A/HRC/12/48 page 197 904. Flechettes were fired during the military operations on several occasions by tanks and on at least one occasion from an air-to-surface missile of the “Helfire” type.486 In all cases those hit by these devices were civilians and in one case were attending a condolence tent following the loss of a family member who was also killed by flechettes. 905. