Gaza: Advanced care needed for complex gunshot wounds

An MSF surgeon at Al-Awda Hospital examines X-rays from a patient shot by the Israeli army during protests in Gaza in Jul 2018. (photo: Jacob Burns / MSF)
For the most serious cases, the necessary treatment is very difficult to obtain in the Gaza Strip, which is isolated by a blockade.

By Staff | MSF Doctors Without Borders | Jan 25, 2019

MSF has increased its capacity in the Gaza Strip, performing 302 surgeries in December 2018 and caring for about 900 wounded patients. The needs of wounded patients, however, are overwhelming both MSF and other health care actors, and much more remains to be done to ensure adequate treatment of these serious and complex injuries.

Doctors Without Borders/Médecins Sans Frontières (MSF) medical teams in the Gaza Strip have the arduous task of treating bone injuries in patients who were shot by the Israeli military during protests. Limited resources make it impossible to provide adequate treatment in many cases, making it necessary to refer patients to hospitals outside the Gaza Strip. However, legal obstacles complicate referrals outside of the territory, and MSF was only able to make its first referral this month.

Treating gunshot wounds is complicated. At al-Awda hospital in Jabalia, northern Gaza, MSF surgeons operating on the shin of Yousri [name changed] who was shot in July 2018, found that the bullet had left a large gap in the bone just below his knee. They took bone from Yousri’s hip to fill the gap and help him walk again. “It will take at least two or three months for the bone to fuse, and could be longer,” said MSF surgeon Hiroko Murakami. “After that time we will see if everything is OK, and, if it is, then we can remove the external fixator and the patient can start physiotherapy. So it’s still going to take him a long time to recover.”

In total, 6,174 people have been injured by bullets fired by the Israeli army since March 30, 2018, during Palestinian protests along the fence separating Gaza from Israel. Nearly 90 percent suffered injuries to their lower limbs. MSF has provided care for about half of the wounded people after their initial treatment in local hospitals, and the wounds MSF has observed have been unusually severe. Patients often have complex open fractures — in which the bone is exposed to the air — or severe tissue and nerve damage. Sometimes one or more inches of bone are missing.

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