by Mersiha Gadzo and Anas Jnena
The only way Sari al-Shubaki can now communicate is by closing and opening his eyelids. He was shot with a live bullet by an Israli soldier as he was peacefully protesting near eastern Gaza borders.
An Israeli sniper shot him in the neck with a live bullet during demonstrations in Gaza on the morning of May 14. Since then, the 22-year-old has been paralysed. A fragment of the bullet is still stuck between his shoulder and neck.
For the past month he has been lying in the intensive care unit at Gaza City's Al Shifa Hospital in critical condition.
Since then, his family has been waiting for Israel to approve his exit permit to leave through the Israeli-controlled Erez checkpoint, known to Palestinians as Beit Hanoun, in northern Gaza to receive treatment.
The day after Sari was shot, doctors said they would transfer him for treatment in Egypt, but a special ICU ambulance required to move him never came as promised, according to his father, Dawud al-Shubaki.
"I don't know if it's the truth or if it's because they see him as a hopeless case. I think they seem to prioritise cases since there's many injured people," Dawuf told to Al Jazeera from Al Shifa.
Out of options, Dawud has been protesting in the hospital's yard to raise awareness about his son's condition and get help for him.
"There's still hope. He's conscious. Now we've heard from St. Joseph's Hospital in Jerusalem that they're ready to receive him, but how long will that take? The injured person that was next to his bed yesterday died today," Dawud said.
"I call on any human that still has a merciful heart to help my son undergo the treatment that he needs. Just get him out. We can't bear losing him. If we lose him, it will be a catastrophe for the whole family," Dawud said, breaking down in tears.
Israel uses lethal force
Since the March of Great Return protests began on March 30, Israeli forces have killed at least 129 Palestinians in the besieged coastal enclave and wounded more than 13,000 people.
Amid a lack of adequate resources to provide basic treatment to patient, doctors in the impoverished Gaza Strip typically refer patients to hospitals in Israel, the occupied West Bank and sometimes Jordan.
But to get there a patient requires receiving Israeli-issued permits, which are often rejected without any explanation offered or too time consuming to obtain for urgent medical conditions.
The other option is to leave through the southern Rafah border crossing for treatment in Egypt but this is often set back with delays.
According to the World Health Organization (WHO), as of June 3, 12 out of 22 injured patients were allowed to cross Rafah to receive treatment in Egypt.
Due to the 11-year Israeli-Egyptian blockade, patients in Gaza have long faced hurdles in leaving Gaza to undergo vital treatment, which has resulted in a slow death for many, but injured demonstrators are now facing even more stringent barriers in crossing Erez.
According to a new report by WHO, only a third of Palestinians injured during demonstrations since the start of the March of Great Return movement 30 have had their exit permits approved by Israeli authorities.
As of June 3, of the 66 injured demonstrators that applied for referral to Erez, only 22 were approved – compared to a 60 percent approval rate for the first quarter of 2018.
Thirty-three, or 50 percent, were denied – significantly lower than the rate of eight per cent for the first quarter in 2018.
The rest are still waiting, while two of the referred patients died.
"It has been decided that every request for entry into Israel for the purpose of medical treatment submitted by an active terrorist or rioter who took place in the violent events near the fence will be rejected out of hand," a spokesperson from COGAT, the bureaucratic arm of Israel's military occupation commented in an email to Al Jazeera.
'Punitive and vindictive policy'
According to Adalah – The Legal Centre for Arab Minority Rights, Israel's rejection of evacuations of injured demonstrators serves as a form of punishment.
Prior to April 15, none of the injured during the March of Great Return rallies were granted approval to cross Erez for treatment.
Al Mezan Centre for Human Rights and Adalah had to launch petitions to the Israeli Supreme Court in order for Palestinian patients to be evacuated through Erez.
On April 16, three Israeli Supreme Court justices unanimously ruled that 20-year-old Yousef Kronz, wounded by Israeli military gunfire, was permitted to leave Gaza for urgent medical care in Ramallah to save his remaining leg.
