Palestinians carry their belongings in Khuzaa, east of Khan Younis, on 3 August 2014 following Israeli air strikes and shelling. Yasser Qudih APA images

The Israeli military opened fire on a mass march of civilians who were carrying white flags and calling out “peaceful, peaceful” as they tried to exit Khuzaa village in southern Gaza, which had been under siege for three days, corralling them back into the village.

Those who were trapped in the village had tried to coordinate a safe evacuation with the International Committee of the Red Cross, but Israel’s shelling would not let up.

This is one of the many disturbing findings from one of the only international and independent fact-finding missions that Israel has allowed to access the Gaza Strip since the 26 August ceasefire that ended 51 days of intensive bombing.

Last week the mission published “No Safe Place,” a more than two hundred-page report on their findings from their forensic investigation. The mission’s aim was to assess the types, causes and patterns of injuries and deaths and to collect evidence for potential use in local or international justice mechanisms.

The investigation devotes special attention to the siege on Khuzaa, detailing the attempts civilians made to flee Israeli fire and finding that the army used people as human shields, executed civilians at close range, and intentionally neglected mortally wounded children. During the four days of heavy bombardment of the village, scores were critically injured. While the report refers to twelves deaths specifically, it says the total number of casualties remains unknown.

The report also finds that most of those who were killed during the summer assault were crushed to death, frequently in their homes, and often with other members of their family by their side. More than 142 families lost at least three members in a single strike. Recent casualty counts estimate the total killed as at least 2,257 and as high as 2,310.

Organized by Physicians for Human Rights-Israel and Gaza-based Al Mezan Center for Human Rights, the investigation team consisted of international experts from the fields of forensic pathology, emergency medicine, pediatrics and health and human rights.

The delegation interviewed 68 injured patients and reviewed 370 digital images and records of those killed and the report includes transcripts of interviews with injured civilians and medical professionals. While limited in scope and access, the report concludes that evidence suggests several serious violations of human rights and international humanitarian law.

All of Gaza a battlefield

The report confirms what was reported at the time: indiscriminate and total bombardment of the Gaza Strip.

While in some cases the Israeli military dropped warning leaflets or sent “warning strikes” or “roof taps,” this did not save lives as there were no clear boundaries of where the battlefield was. The army targeted possible escape routes, ambulances carrying wounded people, and individuals attempting to flee.

Hospitals overwhelmed

The mission found that the rate of injury and death overwhelmed the capacities of hospitals in the Gaza Strip, and the destruction of medical facilities further undermined medical workers’ ability to adequately treat patients. Doctors testified that they were forced to take shortcuts like not using sterile gloves or sterile gauze and had use makeshift suture material. Some patients reported that they found maggots in their wounds after leaving the hospital.

For those needing rehabilitation, their options are now worse. Gaza’s sole public rehabilitation hospital, al-Wafa, was completely destroyed during the war. And while there are other private or nongovernmental medical rehab facilities, there is a lack of cohesion in providing services to the population in part because many international groups refuse to coordinate with Hamas government authorities.

Psychological trauma

The majority of the 68 patients interviewed suffer insomnia, flashbacks, nightmares, screaming, loss of appetite, weight loss, depression and unstable emotional states.

Doctors and nurses said that the trauma they saw was not just a from the attacks, displacement, threats of joblessness and poverty, but also the sense of total isolation from the rest of the world. Those interviewed said that Gaza’s dire situation affects individuals’ life choices, like whether or not to get married and have children.

Medics under attack

Yousef al-Kahlout, a 32-year-old medic with the Palestine Red Crescent Society, said Israel’s tactics posed a danger more grave last summer than in previous wars. Ambulances came under repeated attack and first responders were put at risk by Israel’s method of striking a single target multiple times in close succession, a method called “double tapping.”

The report adds that the Israeli military would often refuse to coordinate with the International Committe of the Red Cross to allow local medics into an area to evacuate casualties, forcing them to enter dangerous areas at their own risk.

Even when the Israeli military would coordinate with the Red Cross to allow Red Crescent staff to enter an area, medics would come under fire.

Powerful explosives used indiscriminately

Huge numbers of injuries and deaths last summer were caused by the indiscriminate use of large amounts of powerful explosives, the report states.

One weapon used to inflict such destruction is called an “explosive barrel” by local residents and “Tzefa Shirion” (Viper Armour) by the Israeli military. Its stated purpose is to clear landmines for advancing troops, but Israel used it in at least two neighborhoods in Gaza: Khuzaa and Khan Younis. The device can be rolled out from a tank or dropped from the sky; as the barrel rolls forward, its explosives are detonated and a corridor is created for the military.

The mission also found evidence corroborating the use of flechette shells, which indiscriminately spray thousands of tiny darts, and evidence suggesting the use of Dense Inert Metal Explosives (DIME), an experimental weapon that was previously used in Israel’s 2008-2009 military attack on Gaza. Doctors also found computer chips with SONY markings embedded in bodies like shrapnel.

The publication ends by encouarging the pursuit of justice, while also acknowledging the deep sense of pessimism Palestinians have towards any international mechanism to deter Israel’s constant attacks on Gaza. One head nurse at al-Shifa hospital said: “Many felt that ‘another report’ documenting their pain and suffering would be ineffective in addressing the root causes of the morbidity and mortality they experience daily.”