advising him that he had ‘five minutes to get out.’ He responded that he was notat home, but at work in the hospital, and did not have time to go back and ensurethat his family was safe; however, the voice reiterated that he had 5 minutes andhung up. He managed to warn his wife and children; and, a few minutes later, hishouse was completely destroyed. Fortunately, no one was injured.• As a further example of the panic caused by warnings, the same Head Nurserecounted the case of the mayor of the Gaza City municipality, Nizar Hijazi,whose extended family lived on A-Shoda Street in Remal, Gaza City. By chance,he was in the area and saw the women of the family ‘running for their lives’ fromtheir home, after receiving a warning late at night. They were wearing pyjamas,trying to get dressed and cover their heads with hijabs or prayer shawls. Themembers of the family were coming out of the house ‘in total shock, crawling,screaming, and sobbing.’ Two or three hours later the house was destroyed.3. Attacks on medical personnel and medical facilitiesIn situations of armed conflict, medical personnel, units and transports are affordedspecific protection under the provisions of International Humanitarian Law (IHL).Under these provisions, medical personnel, units and transports must be respectedand protected, and must never be the object of attack. 67 All vehicles marked withdistinctive medical signs, including ICRC, PRCS, and others, should be protected,with every effort made to secure safe evacuation. During their visits, the FFMteams were informed repeatedly that ambulance insignia, as well as GIS maps ofall health care facilities (hospitals, long-term care centres and primary healthcareclinics) were given in advance to the Israeli military to avert any confusion about whatconstituted medical personnel and facilities, and to secure the respect of medicalneutrality. In practice, however, medical units and facilities were not protected and insome instances, as documented, they appear to have been hit as direct targets withpatients present.3.1 Attacks on emergency teamsAccording to the Health Cluster Report, 68 23 health workers died as a directconsequence of the conflict, of whom 16 were killed while on duty. A further 83 wereinjured, the majority of whom were ambulance drivers for the various pre-hospitalemergency service providers (MoH, PRCS, Palestinian Medical Military ServicesPMMS, Civil Defence and NGOs). According to the Palestinian Ministry of Health,as cited in the same report, an ambulance station and a total of 45 ambulanceswere damaged or destroyed either as consequence of direct attacks or as collateral67Additional Protocol I, Art 15; Additional Protocol II, Arts 9, 11.68Health Cluster Report pp10, 13.44
damage. 69 According to one interviewee, 70 these deaths occurred despite the fact thatthe Israeli military had been provided via international organisations with a sample ofthe uniforms of all the medical/first aid teams from different organizations in Gaza.The teams met and interviewed a coordinator of evacuation services for the PalestineRed Crescent Society (PRCS), 71 as well as four PRCS paramedics who had been injured inthe course of medical evacuation. 72 An additional doctor from the Ministry of Interior’sMedical Military Aid ambulance service, who had accompanied a paramedic who waskilled on duty, was also interviewed and his testimony is paraphrased below. 73The interviewees cited two issues which compromised the protection afforded tomedical personnel and transports during armed conflict. One was the pattern of‘double tap’ attacks, 74 which led to injuries and deaths among medical evacuatingteams, and the other was the failure of the coordination mechanism instituted bythe International Committee of the Red Cross (ICRC) and the Israeli military for safeevacuation during military attacks.3.1.1 ’Double tap’ attacks on medical evacuation teamsAccording to the PRCS coordinator interviewed by the team, PRCS headquartersattempted to respond to the air attacks by distributing ambulances to strategicplaces, hoping to decrease response time and to respond even when injured peoplewere unable to call for help in the event of electricity and communication failures. Inpractice, the result was that in many cases the ambulances travelled to a locationafter a first explosion, without knowing its nature, and shortly after they arrived therewas a second, larger explosion, causing damage, injuries and sometimes casualtiesamong the medical teams. The Israeli military ground invasion also affected wherePRCS could place ambulances. They were restricted to central Gaza, and neededcoordination with the Israeli military for each evacuation.According to one of the paramedics interviewed by the team, Akram Al Awoor: 75The 2014 war was by far the most difficult of 3 wars I have experienced as a PRCS medic- a massive burden of injured, and targeting of medics and ambulances; typically