Introduction The deliberate injury of the limbs of 23 boys by high velocity weapons has been logged and described by Defence for Children International Palestine Branch (DCI-P) since March 2010. (1) Some of the facts have been published in national newspapers. These barbarous acts contravene international and national law but there are no judicial responses. The caring professions see the physical and mental pain of those who suffer and they should be in the vanguard in calling for this great cruelty to cease forthwith. Political leaders have failed to act. The Geneva Conventions Act 1957, which is of central importance in holding war criminals to account in the jurisdiction of the UK, is being emasculated.
Context
Most of the 1.5 million population of the Gaza strip is impoverished. Half are refugees from Mandate Palestine or their children. About 50% of the male population is without work. It has been isolated and occupied for decades. A commercial port was being built in 2000 but that was bombed by Israel. The isolation and the hobbling of its commerce was increased by a siege which was started in March 2006 in response to the election of a majority of Hamas members to the legislature. It was further tightened in June 2007 after the Hamas government pre-empted a coup by the Fatah faction that was led in Gaza by Mohammad Dahlan.
The lack of any work and the extreme poverty of the large extended families has drawn the boys and men to scavenge for broken concrete ('gravel') in the evacuated Eli Sinai 'settlement' and in the industrial zone by the Erez border control post at the northern limit of the 'Strip'. The factories of the industrial zone have been progressively demolished by Israeli shelling etc. They are seen to the west as one enters Gaza through Erez. A donkey and cart, shovel, pick, sieve, muscles and courage are the tools. The rubble is used to make blocks and poured concrete with the cement that is imported largely through the tunnels. Many dozens of men and boys do this work for precious shekels in the shadow of manned watch towers and under 'drones' above.
The 23 boys who have been shot between 26/03/10 (Said H) and 23/12/10 (Hatem S) are listed in the table below with skeletal facts. These points are made:-
- In 18 there were single shots and not automatic fire
- The reported range in most cases confirms that the weapon was a sniper's rifle in the hands of a sniper
- Almost always there were many dozens of other men and boys at work; these victims were picked off
- A leg was the target in most cases. Where the leg was not the target it is likely the sniper was 'aiming up' so the flank, elbow etc was hit instead.
- No weapons were being borne by the gravel workers so they posed no threat to the Israeli Occupation Force personnel. Instead they were bending their backs to their menial work within their internment camp
- The histories refer often to the recovery of the injured boy by friends and relatives under fire. This was a feature during 'Cast Lead' or instead the paramedics were barred from getting to the victims so they died without care.
- How many boys will regain full, or nearly full function is difficult to judge without the radiographs. Cases 3,4, 5,7,13 and 15 are likely to have joint involvement and thus some lifelong disability.
- In cases 1 and 3 there is nerve injury. If that proves to be an axonotmesis in either, it is possible that a first class repair will not be available in Gaza.
- The fractures are open by definition and no doubt comminuted. Delayed or non-union is possible. Deep infection is a real risk, antibiotic therapy not withstanding. The risk of deep infection relates to a. the possible inclusion of fabric b. the high energy injury causing irregular and wide devitalisation of the tissues c. the probability that these difficult bullet wounds were not laid open and a complete wound toilet performed. One or two of these boys might end with an amputation.
- Almost all the boys have been frightened off or forbidden from gravel work. There are few, if any, other means of earning shekels.
These quotations from the available stories convey a little of the poverty, the suffering and the courage:-
- 'The three of us would wake up every day at around 5:30am and leave to collect gravel. We were not the only ones doing this type of work. Hundreds of youngsters aged between 13 and 22 used to work with us, despite the danger we faced because we were close to the Israeli border.' Awad W- 3
- The work was exhausting and dangerous. Israeli soldiers would sometimes shoot at us, and sometimes shoot in the air to intimidate us, recalls Ibrahim . 'Sometimes they would shoot at the carts, horses and donkeys we used to move the gravel. But we had to do the work despite the dangers, because we didnt have any other job to do. Ibrahim K- 4
- Mohammad was taught by his neighbours to watch for birds flying away from the watch towers, as this was a sign to start running, as it meant soldiers were climbing into the towers and the shooting would soon begin. Mohammad M 6
- 'They killed our three horses and one donkey in four months, and we had to spend the money we earned on replacing them.' .. They were down on their stomachs pointing their rifles towards us, but they didnt shoot. We got used to such things. Mohammad S 11
References
1.http://www.dci-pal.org/english/doc/press/UA_4_10_Children_of_the_Gravel_UPDATE_29_DEC_%202010(b).pdf
2.http://www.haaretz.com/news/barak-hamas-will-pay-for-its-escalation-in-the-south-1.240417
3.http://www.amnesty.org.uk/uploads/documents/doc_21083.pdf
Conflict of interest: I founded the Dove and Dolphin Charity 110119 with a voyage to Palestine 8 years ago and chair its trustees. It attends to the welfare of children in Gaza in the main. No pecuniary benefit is derived from this charity.
