Red Cross - Report on Operation Cast Lead

22 Days of Extreme Humanitarian Suffering in Gaza Strip

1. General From Dec 27, 2008 till January 18, 2009 the Israeli occupying forces (IOF) launched a military operation which was the most intensified attack in the oPt since June 1967. According to many local and International sources, the operation was characterized by the excessive use of force including heavy bombardments by airstrike, land and sea which did not stop at all during that period.

The indiscriminate attacks of the Israeli occupying forces resulted in a high fatality rate of 1325 Palestinians and 5320 injured. According to the PRCS most updated statistics the fatalities included 446 children, 110 women and 108 elderly while the injured consisted of 1855 children and 795 women.

According to the main three Palestinian military factions' brigades (Al Qasam Brigades, Saraya Al Quds brigades and Al Aqsa Martyrs brigades) the total number of deaths among their fighter reached 118, (49, 34,  and 35 respectively). This means thatthe percentage of innocent civilians' deaths is 85% - 90% of the total number.

age_matters_nomoreMoreover, the Israeli military operationwith all its phases resulted in a massdestruction of private properties. At least4,000 houses were completely destroyedwhile 16,000 houses were partiallydamaged. According to the preliminaryreport done by the Ministry of health on theeffect of the Israeli aggression on the healthinstitutions in Gaza Strip, since 27December, 21 health facilities (4 hospitalsand 17 PHC clinics) have been totally orpartially damaged in a direct or indirectshelling.  Palestinian elderly stands on the rubble of hisdestroyed building.In addition approximately 1500 factories, shops and markets were damaged by theIsraeli army air, land, and sea bombardment. The UN estimates that 35,500 civiliansare now being housed in shelters for internally displaced civilians across the GazaStrip. According to Palestinian sources the losses in the Palestinian economy reachedapproximately 2 billion USD.

According to MOH reports the daily breakdown of casualties is the following:



2. Violation against PRCS and other medical teams:

hospital_premisesDuring the period of the Israeli military operation on Gaza Strip the medical teams faced many challenges and difficulties due to the lack of respect and protection of the Israeli occupying forces. According to PRCS records, 14 medical personnel were killed, including one PRCS volunteer, and 24 others including 5 PRCS were injured.

The Israeli army bombarded PRCS primary health care and EMS station in Jabaliya, PRCS premises in Al Nur medical center, which also included Al Quds hospital, EMS stations, ware houses, administrative building and other premises. Sixteen PRCS ambulances were partially damaged, and three were totally destroyed. According to the most recent assessment by the PRCS, the massive damages that resulted will cost approximately 13 million USD.

In addition to the lack of protection and respect, the PRCS medical teams faced many challenging obstacles; one of which was access to the injured victims. The medicalpersonal in the fields were subjected to direct Israeli army gunfire in several cases inareas such as Al Zaytoon, Al Atara, and Jabaliya. Although PRCS was doing allnecessary coordination through ICRC to allow its ambulances and medical teams accessthe isolated and the affected areas, the access was difficult and dangerous due to theattacks on the medical personal. PRCS was forced into evacuating Rafah, Gaza city,and Jabaliya EMS stations due to these areas being directly targeted and by nearbystations.

Dr. MuhamadAwadeh, PRCS' Director of Emergency Medical Services stated:

"During the first 18 days of the military operation, there were 140 attempts to coordinate access by the PRCS, through the ICRC, in order to enter the affected areas, and only five cases were successfully approved… However in the five cases we were not able to complete our humanitarian tasks because of the obstacles and the gunfire by the Israeli soldiers… the ICRC staff witnessed the Israeli army shooting at the medical teams… We requested from the ICRC to put pressure on the Israeli authorities to enable the medical teams to carry out its humanitarian mission, to alleviate the suffering of the wounded, sick, and pregnant women, especially in the affected and the isolated areas".

