The live-fire wounds suffered by more than 1,700 Palestinians in the Gaza Strip over the past month have been unusually severe, Palestinian and foreign doctors say.

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Since the series of demonstrations known as the March of Return began on March 30, Israeli soldiers have killed 37 Palestinians and wounded about 5,000, of whom 36 percent were wounded by live bullets.

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Doctors at Gaza’s Shifa Hospital said they haven’t seen such severe wounds since Israel’s Operation Protective Edge in Gaza in 2014. The aid group Medecins Sans Frontieres said its medical teams have given postoperative care to people “with devastating injuries of an unusual severity, which are extremely complex to treat. The injuries sustained by patients will leave most with serious, long-term physical disabilities.”

Since April 1, MSF has given postoperative care to 500 people with bullet wounds, mostly in the lower extremities. Most were young men, but some were women or children.

“MSF medical teams note the injuries include an extreme level of destruction to bones and soft tissue, and large exit wounds that can be the size of a fist,” the group said in a report on April 19.

It quoted Marie-Elisabeth Ingres, MSF’s head of mission in Palestine, as saying, “Half of the more than 500 patients we have admitted in our clinics have injuries where the bullet has literally destroyed tissue after having pulverized the bone. These patients will need to have very complex surgical operations and most of them will have disabilities for life.”

The report concluded: “Apart from regular nursing care, patients will often need additional surgery, and undergo a very long process of physiotherapy and rehabilitation. A lot of patients will keep functional deficiencies for the rest of their life. Some patients may yet need amputation if not provided with sufficient care in Gaza and if they don’t manage to get the necessary authorization to be treated outside of the strip.”

The London-based group Medical Aid for Palestinians echoed MSF’s findings. It quoted a Shifa surgeon as saying, “The bullets used are causing injuries local medics say they have not seen since 2014. The entrance wound is small. The exit wound is devastating, causing gross comminution of bone and destruction of soft tissue.”

The group’s April 20 report also said that Gaza surgeons had performed 17 amputations – 13 legs and four arms. In addition, a boy shot by Israeli soldiers on April 17 had his left leg amputated in Ramallah. His parents said he was playing soccer near the Israel-Gaza border fence east of the Al-Bureij refugee camp.

Both aid groups repeatedly used the same word to describe the bullet wounds – “destruction.”

To cope with the flood of patients, both official and private medical institutions in Gaza have beefed up their presence near the demonstrations that are taking place along the Gaza-Israel border.

The Palestinian Health Ministry set up five field clinics near the protests in order to stabilize patients before they reach the hospital. Each clinic has three beds plus several mattresses, and is staffed by up to 10 doctors and 15 nurses, plus volunteers.

In addition, the Palestinian Red Crescent has set up five emergency treatment stations. MSF has brought in surgical teams that work alongside Gazan teams at the Shifa and Al-Aqsa hospitals.

Yet the World Health Organization says the lack of medication and nonreusable medical supplies like bandages is undermining the ability to give patients proper care. The Palestinian Health Ministry urgently needs stocks of 75 essential drugs and 190 types of nonreusable medical supplies.

The WHO also criticized Israel for harming medical personnel, saying 48 medical staffers have been wounded by Israeli fire while trying to evacuate the wounded. At least three were hit live bullets. In addition, 13 ambulances were hit by live bullets or tear gas grenades.

Between March 30 and Thursday, 1,539 Gazans were wounded by live bullets and around 500 by sponge-tipped bullets, according to the Palestinian Health Ministry. Of the victims, 62.3 percent were hit in the lower body, 16 percent in the upper body, 8.2 percent in the head or neck, 4.8 percent in the stomach and four percent in the chest. In addition, 4.7 percent had multiple injuries.

On Friday, the ministry said 729 Palestinians were wounded by Israeli bullets or riot-control equipment, of whom 305 required hospital treatment. Of the latter, 156 were hit by live bullets.

Fifteen of the 305 hospitalized patients were women, it added, while 45 were children. Altogether, 500 minors have been wounded by Israeli fire since March 30.