there were in the Gaza Strip on May 14, say international medical figures. Yet Gaza’s medical system, which for years has been on the brink of collapse as a result of the Israeli blockade and Palestinian internecine conflict, coped amazingly well with the challenge. In Israel, the events of May 14 are already history. In the Strip, their bloody consequences will shape the lives of thousands of families for years to come.

It was the number of people injured by gunfire, more than the high body count, that was so shocking: Nearly half of the more than 2,770 people who sought emergency care had gunshot wounds. “It was clear that the soldiers are shooting above all in order to injure and maim demonstrators.” That was the conclusion I heard from my interlocutors, some well experienced in bloody international conflicts. The aim was to hurt rather than to kill, to leave as many young people as possible with permanent disabilities.

The preparations at the 10 triage and trauma stabilization stations were impressive. Each of the stations erected near the protest sites was staffed by paramedics and volunteer medical students. Within six minutes, on average, they managed to examine each patient, to determine the type of injury, to stabilize the patient and decide who needed to be treated in a hospital. Beginning at around noon, one ambulance arrived at Gaza City’s Shifa Hospital every minute. The sirens didn’t stop wailing. Each ambulance carried four or five people with injuries.

Twelve operating rooms worked nonstop. The first to be treated were people with injuries to blood vessels. Hundreds of people with less critical injuries waited in the hospital corridors for their turn, groaning and dizzy. The only pain relievers available were meant for bad headaches at most, not gunshot wounds. Even if the Health Ministry of the Palestinian Authority in the West Bank had not reduced its medicine shipments to the Gaza Strip in the past year, following directives from top Palestinian political echelons, it’s doubtful that the hospital would have had the painkillers and anesthetics needed to treat the 1,300 or so patients with gunshot wounds and carry out the hundreds of operations performed on May 14.

No hospital in the world has enough vascular and orthopedic surgeons to operate on hundreds of gunshot victims in a single day. Surgeons from other specialties were brought in to operate under the guidance of the specialists. No hospital has enough medical teams to care for so many patients. After 1:30 P.M., when the families of the injured began streaming into the already overcrowded hospital, things began to fall apart. An armed security detail from the Hamas-controled Interior Ministry was called in to impose order, and remained there until 8:30 P.M. At night, 70 injured demonstrators still awaited treatment, and another 40 waited the next morning. One week on, the time for orthopedic surgery and physical therapy rehabilitation has arrived, but the Strip lacks sufficient physiotherapists, orthopedic surgeons and medical equipment.

 From March 30 to May 22, a total of 13,190 people, including 1,136 children, were injured in the demonstrations along the border with Israel, according to a World Health Organization report issued May 22. Of these, 3,360 were injured by live ammunition fired by our heroic – and well-protected – soldiers; 332 are still in critical condition (two people died of their injuries over the weekend). Five upper-limb amputations and 27 lower-limb amputations were performed. In the week of May 13-20 alone, Israeli soldiers injured 3,414 Gazans. Of these, 2,013 were treated in hospitals and in clinics operated by nongovernmental organizations, including 271 children and 127 women; 1,366 had gunshot wounds.

Our brave soldiers also shoot at medical teams that approach the fence to rescue casualties. Orders are orders, even when it means firing at paramedics. As a result, the medics work in teams of six: If one is wounded, two others will carry him away for treatment and the three who remain will continue to work, praying that they won’t be hit themselves.

On May 14, a paramedic from the Palestinian Civil Defense was killed, shot on the way to rescuing an injured protester. For around 20 minutes, his colleagues tried to reach him but failed, deterred by the heavy gunfire. The paramedic died of lung collapse. In the week of May 13-20, an additional 24 medical personnel were injured — eight by live ammunition, six by bullet shrapnel, one by a tear gas grenade and nine by exposure to tear gas. Twelve ambulances were damaged. Between March 30 and May 20, a total of 238 medical personnel were injured and 38 ambulances were damaged.

On May 23, following a visit to a hospital and a rehabilitation center in Gaza, UN Relief and Works Agency Commissioner-General Pierre Krähenbühl highlighted the ramifications of the recent events: “I truly believe that much of the world completely underestimates the extent of the disaster in human terms that occurred in the Gaza Strip since the marches began on March 30. ... As many people or even slightly more were injured during a total of seven days of protests than were injured during the full duration of the 2014 conflict. That is truly staggering. During the visits, I was also struck not only by the number of injured but also by the nature of the injuries. ... The pattern of small entry wounds and large exit wounds indicates ammunition used caused severe damage to internal organs, muscle tissue and bones. Both the staff of the Gazan Ministry of Health hospitals, NGOs and UNRWA clinics are struggling to deal with extremely complex wounds and care.”