Due to the delay imposed by the Israeli military and court regarding his initial request for evacuation which had been filed more than two weeks prior, Kronz already had one leg amputated, according to Adalah.
The court ruled that Kronz posed no security risk and that his medical situation posed "a complete change in the essence of his life".
"From our experience in the Kronz case, the Israeli military seeks to implement a punitive and vindictive policy of denying Gaza residents access to life-saving medical treatment in the West Bank simply because they participated in a protest," said Mati Milstein, international media coordinator for Adalah.
"In fact, during the court hearings, state representatives made clear that Israeli Defence Minister Avigdor Lieberman had decided to prevent the evacuation for urgent medical care of wounded Gazans who had participated in protests and sit-in demonstrations – even at the cost of amputation."
Under international humanitarian law, Israel as the occupying power is obliged to ensure Palestinians' access to treatment and to maintain its medical facilities, hospitals and services in the occupied territories.
Yet, for the Physicians for Human Rights Israel (PHRI) delegation who visited Gaza last April, operating in the city's most advanced hospital felt like going back several decades.
Dr Jamal Hijazi, of Shaare Tzedek Medical Centre in Jerusalem, explained that there were no antibiotics; patients were expected to bring their own. There were no disinfectants either, and medical staff would use saline solution instead, raising the likelihood of infection.
PHRI said medical staff repeatedly use disposable products, as well as expired medicines. There is also a shortage of basic supplies such as gauze, morphine, surgical sutures, anesthetics and external fixators for leg fractures.
"The injured were not treated appropriately, and some paid for it with their lives," PHRI said in its latest report, referring to the heavy casualties in Gaza on May 14.
"Forced to scavenge for remains of medical equipment and medicines – whatever they could lay their hands on – the doctors felt like homeless persons begging for alms."
“The injured were not treated appropriately, and some paid for it with their lives,” PHYSICIANS FOR HUMAN RIGHTS ISRAEL.
Nothing to do but wait
Paramedic Mazen Jabreel Hasna underwent six surgeries to save his right leg after being shot with an explosive bullet on April 27 in Gaza's Malaka area.
Doctors said they would transfer the 33-year-old to Egypt or Jordan for surgery but this has still not happened. As he waits for his permit, he worries that the artificial arteries doctors used to save his leg could soon explode or become diseased as they aren't the right size.
"I'm waiting now and God willing, I'll be able to do it before something goes wrong," Hasna said.
Omar al-Housh, 25, is also waiting for a permit to leave Gaza for surgery. The pain is constant, he says. "Day and night".
He spends all his time in bed, unable to even use crutches and keeps his injured leg covered with a sheet; he hasn't dared to look at it since an Israeli sniper shot him with an explosive bullet on May 14.
His brother showed photos of Omar's injured leg – a gaping wound stretches from his thigh to the ankle, his muscles and tissue fully exposed.
The hospital called for urgent blood donations when Omar arrived. He received more than 60 blood units due to his damaged vessels and veins and underwent three operations to save his leg.
Omar said the day after he was shot, his referral to Egypt for treatment was denied.
He is currently on a waiting list to undergo an operation in Jordan, since the suture used to stitch his damaged veins and vessels isn't the right type and his fractured bones are partly out of position.
He waits for a permit from Israeli and Jordanian authorities, but he has already been denied entry repeatedly.
"It takes so long and I'm afraid I'll be denied entry by Israel or Jordan once again," Omar said.
"What the doctors did was a short-term, temporary surgery to avoid my injury getting worse. I want to be able to walk again," Omar said, adding that his struggle has also become a mental one as he suffers from nightmares and flashbacks.
Omar had worked occasionally as a fisherman with his brother, but he and his family cannot afford his medication and painkillers, adding to their worries.
"Every day he needs painkillers and injections or else he wakes up the whole neighbourhood with his screams, but I can't always afford them," said his father, Younis al-Housh said, a teacher.
"The other day he asked me not to get him the injections and medication because he felt he's burdening us. See how cruel life has become here? But what's important now is that we want him to receive treatment outside and be able to walk."