A/HRC/9/26 page 10 killing and injuring people inside, most residents fled to the street. Once in the street, people congregated to assist those who had been injured. More shells then landed in the street and surrounding lanes, killing and injuring dozens more. A number of survivors ran into surrounding fields. Others indicated running towards the nearby Erez crossing, believing that the Israeli installation there would offer safety. 28. The testimony received by the mission paints a horrific scene. Woken by the first shell, families fled their homes and assembled in the street outside, where dead and injured persons already lay. One mother described being faced with one of her children with an open skull wound while trying to help another son as he scooped his intestines back into his abdomen. Another spoke of helping his injured father to the door of the house, only for him to be killed by a direct shell at the door. As people gathered and attempted to provide assistance to the injured, more shells landed in the street. There was, according to one witness, “no one left standing”. The nature of injuries caused by artillery shells meant the street was “strewn with limbs”. Children were decapitated and a mother worries for her surviving son who “saw his brother cut in half”. 29. Some time after the first shell landed, the injured started to arrive by private vehicle at the Beit Hanoun hospital, most having lost limbs or requiring amputation. Within a short amount of time, 30 to 40 injured people arrived at the hospital. The director of the hospital declared an emergency and called for ambulances from across Gaza to assist. The first ambulance to reach the scene of the shelling itself came under fire, the driver and assistant being forced to abandon the vehicle. Footage obtained by the mission of the scene in Beit Hanoun hospital as casualties from the shelling arrived showed an extremely disturbing scene of a small hospital crowded with medical staff, victims with blast injuries and their families. Medical staff interviewed by the mission described not only the trauma in dealing with the onslaught of casualties, but also of their exhaustion following their efforts during the Autumn Clouds incursion, as described above. 30. The shelling resulted in the immediate death or mortal wounding of 19 civilians, including seven children and six women. All but one of the victims were from a single family group, the Al-Athamna. Over 50 others were wounded during the attack. 31. A number of the more seriously injured required treatment that could not be provided in Gaza. Families of the injured ran directly to the Erez crossing to plead for Israeli approval to transport injured people to Israeli hospitals. According to survivors, approval to move some injured to Israeli hospitals was received only some 12 hours after the shelling. Survivors told how significant obstacles were placed in the way of individuals travelling to Israel for emergency treatment, in particular: (a) The refusal by Israeli authorities in some cases to allow the injured to be accompanied by family members. This was particularly distressing in the case of the elderly and children who travelled without their closest relatives; (b) The refusal by Israeli ambulances to transport the injured from Erez crossing to Israeli hospitals without an immediate payment of some thousands of shekels. These fees were later reimbursed by the International Committee of the Red Cross.