Medics in the Gaza Strip have reported treating an influx of protesters who appear to have been deliberately targeted in the ankle by Israeli forces in recent unrest at the volatile boundary of the blockaded Palestinian enclave.
At least one person has been killed and dozens more wounded since demonstrations by groups of young men, some of them throwing stones and molotov cocktails, began in mid-September.
The protests were ostensibly organised in response to an uptick in visits by Jewish groups to Jerusalem’s sensitive al-Aqsa compound, ongoing Israel Defence Forces (IDF) raids targeting armed Palestinian cells in the occupied West Bank, and the economic misery caused by the Israeli-Egyptian siege of Gaza, now in its 16th year.
An uneasy calm has returned to the strip, and border crossings for workers to enter Israel reopened on 29 September after mediation efforts by the UN, Egypt and Qatar. Hazem Qasem, a spokesperson for Hamas, the Islamist militant group that has controlled the area since 2007, told the Guardian: “the people of Gaza want to live in peace and dignity. Further unrest is possible if our conditions are not met”.
Seven people admitted to al-Awda hospital in the northern town of Beit Lahia are still receiving treatments for bullet wounds to the ankle, a joint that Dr Jean Pierre, a medical activity manager in Gaza for Médecins Sans Frontières (MSF), said was extremely difficult to treat.
“It’s much harder to treat than any other part of the leg, because it is a joint that bears weight,” he said. “It involves a complicated graft called ‘free flap’ surgery, and it doesn’t always mean the patient will be able to walk. If it fails, amputation is often necessary.
“Only two doctors in Gaza can do it, and they do not have the microscopic equipment necessary to do intricate vascular repairs.”
Human rights groups say that such targeting procedures are unlawful as they allow the use of potentially lethal force with no immediate threat to soldiers’ lives.
In a statement, the IDF said: “Over the past few weeks, the Hamas terror organisation has organised violent riots along the border fence, for purposes of harming Israeli security forces … It should be noted that the IDF resorts to live fire only after exhausting all available options, and only as necessary to handle imminent threat.”
The latest violence echoes the “Great March of Return” protests that began in 2018 and lasted nearly two years, in which 227 Palestinians were killed during weekly demonstrations at the separation fences. The protests were triggered by Donald Trump’s decision to recognise the disputed city of Jerusalem as the capital of Israel.
About 60% of the thousands of injured were hit in the legs by sniper fire, according to the local health ministry – admissions that overwhelmed an already crumbling medical sector.
Since then, amputees using crutches have become a common sight on the enclave’s streets. In response, MSF has funded a new prosthetics clinic for the strip’s residents, and a limb reconstruction centre at al-Awda hospital.
“It is sad to say we have become experts in this work,” said Rami Abu Jasser, one of the centre’s supervisors. “We have much better facilities and equipment now than we did in 2018 and we can do most orthopaedic and plastic procedures. But we still cannot treat more than a handful of people a day.”
One of the injured protesters, who gave his name as Khalid, had been shot through both ankles with one bullet. He was healing well, doctors said, but it would not be clear for months whether he would be able to walk again.
“I was injured five times in the March of Return,” the 26-year-old said, pulling up his shorts to reveal scars around his knees. “In my thigh, in my hips, and I have shrapnel in my head.”
Khalid was one of several hundred young men who took part in the recent clashes at the separation fence, at the behest of a newly formed group called “Rebel Youth”. Many people in Gaza, however, said that they believed Hamas was ultimately responsible for stoking the violence along the periphery. The latest round of protests do not seem to have significant public support.
Since Hamas seized control of the 42km x 12km strip, Israel has fought four wars and several smaller conflagrations against the area’s rulers and its other active factions. These have proved devastating for the area’s 2.3 million inhabitants. Gaza’s residents also have next to no freedom of movement, and healthcare, electricity, sanitation and other crucial infrastructure have all but collapsed since Israel imposed the blockade.
After the last major war in 2021, Israel has gradually increased permits for people from Gaza for agricultural and construction work, an incentive for Hamas to keep quiet in order to alleviate the area’s dire poverty and accompanying unrest. Gaza’s unemployment rate has hovered at about 50% for years and more than half of the population lives below the poverty line.
About 18,500 men are eligible to work in Israel, bringing about £2m into Gaza a day; many families and businesses keenly felt the 12-day border closure imposed after the protests began. Israel is now caught between a desire to show Hamas that there are financial consequences for fuelling the current wave of unrest in the West Bank and the need to maintain calm on the Gaza front.
Hamas last month announced that it would be cutting salaries of 50,000 civil servants, blaming a redirection of promised aid from Qatar. Talks with Doha on funding are ongoing.
A recent International Monetary Fund report said that for any stable long-term economic recovery in Gaza, “lifting of the blockade and easing of the Israeli-imposed restrictions are essential”.
