At 10 PM on August 8, a twenty-year-old resident of the Al Amari refugee camp named Muhammad Qatri arrived dead at the Palestinian Medical Complex in Ramallah. He had been killed by Israeli soldiers during a protest near the illegal West Bank settlement of Psagot — shot through the heart right on the spot on his shirt that read, “Gaza.”

From the parking lot outside the hospital’s emergency room, a group of men bellowed chants about the latest unarmed young man to fall before Israeli gunfire in an usually bloody few weeks. I arrived at the hospital gates with a colleague and met Dr. Rajai Abukhalil, a 26-year-old resident physician who had just phoned Qatri’s father to deliver the bad news. Not even midway through his night shift, Abukhalil was already on his fifth coffee and still awaiting a free moment to take breakfast.

At a coffee kiosk behind the hospital’s emergency room, Abukhalil told me Qatri’s body arrived cold. The soldiers who killed him had apparently delayed his evacuation by at least an hour, possibly preventing the opportunity to save his life.

Most disturbing about the killing was how familiar scenes like it had become. According to Abukhalil, the Israeli army has exhibited a clear pattern of either shooting to kill or shooting to cripple over the past six months. Rather than disperse protests with traditional means like teargas and rubber coated metal bullets, the army has begun firing at protesters’ knees, femurs, or aiming for their vital organs.

Like the army’s old policy of breaking the arms of young stone throwers to deter protests during the First Intifada, the new tactic suggests an attempt to winnow out the ranks of demonstrators by shattering their legs. By eroding the front line of protests through brute force, Israel’s military is apparently trying to undermine the capacity of Palestinian society to mount an effective new Intifada.

“It’s very much like the bone breaking policy of the First Intifada but it’s a more specific and less media attention-grabbing policy,” Abukhalil explained to me. “No matter how much people want to resist, everyone’s human. If you get shot or someone next to you gets shot, you won’t be on the front line at the next clash. And then there will be no front line.”

Abukhalil said he first witnessed signs of the shoot to cripple policy in the Jalazone refugee camp near Ramallah. Following the gratuitous killing of a 15-year-old boy shot in the back in December by a sniper hiding near his school, protests raged throughout the camp. As the army cracked down, it began aiming for the knees of demonstrators, according to Abukhalil.

“Every Friday we’d have ten to twenty guys coming in [to the hospital] all injured around the knees,” he explained. He added that many of the wounded demonstrators claimed to have heard the Israeli commander in Jalazone, “Hilal,” order his soldiers to cripple as many protesters as they could.

At the 10,000-strong Palestine Authority-sanctioned march on June 24 from Ramallah to the Qalandia checkpoint separating the occupied city from Jerusalem, the shoot to cripple tactic was on bold display. The first twenty injuries doctors at the Palestinian Medical Complex treated had been shot above the waist — soldiers aimed at their vital organs. Two ultimately died while others were miraculously saved despite critical injuries.

“It was shoot to kill at first,” Abukhalil recalled. “We had eight to ten extremely critical cases. It was amazing that they made it. One had a bullet in the heart. The other had a bullet in the major vessels in the neck. Then after the first injuries it shifted, it was shoot to cripple. We had more than 100 injuries in the femur and the knee.”

By the following day, the Palestinian Ministry of Health reported a total of 280 injuries, most from Israeli live fire. Abukhalil told me it took four days for the hospital’s team of orthopedic surgeons to complete their operations. “Many of the injured will suffer for life,” said. “They have metal in their legs; many will definitely have problems walking if not be crippled 100%. Many won’t be able to run or walk long distances without pain.”

Doctors at the Palestinian Medical Center have recently begun treating critical wounds inflicted by “dum dum” bullets. Banned under customary human rights law, the ammunition is designed to cause extreme damage to tissue by expanding outwards upon entry, thereby preventing the bullet from exiting.

“You can’t extract it,” Abukhalil said of the dum dum bullets. “It goes in and explodes and expands outwards. If you try to remove it you could harm the muscle or the bone so if it hits the bone you just have to keep it in there.”

Doctors who had worked at the hospital for more than a decade told Abukhalil they had not seen dum dum bullets in use since the bloody days of the Second Intifada in 2000.

For the first time since the beginning of Israel’s most recent assault on the Gaza Strip that has left over 1900 dead, the Palestinian Medical Center in Ramallah has begun receiving survivors evacuated from Gaza for post-op care. I met two of them in the hospital’s recovery ward.

In a bed on one side of a room lay Majdi Abu Ganima, his right leg badly fractured and swollen from shrapnel received during Israel’s combined aerial and artillery assault on the neighborhood of Shujaiya. On the other side of the room was Waseem Washa’a, also the victim of compound fractures to his legs inflicted by artillery and F-16 fire during the attack.

The two young men lay in a semi-sedate state while a few male family members stood around bantering. Washa’a told me he was wounded in the street while attempting to evacuate under heavy shelling. He was rescued by strangers as his home was destroyed by missiles from an F-16, arriving at Gaza City’s overcrowded Shifa Hospital the same day. His entire neighborhood was flattened and he has no idea what became of his friends and neighbors. He was lucky to be alive.

Still weary from the trauma he had endured, Washa’a spoke to me in short, halting sentences. Finally, as our interview concluded, he remarked to me, “Open up Gaza. End the siege. That’s what I want to say.”

A “Day of Rage” has been called across occupied Palestine to protest the continuing attack on Gaza. With protests expected in all West Bank cities and occupied East Jerusalem, many more may fall in agony before the barrels of soldiers shooting to cripple.