a firststrike followed by a second strike when people gathered to assist victims of the first.69In the course of the interview with the PRCS coordinator, at 19:08 on 20 Aug 2014, he received a cell phone call reporting thatan ambulance at Bureij Refugee Camp had been targeted.70Dr. Diab Al Din Muhammad Abu Hussein, medical doctor with the Ministry of Interior Medical Military Aid, interviewed by thesecond FFM team on 9 Sep 2014 at the offices of Al Mezan Center for Human Rights in Gaza City.71The Palestinian ambulance service, recognized by the International Federation of the Red Cross for emergency medicalevacuation in the occupied Palestinian territory. PRCS in Gaza has 5 branches: Gaza City (Al Quds hospital), Khan Younis,Jabalya, Rafah and Deir Al Balah. The two most important are Khan Younis (which includes a rehabilitation center) and Al Quds,a general hospital which also has emergency, psycho-social, PHC, ambulance, and disaster management unit services.72The full texts of the interviews with the latter are at interview sortcodes MED1, MED2, EJM1 and WBBJ1.73Dr. Diab Al Din Muhammad Abu Hussein, interviewed by the second FFM team on 9 Sep 2014 at the offices of Al MezanCenter for Human Rights in Gaza City.74Described above, 2.1.1 ‹‘Double tap’ and multiple consecutive strikes.’75Interview sortcode MED245
- Page 2 and 3: Gaza, 2014Findings of an independen
- Page 4 and 5: TABLE OF CONTENTS611131516181820222
- Page 6: There״ was a call for help in a ho
- Page 9 and 10: Meetings and site visits were held
- Page 11 and 12: RecommendationsThe FFM• Calls upo
- Page 14: Part AIntroduction and Methodology1
- Page 17 and 18: 1.2 Composition of the fact-finding
- Page 19 and 20: Louis Reynolds, South Africa (LR)Re
- Page 21 and 22: Meetings and site visits were held
- Page 23 and 24: of their injuries or were either mi
- Page 25 and 26: The FFM teams acquired an overview
- Page 27 and 28: 4. Writing and editing of this repo
- Page 30 and 31: Part BFindings and Key Concerns1.Ty
- Page 32 and 33: It is difficult to estimate the exa
- Page 34 and 35: Buses destroyed in the attack on Mu
- Page 36 and 37: Location of incident leading to pat
- Page 38 and 39: 2.2 ’No safe place’According to
- Page 40 and 41: intense attacks during the air phas
- Page 42 and 43: In two cases the team was told of w
- Page 46 and 47: Injured paramedic Akram Al Awoor, A
- Page 48 and 49: These cases are a clear example of
- Page 50 and 51: Damage to Shuhada' Al Aqsa Hospital
- Page 52 and 53: Casualties arrive at Shifa Hospital
- Page 54 and 55: Bomb fragment shown to first FFM te
- Page 56 and 57: evacuation took 15-30 minutes; in 1
- Page 58 and 59: her wound after arrival at Maqassad
- Page 60 and 61: According to several patient interv
- Page 62 and 63: According to the ambulance drivers,
- Page 64 and 65: the level of violence and threat in
- Page 66 and 67: outside on the grounds; other IDPs
- Page 68 and 69: Body of small child killed playing
- Page 70 and 71: Dr. Kamal Qdeih, of Khuza’a in Kh
- Page 72 and 73: 6.3.1 Mental health impact of the a
- Page 74 and 75: 6.4.2 Rehabilitation resources in G
- Page 76: PART CKhuza’a - Focusand site vis
- Page 80 and 81: during the events. She also met Iya
- Page 82 and 83: Ramadan Qdeih and his father, Muham
- Page 84 and 85: were so close to the civilian popul
- Page 86 and 87: Damage to inner yard of clinic, whe
- Page 88 and 89: Samia Abu Daka at place from which
- Page 90 and 91: On 24 July 2014 at about 09:00, mos
- Page 92 and 93: Bullet hole A in front door of Muha
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middle: House's side and front entr
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PART DConclusions andRecommendation
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all crossings and borders, there we
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will persist to others as permanent
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INDEX OF INTERVIEWS BY SORTCODEInte
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1.1 Erez areaWBBJ1 (MED4)Patient: S
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1.2 Beit Hanounof ambulances ahead
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1.2 Beit HanounHome address: Beit H
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1.3 Beit LahiyaEJJ19Image by PHR-Is
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1.3 Beit LahiyaEJM8Image by PHR-Isr
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1.3 Beit LahiyaThere was no fightin
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1.4 Jabalia Refugee Campmaimed, and
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1.4 Jabalia Refugee Camprehabilitat
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1.4 Jabalia Refugee CampCircumstanc
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1.5 Jabaliarespiratory compromise d
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1.5 JabaliaEJM9Image by PHR-Israel,
