From [HERE] and [HERE]  A Palestinian has been killed and hundreds more have been wounded amid fresh violence at the final Friday protest in six weeks of demonstrations at Gaza's border with Israel.

Israeli soldiers fired live bullets and tear gas as activists across the frontier fences burned tyres and threw stones. 

The clashes broke out days before weeks of protests, aimed at ending a decade-old blockade of Gaza, culminate in a planned mass march expected to involve tens of thousands of people.

At least 146 protesters were wounded by live fire, seven of them critically, including a 16-year-old boy who was shot in the head, Gaza health officials said. Dozens more were overcome by tear gas.

The six weeks of demonstrations will come to and end with a large-scale protest planned for Tuesday, when Palestinians mark their "nakba," or catastrophe, referring to their mass uprooting during the Middle-Eastern war over Israel's 1948 creation. Hundreds of thousands of Palestinians were driven out or fled homes in what is now Israel, and more than two-thirds of current Gaza residents are descendants of refugees. [MORE]

Since 30 March 2018, snipers firing military grade ammunition have caused crippling wounds to unarmed demonstrators. As of 23 April 2018, 5511 Palestinians, including at least 454 children, have been injured by Israeli forces, including 1,739 from live ammunition according to the Palestinian Ministry of Health in Gaza. As of April 27, the death toll has reached 48 and additional hundreds wounded.

Even the BBC has shown films of the deliberate shooting of people who were standing harmlessly or running away, including children and journalists. The sniper-fire is mostly not to the head, with most of the wounds to the lower torso and legs. Dozens have needed emergency amputation of either one or both legs, and a further 1,300 required immediate external fixations which will entail an estimated 7,800 hours of subsequent complex reconstructive surgery if the limbs are to be saved. This is calculated maiming. More may die or incur life-long disability because of the degraded state of health service sand the prohibition by Israel of the transfer for the seriously wounded. How is Gaza to survive this situation? And meanwhile, the many that have lost non-emergency healthcare because of the ongoing lack of medicines and energy will be joined by many more now that all scarce resources are going to life and limb saving efforts. [MORE]

The asymmetry of force has brought criticism of Israel’s policies. No Israelis have been injured since the protests began.

The European Union and others have called for an investigation into Israel’s response, but the Jewish state has rejected the idea.

The United States, Israel’s strongest backer, has blocked moves for a probe at the United Nations.

Doctors have reported unusually severe injuries.

“What is unusual is the lesions and the fact that the wounds are very wide, and the bones can be in many fragments,” said Marie-Elisabeth Ingres, head of the Medecins Sans Frontieres mission (MSF) in the Palestinian territories.

The charity has given nearly 600 people post-operative care since March 30.

Abdel Latif el-Hajj, director general of hospitals in Gaza, accused Israel of using types of ammunition aimed at permanently disfiguring their targets.

He said the army was using “expanding bullets” that separate inside the body, “breaking the bones and blood vessels, causing severe rupturing of the tissue”.

Amnesty International on Friday said some of the wounds appear consistent with bullets that expand inside the body. Such ammunition is considered illegal in international warfare.

“The nature of these injuries shows that Israeli soldiers are using high-velocity military weapons designed to cause maximum harm to Palestinian protesters that do not pose imminent threat to them,” an Amnesty statement said.

It accused Israel of “deliberate attempts to kill and maim” protesters.

In a statement the Israeli army said it was only using “standard weapons and ammunition that are lawful under international law”, and accused Gaza’s health ministry of regularly spreading false information.

Gaza’s severely limited medical facilities have been stretched thin by the number of injuries.

Hajj estimates they have only a few weeks of saline solution and antibiotics left.

They also have only around 50 orthopaedic devices, used to support damaged bones or replace destroyed ones.

“I suspect they will be gone in a week,” he said.

Ingres from MSF thinks hundreds of people will need costly treatment for months, if not years, with the risk of infection and further amputations if quality treatment is not given.

“The impact will be long term – not only on the individuals but on the health system, on their families, on the society in total.”

There is the ongoing impact of the 12 year long Israeli blockade of Gaza on the care and health of her people, and the degrading of its health services. The violence and destruction inflicted by Israeli military action in Operation Protective Edge in 2014 and Operation Cast Lead in 2008-9 marked a distinct turning point in the pauperization of Gaza, against a backdrop of an ever tightening blockade since 2006. That assault in 2014 killed over 2,200 civilians, a quarter of whom were children, wounded 11.000, destroyed 15 hospitals, 45 clinics and 80,000 homes.

Since 2014 Israel has further tightened the passage of essential medicines and equipment into Gaza, and of the entry of doctors and experts from abroad who offer technical expertise not available locally. Gazan hospitals have been depleted of antibiotics, anaesthetic agents, painkillers, other essential drugs, disposables, and fuel to run surgical theatres. (2) Patients die while waiting for permission to go for specialist treatment outside Gaza. All elective surgery has been cancelled since last January 2018, and 3 hospitals have closed because of medication, equipment and fuel shortages (3). Medical personnel have been working on reduced salaries. Gazan health professionals find it almost impossible to get Israeli permission to travel abroad to further their training.The regular episodic military assaults on Gaza and the current targeting of unarmed demonstrators are part of a pattern of periodically induced emergencies arising from Israeli policy. The cumulative effects of the impact on healthcare provision for the general population have been documented in multiple reports by NGOs, UN agencies and the WHO.This appears to be a strategy for the de-development of health and social services impinging on all the population of Gaza. [MORE]