FOOTNOTE
4 January 2011
To the editor of the British Medical Journal, Ms Fiona Godlee
Dear Fiona,
I wish you well for the new year.
I spent some time on the editorial board of the Journal of Bone and Joint Surgery so I have insights into review and publication. However, having been fully retired for about 7 years now I am a bit out of touch with how one should present material now. I have been involved with teaching and writing about essential clinical skills in Gaza. I have a good knowledge of the tremendous pressure the caring professions are under there and of the chaos that ensues.
The paper that I have written, and which is based on the reports from DCI-P that I follow carefully, should be put in front of doctors. I read the Christmas appeal to BMJ readers is for Save the Children. This link speaks of their rights denied. I know from previous correspondence that you would agree that intentions and words are alone insufficient. As I say in my paper, the professions should be in the vanguard of exposing the violation of children worldwide and insisting that it stop. I speak simply of healing.
http://www.savethechildren.org.uk/en/child-rights.htm
There is this side too. The professions are always picking up the pieces. I can think of the 5 million orphans in Iraq and the thousands of ex-servicemen with PTSD (three-quarters of a million in the US) whose GPs are powerless to help.
I attach the paper and table in pdf. I should be grateful to know as soon as possible. If this is highlighted in the BMJ, it is highly unlikely another child will be shot deliberately.
For truth, reason and justice
David Halpin
The refusal from the latter is here:
BMJ/2011/850099
The methodical shooting of boys at work in Gaza by snipers of the Israeli Occupation Force by David Sydney Halpin
Dear Mr. Halpin
Thank you for sending us your paper. We read it with interest but I regret to say that we have decided not to publish it in the BMJ.
Clearly soldiers shooting at children is awful, but we didn't think your article gave a clear reason why we should be publishing it now. The information comes from the Defence for Children International (palestine section) website, there isn't much context, there's no description of the Israeli soldiers' explanation for these events, and the article just sort of ends.
We receive over 8000 submissions a year and accept less than 10%. We do therefore have to make hard decisions on just how interesting an article will be to our general clinical readers, how much it adds, and how much practical value it will be.
I am sorry to disappoint you on this occasion.
An editor at the British Medical Journal
|
Number Name Age |
Date of injury |
Distance from border metres |
Injury |
Activity |
Single shot heard? |
Hospital Rx |
Outcome |
?Work again near Erez or other |
Date report made - Arabic to English |
|
1 Said H 15 yrs |
26/03/10 |
100 |
Deep and tranverse, lower L thigh |
Searching for brother |
Y |
3 days |
'Toe will not work' Persisting pain Nerve injury |
Lost 2 months training as plumber and car sprayer |
27/10/10 |
|
2 Hasan W 17 yrs |
22/05/10 |
300 |
Below R knee. 'Shattered' 2 months in plaster |
Gravel (G) |
Y then repeated shooting |
Home same day (HSD) |
Cannot walk. Pain on movement. |
'.. not be able to collect gravel though family needs money' |
01/09/10 |
|
3 Awad W 17 yrs |
07/06/10 |
350 |
Shot in R knee |
G |
Y |
HSD |
Numbness Cannot walk as he used to. |
Therapy from Doctors without Borders. Cannot work. |
06/09/10 |
|
4 Ibrahim K 16 yrs |
16/06/10 |
400 |
Shot in R knee |
G |
Y after shooting |
2 days |
Pain in R leg |