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1.5 JabaliaOthers killed/injured in
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1.5 JabaliaInjuries: Broken knee ca
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1.5 JabaliaCrossing they underwent
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2.Gaza City133
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2.1 Al TuffahNo warning was given t
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2.1 Al Tuffahevery time he woke up
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2.1 Al TuffahAge: 38Witness: TR [Na
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2.2 Al Shati Refugee CampLocation o
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2.2 Al Shati Refugee CampOccupation
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2.3 Shuja’iyashe underwent left f
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2.3 Shuja’iyaProgramme and an int
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2.3 Shuja’iyaA near-by house was
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2.3 Shuja’iyaCircumstances of inj
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2.5 Al NaserWBN3Image by PHR-Israel
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2.6 Gaza Beach & PortInjuries: Brai
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2.7 Othertaken by private car to Sh
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2.7 Other43,000 (about $11,000). Is
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2.7 Otherfourth floor of a 9-story
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3.Central Gaza / Middle Area163
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3.2 Bureij Refugee CampImage by Ali
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3.2 Bureij Refugee Campdespite the
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3.2 Bureij Refugee CampEJM4Patient:
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3.3 Deir Al Balahthe same tank miss
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3.3 Deir Al Balahdamaged but habita
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3.3 Deir Al Balahare deep black. A
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3.3 Deir Al BalahJ6 (MED5)Patient:
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3.3 Deir Al Balahand arrived in Amm
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3.3 Deir Al Balahpatient who was se
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4.1 Khan YounisEJJ5Patient: YA [Min
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4.1 Khan Younisresponsive to verbal
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4.1 Khan YounisCircumstances of inj
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4.1 Khan Younissurgical procedures,
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4.1 Khan Younispatient and her fami
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4.1 Khan YounisEvacuation and care
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4.1 Khan Younisremained in the Euro
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4.2 Khuza’aComments on displaceme
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4.1 Khan Younishusband went to Khan
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4.2 Khuza’acheckpoint. According
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5.Southern Gaza / Rafah203
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5.1 Rafahpatient’s home was struc
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5.1 Rafahinterview heavy breathing,
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5.1 RafahCircumstances of injury: T
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5.1 RafahLocation of incident: Site
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5.1 Rafahevacuated, and the family
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5.1 RafahEvacuation out of Gaza: Th
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5.1 RafahWBN7Image by PHR-Israel, A
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5.1 Rafahsince the convoy to Erez C
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interview questionnaireTestimony of
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APPENDIX 2Forensic Pathology223
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Appendix 2Forensic pathologyThree f
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Photos no. Date Gender/age Notes1 D
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Photos no. Date Gender/age Notes10
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Photos no. Date Gender/age Notes20
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Photos no. Date Gender/age Notes34
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Photos no. Date Gender/age Notes48
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Photos no. Date Gender/age Notes68