PRCS faced a massive obstacle throughout its communication networks particularly in the northern part of Gaza Strip. In addition, PRCS EMS stations in Gaza faced the cut of telephone network, affecting the response to people calling 101. An alternative linewas organized, and the PRCS notified the people in Gaza city to contact the PRCSoperations room in Gaza and PRCS Al Quds hospital if there is any emergency. Afterthe Israeli army targeted PRCS Al Nur medical city where the PRCS central operationsroom and the VHF tower exists, the flow of information from the PRCS stations to theoperations room and vice versa had been disrupted and nearly stopped.

PRCS Al Nur Medical City in the Heart of Hell:

hospital_premises (1)On 15/01/2009, 08:30am, the Israeli army bombarded PRCS premises in its Al Nur medical center which included Al Quds hospital, EMS station, ware houses, the administrative building and other premises.

The bombs which were reported to be phosphorous hit the Medical City which includes three main buildings. As a result multiple fires broke out in different parts including the pharmacy and nurses room.
Fortunately no injuries were reported at that time. Note that there were approximately 500 people inside the hospital.

The PRCS staff and volunteers in the hospital evacuated the sick and the injured alongwith their families to the ground floor for safety. Later at 22:30 pm, less than 24 hoursfrom the previous attack the Israeli army bombarded the PRCS premises in its Al Nurmedical center. At this time the bombs hit directly Al Quds hospital. As a result the firebroke out in its upper floor. Fortunately no injuries were reported. More than 500 peoplewere inside the hospital at that time, including the sick and injured, were evacuated to AlShifa Hospital. All PRCS staff and volunteers evacuated the hospital for obvious safetyreasons. The central operations room in Gaza strip which was based in the hospitalcompletely was unable to function. Thus the result of flow of information was seriouslyaffected.


The civil defense could not enter the area to put out the fire due to the Israeli army's obstacles and its heavy gunfire. The ICRC coordination to allow the civil defense and medical teams order to evacuate the people inside was unsuccessful and took three hours of ICRC to negotiate with the Israelis to allow the teams in. During that time the fire spread to a wide area in the PRCS premises and destroyed the warehouses, the administrative building which consists of 11 floors, the building which consists of the theatre, halls and the hotel, in addition to parts of AlQud hospital.

Other significant incidents:

On 12/01/2009, one medical personnel from the military medical services was killedand another was injured as a result of the IOF airstrikes in Jabaliya.

On 08/01/2009 the Israeli occupying forces opened fire at an UNRWA truck while onroute to transport humanitarian assistance. The UNRWA driver was killed in theincident and another staff was injured. After this incident the UNRWA suspended itsactivities in the Gaza Strip, thus deteriorated the humanitarian situation of 750,000Palestinian refugees who receive humanitarian assistances from the UNRWA anddepend on its services.

PRCS_ambulance_partially_damagedOn 08/01/2009 a convoy consists of three PRCS ambulances, 8 MOH ambulances, and one ICRC vehicle, was subjected to direct Israeli Occupying Forces gunfire, near Netsarim Junction, while on route to transport injuries to Rafah border. One ICRC staff was injured and his vehicle was damaged.

On 07/01/2009, a PRCS ambulance was dispatched to Zamo area near Jabaliya totransportinjuries. One Israeli soldier opened fire at one of the PRCS medical personnelwhile he was providing first aid medications to one of the injured. The EMT was shotby a live bullet in the leg which was treated in the hospital. Later another bulletpenetrated the head of the wounded.

On 07/01/2009 the Israeli occupying forces opened fire at a PRCS ambulance in AlJurn area, north of Gaza Strip, while attempting to transport injured from the area. OnePRCS medical personnel were injured in the leg and the ambulance was damaged.

totalled_ambulance (1)On 06/01/2009, a PRCS ambulance was dispatched to Al Samoni area, south of GazaStrip, after coordination was made with the ICRC and got the green light to proceed totransport one of the injured. When the ambulance reached the location of the incident,and without any provocation, the Israeli soldiers opened fire at it. Fortunately noinjuries were reported, but the ambulance received damage.