Forbidden by father to return to same work |
16/09/10 |
|
5 Abdullah M 16 yrs |
22/06/10 |
60 |
Shot in R ankle |
G |
Y |
HSD |
Painful. ?Will be able to walk normally again |
'I will never collect gravel again.' |
08/09/10 |
|
6 Mohammad M 16 yrs |
23/06/10 |
500 |
Shot in R flank |
G |
|
3 days |
Very tired when he runs |
Cannot work or play |
30/09/10 |
|
7 Arafat S 16 yrs |
10/07/10 |
50 |
Shot in R ankle |
G |
Y |
HSD |
Still some pain and a little limp |
|
18/09/10 |
|
8 N'uman A 14 yrs |
10/07/10 |
300 |
Shot R lower leg not deep |
G |
Y |
HSD |
|
Forbidden by grandfather to return |
20/09/10 |
|
9 Hameed O 13 yrs |
14/07/10 |
50 |
L arm not deep |
G |
Y |
HSD |
Occasional pain |
No work. Forbidden by father to return |
26/09/10 |
|
10 Khaled I 16 yrs |
31/07/10 |
600 |
L thigh. 'Cut artery and vein |
G |
Y ?Heavy machine gun |
15 days |
|
'Considering what happened, not going to collect gravel again |
27/09/10 |
|
11 Mohammad S 17 yrs |
25/08/10 |
800 |
L thigh |
G |
|
HSD |
Pain 'I have nightmares about being shot by Israeli soldiers' |
I dont think of going to the dangerous places anymore' |
30/09/10 |
|
12 Mahmoud J 16 yrs |
07/10/10 |
450 |
R thigh. Bled profusely. Exit wound diameter 5 cms. |
G |
Y ?From tank or jeep |
|
|
'I wanted to buy two pigeons and raise them on the rooftop of my house. I will never go back to that place.' |
27/10/10 |
|
13 Ahmad H 17 yrs |
13/10/10 |
600 - 700 |
R foot/sankle 'Big hole in my foot 4 cms with small hole other side |
G |
Y |
|
|
|
16/10/10 |
|
14 Yahia Z 16 yrs |
14/10/10 |
450 |
R lower leg |
G |
Y |
HSD |
|
I will never go back to the industrial zone even if I starve to death.' |
16/10/10 |
|
15 Shamekh D 15 yrs |
27/11/10 |
150 |
L foot |
G |
Y |
Operated BK cast |
Awaited |
|
02/12/10 |
|
16 Mokhles M 15 yrs |
28/11/10 |
500 |
L lower leg |
G |
Y |
?Op BK cast |
|
Ill wait for my wound to heal before I go back to collect gravel. |
02/12/10 |
|
|
|
|
|
|
|
|
|
|
|
|
17 Belal L 16 yrs |
04/12/10 |
600 |
L leg |
G |
Y plus a second shot into the L leg of his 22 yr old cousin |
Fractured in two places. External fixation above and below knee |
I still feel pain in my leg, says Belal, and I dont know whether I will walk again or not. |
I have come under fire several times from Israeli soldiers guarding the border. Once they shot and killed our horse. Belals older brother Nedal (24) has been shot four times whilst collecting gravel, three times in the left leg and once in the right leg, says Belal. |
08/12/10 |
|
18 Suhaib M 16 yrs |
10/12/10 |
250 |
Through and through, just below L knee. Exit wound 5 cms diameter |
Wood |
Y |
'Bullet exploded in leg.' Long cast. |
|
'I dont know if I will be able to walk again, says Suhaib, but certainly I will never go back to collecting gravel. |
18/12/10 |
|
19 Rasmi G 15 yrs |
10/12/10 |
200 |
R lower leg. Fractured tibia |
G |
Y |
External fixation |
In Kamal Udwan hospital |
I still feel great pain in my leg and dont know whether I will walk again or not.' |
15/12/10 |
|
20 Fadi H 17 yrs |
13/12/10 |
500 |
Below L knee |
Goatherd |
4 shots |
HSD |
Moving about at 2 days |
|
28/12/10 |
|
21 Rami 17 yrs |
21/12/10 |
400 |
R lower leg |
G |
Y |
HSD |
|
Will collect G again. 'What can I do?' Disabled father. Large family |
28/12/10 |
|
22 Mahmoud S 17 yrs |
23/12/10 |
400 |
R elbow |
G |
Gun-shots |
HSD |
|
'For the record, I will never go back to collecting gravel for it's a death profession.' |
29/12/10 |
|
23 Hatem S 17 yrs |
23/12/10 |
800 |
Head back of. Embedded 'shrapnel' from bullet |
Collect 'straws' |
Gun-shots |
HSD |
Headache plus nausea |
|
29/12/10 |
