29 March 2019
Medical Aid for Palestinians (MAP) has been working to ensure that the call for global action in support of Palestinians’ rights to health and dignity is heard at the very highest levels, including at the UN. In March our Advocacy and Campaigns Team travelled to the UN Human Rights Council in Geneva to engage in the discussions surrounding the findings of a UN Commission of Inquiry investigation into the “Great March of Return” protests in Gaza, and to highlight the devastating effects of Israel’s use of force on Palestinians’ health and access to healthcare.
The Commission’s report described the “enormous burden of injuries from the protests” and outlined how this has affected healthcare for all people in Gaza:
“Hospitals were forced to divert resources away from ordinary medical needs, such as cancer treatment, obstetrics and routine operations … Approximately 8,000 elective surgeries were cancelled or postponed, resulting in a backlog that will take years to address.”
It found that “the use of live ammunition by Israeli security forces against demonstrators was unlawful” in all the cases it investigated – all 189 fatalities and over 300 of the 23,000 injuries – with the possible exception of two incidents. It described the occupied Palestinian territory as “one of the most dangerous places in the world to be a health worker”, and found “reasonable grounds to believe that Israeli snipers intentionally shot health workers, despite seeing that they were clearly marked as such.”
We were joined in Geneva by Dr Mahmoud Matar, a senior orthopaedic surgeon treating protestors’ complex limb injuries at Gaza’s largest hospital, and Dr Tarek Loubani, an emergency physician who was shot in the legs while working to save lives at the protests.
On our first day in Geneva, Dr Tarek Loubani addressed the Council to speak directly to states and share his testimony of being shot while providing medical care to wounded protesters taking part in the “Great March of Return” demonstrations. His case was featured in the Commission of Inquiry’s report as an incident of attacks on health workers in Gaza:
I am here with Dr. Mahmoud Matar on behalf of our colleagues from the hospitals of Gaza. I am an emergency physician in Canada and Gaza and associate professor of Medicine at Western University in Canada.
On 14 May 2018, I was at the protests delivering trauma care on the field. I saw only peaceful protesters, and none posed any threat to the soldiers. When protestors were shot, me and my team of medics would treat and evacuate them. Due to the blockade I did not have the materials or medics to care for my patients.
I was one of the 19 medics shot that day. I wish I could tell you I was in the midst of some chaos when it happened. I was not. The skies were clear, with no gas and no burning tires. I was standing among a group of medical professionals away from the main protest area wearing full hospital green uniform.
We were not close to protesters and there was no Israeli gunfire at the time. I heard a loud bang, felt an incredible pain and found myself on the ground.
I was treated, stabilized and discharged within an hour. I sewed my own legs because of the number of wounded. Like hundreds of others that day, I did not receive the care I needed. Still, I was lucky.
When I was shot, paramedic Musa Abuhassanin treated me. He was my rescuer. About an hour after, he was shot in the chest during a rescue.
Musa died. Medical teams are not political actors, but humanitarians. We simply want to ensure that if people get into trouble, we're there to help them.
Some 600 health workers have now been wounded at the protests and three killed. Thirty-nine were killed between 2008 and 2014. We are still under fire. Four paramedics were wounded last week. International law is clear on the duty to protect health workers, and to facilitate our life-saving work.
When I return to my work in Gaza, I should not worry that next year I will have to speak to you again about what I saw. I should not worry that my name will be added to the list of dead health workers doing their jobs. When you here do not act meaningfully, it is more likely that injuries and deaths to medics occur – more likely that I will be injured or killed. Madam Vice President, I ask you and members of the council to do all you can to ensure we are protected in line with international law.
On our second day at the UN, Dr Matar described the difficulty of treating the many complex limb injuries caused by Israeli forces’ use of live ammunition against demonstrators at the protests. At side event organised by MAP and its partners, he shared the following testimony:
I am the Head of the Limb Reconstruction Unit at Al Shifa Hospital, the largest hospital in Gaza. It is an honour to speak to you today. I speak also for my patients and colleagues in Gaza.
On the first day of the “Great March of Return”, I thought that most of the injuries will be from gas inhalation. I was wrong. I never imagined so many serious gunshot injuries.
On 14 of May Al Shifa received 1700 patients with gunshot injuries to their limbs between 2pm and 8pm. 270 out of them need complex limb reconstruction. These patients should all be treated within a few hours, but it took us three days to treat them all.
On that day we ran out of everything. I went from operation to operation only changing my gloves because there were no clean scrubs. We ran out of antibiotics, wound dressings and painkillers, leaving many at risk of complications.
Many limbs are at risk of amputation because there is significant bone loss and damage to blood vessels, nerves and soft tissue. Across Gaza, we estimate 1300 need major limb reconstruction treatment, taking up to two years and on average need three surgeries as well as extensive rehabilitation. In the UK, colleagues estimate that this would cost £30,000 per patient.
After 12 years of blockade our health system is very close to collapse. We have shortages of electricity, medicines, equipment, clean water and hospital bed capacity. 8000 elective surgeries have been postponed. Many doctors only received 50% of their salaries since 2015, and it is difficult for us to exit Gaza for conferences and training.
I hope that the international community will support Palestinians’ right to health and to life. Thank you.
Upon return from Geneva, MAP received alarming news that the UK had abstained on a resolution at the Council welcoming the Commission of Inquiry’s report and urging action to implement its recommendations relating to accountability for potential violations of international law, the protection of healthcare, and international support to Gaza’s health system.
The abstention represents a regrettable dereliction of the UK Government’s responsibility to uphold respect for the rule of international law and the rights to health and dignity of Palestinians. MAP’s work to speak out for these rights continues. You can get involved at: www.map.org.uk/campaigns
