One Palestinian killed and hundreds injured in Gaza during ongoing demonstrations

Mass demonstrations along Israel’s perimeter fence with Gaza took place again today for the seventh consecutive Friday, as part of the ‘Great March of Return’. As of 20:00, a Palestinian man was reported killed by Israeli forces, and, according to the Ministry of Health (MoH) in Gaza, 973 people were injured, of whom 38 per cent required hospitalization; 176 of those injured were hit by live ammunition and 10 are reported to be in a critical condition.

The overall number of participants in today’s demonstrations was estimated at 6,000 to 8,000, slightly above the figures recorded last Friday. Following midday prayers, hundreds of demonstrators marched from the five tent camps towards the perimeter fence, where they burned tires and threw rocks at Israeli forces, and flew kites with flaming materials attached to them into Israeli territory, reportedly setting crops on fire in Israel. They have also damaged the barbed wire deployed on the Gazan side of the perimeter fence at various points, however, no attempts to break the fence have been reported.

Israeli forces responded to the demonstrations by firing rubber bullets and tear gas canisters, also dropped from drones, and by firing live ammunition, including by snipers. The forces have also given verbal warnings via loudspeakers about the impending use of live fire, encouraging protestors to retreat from the fence.

Hundreds of Palestinians broke into the Palestinian side of the Kerem Shalom crossing, with the initial reports on the scope of damage to the crossing’s facilities exceeding the damage recorded in the previous Friday. Initial reports indicate that the control room, the main conveyer belt and the fuel pipelines were set on fire and severely damaged. The Humanitarian Coordinator for the oPt, Jamie McGoldrick, said: "I am deeply concerned by the reports of damage on the crossing. While loss assessments are ongoing, the possibility of the crossing’s operations being disrupted is troubling. I call on demonstrators to avoid actions that negatively affect the functioning of Gaza’s main entry point for humanitarian goods and on relevant authorities to quickly repair any damage." 

The Egyptian authorities have announced the opening of the Rafah passenger crossing, on an exceptional basis, from 12 May for four days. The Erez passenger crossing with Israel will be closed on Saturday, except for urgent humanitarian cases, and is expected to re-open for permit holders from Sunday.

Since 30 March, 41 Palestinians, including five children, have been killed by Israeli forces during the course of the demonstrations. In addition, 12 Palestinians were killed during the same period in other circumstances, including five shot at the fence or after crossing into Israel, whose bodies are reportedly withheld by the Israeli authorities. The cumulative number of injuries has exceeded 9,800, of whom nearly 5,000 have been hospitalized. As of 4 May, at least 169 health personnel had been injured and 18 ambulances damaged, according to the MoH in Gaza. There have been no reports of Israeli injuries.

The large number of casualties among unarmed demonstrators, in particular the high percentage injured by live ammunition, has raised concerns about excessive use of force, alongside calls for independent investigations of these incidents, including by the UN Secretary-General. The Israeli authorities have stated that many of the fatalities were members of Hamas and other armed groups and have accused the MoH of inflating the number of those wounded by live ammunition. Israel has also stated that a fact-finding mechanism will review the use of force, including incidents of fatal shooting.

The peak events of the ‘Great March of Return’ are expected on 14 and 15 May, with calls to participants to march towards the fence and break through it, raising concern about the possibility of high levels of additional casualties.

Ongoing humanitarian responses

Humanitarian actors have identified three areas of intervention to respond to the urgent needs arising from the ongoing protests: providing immediate life-saving healthcare; monitoring, verifying and documenting possible protection violations; and scaling up the provision of mental health and psychological support for people injured or otherwise affected. Some US$ 5.3 million has been requested to respond to needs emerging until 31 May 2018. So far, $2.2 million have been provided by the oPt Humanitarian Fund, while the UN Central Emergency Relief Fund (CERF) allocated $1.26 million yesterday.

The health response is the main priority, given the enormous rise in casualties and the poor conditions of the health system in Gaza, affected by 10-year blockade, the deepening intra-Palestinian political divide, deteriorating energy crisis, inconsistent payment of public sector medical personnel, and growing shortages in medicines and disposables.

Out of the 148 types of drug items needed to respond to trauma casualties, only 107 (72 per cent) are available in Gaza at present, while overall, 45 per cent of essential drugs are at zero stock (less than one month’s supply) and 40 per cent are completely depleted, according to the World Health Organization (WHO). The MoH reported that arrangements for the delivery from the West Bank of a shipment of 20 trucks containing pharmaceuticals and medical supplies items worth US$ 3 million are underway. Its arrival into Gaza’s central store, however, may be delayed by the disruption of operations at the Kerem Shalom crossing.

With power cuts ongoing for over 20 hours a day, 54 health facilities in Gaza are heavily dependent on the over half a million liters of emergency fuel provided by the UN on a monthly basis to allow for the operation of backup generators. While funding for the supply of emergency fuel is sufficient to cover needs until August, actual deliveries may be disrupted depending on the functionality of the Kerem Shalom crossing.

A large percentage of patients hospitalized since the start of the demonstrations suffered severe wounds to the lower extremities, requiring complex surgical operations; many of them will have disabilities for life. The MoH, along with the Palestinian Red Crescent Society (PRCS), have established medical trauma stabilization points (TSP) next to the five tent camps, to stabilize injuries before referring them to nearby hospitals. With the support of the Health Cluster, the TSP have been recently upgraded, improving the treatment provided to trauma injuries, thus reducing the burden at hospitals. 

The Health Cluster has also established the Gaza Trauma Working Group in order to enhance real time coordination of visiting emergency teams, establish minimal standards of clinical practice across the trauma pathway and ensure consistent, accurate data collection and sharing.

The Protection Cluster continues to closely monitor the situation, collecting information relevant to its protection mandate, including for identification of urgent humanitarian needs and ways forward to address possible gaps in response.

Protection Cluster partners continue to provide legal aid on behalf of individuals in need of Israel-issued travel permits for urgent treatment outside Gaza. According to WHO, of the 29 patients injured in the demonstrations from 30 March to 4 May who have applied for Israeli permits to exit Gaza for health care, nine applications were approved (31 per cent), significantly lower than the acceptance rate for such permits in the first quarter of 2018 (60 per cent). Other partners have challenged before the Israeli High Court of Justice Israel’s open-fire regulations, and the case is currently pending before the court.

The exposure to violence continues to have significant mental health and psychosocial (MHPSS) ramifications, particularly among children. Protection Cluster partners specialized in MPHSS have provided initial psychosocial support to at least 266 traumatized children, affected by different types of injuries, out of at least 598 so far identified. Of them, 40 children with critical and severe injuries (live and rubber bullets) in need of more specialized care were referred for case management. More than one thousand adults in need of MHPSS responses have been also identified and about 342 have been reached with initial psychosocial support.

Disclaimer: Data and analysis provided in this Flash Update is based on preliminary information available. Further assessments are pending.

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