On 06/01/2009, a PRCS ambulance was dispatched to Al Atatra area, after coordinationwas made with the ICRC and got the green light to proceed to transport casualties.When theambulance reached the location of the incident, the Israeli soldiers openedfire at it. Fortunately no injuries were reported.

ruinesOn 04/01/2008, a PRCS volunteers, Arafa Abdul Dayem, was killed while onhumanitarian duty after an Israeli airstrike attacked a location in Al Salheen area in Jabaliya. The volunteer with other medical personnel from Al Awada hospital weretrying to evacuate a number of injured when a second airstrike hit the same location.Two other medical personnel were injured in this incident.

On 04/01/2008 In another incident an Israeli airstrike hit a location south of Gaza,where a number of medical personnel were providing first aid medication to the injured.As a result three medical personnel from the military medical services were killed.

On 04/01/2008, a PRCS ambulance received damage after an Israeli occupying forcesairstrike hit a location near the ambulance. Fortunately, no injuries were reported.

house_tells_story_of_chaosOn 01/01/2009 Two PRCS medical personnel were injured while on humanitarian dutydue to an Israeli occupying forces airstrike in Deir Al Balah area and the Ambulancewas severely damaged.

On 30/12/2009 one medical personnel was killed and several others were injured, dueto Israeli occupying forces heavy bombardment and air strikes in Al Rayyes hill east of Gaza city, while on humanitarian duty to evacuate wounded people.

On 29/12/2008: Six medical personnel were injured after the Israeli occupying forcesconducted a second air strike on a location where the medical teams and theirambulances provide its humanitarian services.

3. PRCS intervention

3.1 Emergency Medical Services:

PRCS EMS staff and volunteers remained in the highest level of alert in the occupiedGaza strip during the 22 days of the Israeli military operation in the Gaza Strip,

Total number of fatalities and injured treated by PRCS medical teams andambulances from 27 Dec 2008 – 18 Jan 2009:





Fatalities and Injured transported by PRCS ambulances per EMS station:


3.2 PRCS Hospitals:

Number of deaths and injuries received by PRCS hospitals in Gaza Strip:

Name of

Total of

Total of



–over 40



Al Quds








Al Amal








As all Gaza Strip hospitals and medical premises PRCS suffered severe shortages ofmedical supplies and were not properly equipped to receive mass casualties. HospitalOperating Rooms were overflowed and ran out of essential medications. Hospitalsand other medical facilities are also understaffed and unable to respond to the load ofinjuries.


3.3 Phychosocial services:

As the situation in Gaza strip reached to the highest level of inhumane actions by the Israeli occupying forces, the PRCS psychosocial department developed a support plan to PRCS staff and volunteers and people in need of intervention,
particularly children. PRCS psychosocial teams in Gaza and Khan Younis started working with the citizens there.

The work began with an assessment phase for 36 families including 140 childrenbetween 5-16 years old. The PRCS psychosocial teams started with a debriefingworks shops for the children using the drawing and free expressing of the emotionsand feelings, they also visited the EMS staff to give them the psychosocial supportalso known as critical incident stress debriefing status post the Israeli aggression onGaza Strip which put them at their lowest for the past 22 days.

In its upcoming period the PRCS Psychosocial Program will work with thefollowing target groups:

  1. The Affected families.
  2. PRCS staff and their families.
  3. Medical and EMT personnel/teams.
  4. The community in general.
  5. Capacity building for PRCS team to cope with the disasters.


3.4 Rehabilitation services:

The Israeli heavy and indiscriminate bombardments on the Gaza Strip has resulted in over 5,450 wounded. Unprecedented types and complexity of the injuries have been reported. A very large number of those wounded have needed the amputation of limbs. Severe head injuries and a range of
other injuries which can lead to permanent disabilities have been reported.

