A/HRC/40/74 85. Amputations and disabilities have placed a huge burden of care on individuals, families and communities, and disproportionately affected women, mothers, daughters and sisters. Given the unprecedented degree of poverty and food insecurity in Gaza, the loss of a wage-earning family member can lead to severe financial constraints and deep psychological impact. 86. The enormous burden of injuries from the protests has affected health care for all Gazans. After the demonstrations, hospitals were forced to divert resources away from ordinary medical needs, such as cancer treatment, obstetrics and routine operations, with far-reaching effects. Approximately 8,000 elective surgeries were cancelled or postponed, resulting in a backlog that will take years to address. 87. As the health system in Gaza deteriorated owing to the blockade, doctors began to refer cases requiring equipment and expertise that were unavailable to hospitals in East Jerusalem, the West Bank and abroad. Israeli and Egyptian authorities denied, delayed or did not respond to several requests of persons to exit Gaza for medical treatment, with fatal consequences. 88. In early April, the Coordinator of Government Activities in the Territories denied exit permits for wounded demonstrators, primarily on the basis of the policy of the Minister of Defense to deny passage to any person injured during the demonstrations. 89. Although the Supreme Court of Israel subsequently rejected the above-mentioned blanket policy, those injured in the demonstrations continued to face significant challenges in obtaining medical treatment outside Gaza, as illustrated by the case below: • Zakaria Bishbish (14) On 30 May, Israeli security forces shot Zakaria, from the Maghazi refugee camp, in the back at the demonstration site in El Bureij, while he was at least 100 m from the separation fence. The gunshot perforated Zakaria’s stomach and colon, splintered his vertebrae and damaged his kidney. His family sought a two-week exit permit to seek life-saving treatment at Saint Joseph Hospital in East Jerusalem, which had arranged a medical appointment for 4 June. The Coordinator of Government Activities in the Territories, however, denied the request, giving no reasons. His family then attempted to secure appointments for him in Egypt and the West Bank; the Coordinator did not respond to their requests. On 18 June, Zakaria died of sepsis. VIII. Impact on Israel 90. No Israeli civilian deaths or injuries were reported during or resulting from the demonstrations. According to Israeli sources, four Israeli soldiers were injured during the demonstrations. 91. On 20 July, a Palestinian sniper shot Staff Sergeant Aviv Levi of the Givati Brigade while he was near the separation fence opposite Kibbutz Kissufim. According to Israeli sources, he was shot from the first line of houses in Gaza. 92. Extensive damage to Israeli civilian property was caused by hundreds of incendiary kites and balloons launched from the Gaza Strip during the demonstrations. Some landed in empty educational institutions and private houses; others burned agricultural land and crops, causing significant property damage. Civilians in southern Israel reported experiencing psychological distress related to the fires and their fear of demonstrators crossing into Israeli territory and reaching their communities. IX. Findings 93. The commission investigated all 189 fatalities and tracked more than 300 injuries caused by the Israeli security forces at the demonstration sites and during the demonstrations. 18