PRCS rehabilitation role is to support these disabledpersons to cope with their newsituation and to provide them with their urgent needs. PRCS future plan is to provide800 injured people (disabled) with the suitable rehabilitation programs and assistive
devises, to make their life easier, and to integrate them in the society with their newsituation.

PRCS rehabilitation intervention will focus on:

  • Orthopedic fractures: to provide them with the needed assistive devices like: crutches,wheel chairs Walker and a full comprehension rehabilitationprogram (physiotherapy, occupational therapy)
  • Spinal cord injury: to provide them with the suitable wheel chairs andcomprehensive rehabilitation program (physiotherapy, occupational therapy,psychological support,)
  • Head injury: to provide them with wheel chairs and comprehensiverehabilitation program (physiotherapy, occupational therapy, psychologicalsupport, speech therapy…)
  • Limbs amputation: these persons according to the expectations may exceed150 and PRCS will try to help 60 of them by coordinating with PRCSpartners. These cases have to be sent to centers or hospitals specialized inprostheses outside Palestine. The role of PRCS partners is to find those centersand hospitals in their countries or other countries and to coordinate for themand to cover the cost.
  • Hearing problems: many people may suffer from hearing problems resultedfrom the sound of explosions and other aggressive actions. PRCS role is tofind these cases and provide them with the hearing aids and auditory services
  • Articulation problems: the fear and shock resulted from the aggressiveactions will cause some articulations problems especially between children.PRCS speech therapists will provide these cases with the speech therapy incoordination with the psychosocial program.

PRCS_volunteer_distribute_hygiene_kitsto_injury3.5 DMU & Youth and Volunteers:

During the Israeli military operation PRCS called 200 of its volunteers to support theEMS services and the Disaster management unit (DMU). Approximately 50volunteers were allocated to support the EMS stations and the rest for the function ofthe operations room and the logistical support.

After the end of the operation of military the PRCS volunteers participated in theassessing of the damages and the rapid distribution of some blankets and plasticsheets to 4800 partially damaged houses. PRCS is now planning to establish a campin Jabaliya to assist 500 families whose lost their homes in the military operation.

During the military operation the PRCS DMU with the cooperation of UNRWA distributed 400 blankets, 300 Hygiene kits, 2500 water family kit, 6000 bottles of drinking water, and 50 baby and mother kits. In addition PRCS assisted 500 persons in Khan younis who left their homes and took the PRCS premises as a safe shelter. In addition the PRCS assisted around 95 families who sought refugee in PRCS premises in Gaza city after the Israeli army invasion to Tal Al Hawa area and distributed to them 800 Jeri cans, drinking water, blankets and hygiene kits.

Palestinians_seek_refuge_in_PRCS_AlMoreover, PRCS distributed Hygiene and cleaningkits to 40 injuries at Al Quds hospital, in addition to 280 family water kits and 204 bottles of water to AlQuds, Al Shifa, Al Wia'am, Patient's fiends, AlAwda, and Al Wafa hospitals.

3.6 Blood transfusion services:

PRCS blood transfusion services collected around 800 blood units from differentcities and villages in the west bank. PRCS succeeded in sending 560 blood units toGaza strip though the cooperation of the ICRC.

4. Emergency Appeal

PRCS Emergency Appeal for the crisis in Gaza Strip is seeking USD 19,612,132 (CHF 22,292,143 or EURO 15,103,677) in cash, or services to support the PRCS. This appeal is replacing the PRCS Preliminary Emergency Appeal 2009, launched by the society on December 31st 2008, and is the priority of the PRCS Country Plan 2009-2010 launched late 2008 through the Federation (MAAPS001), for its ongoing humanitarian programs in the occupied Palestinian territory and the Diaspora. As a member of the International Federation of Red Cross and Red Crescent Societies the PRCS works to accomplish the Global Agenda of the Federation, partnering with local community and civil society to prevent and alleviate human suffering from disasters, diseases and public health emergencies.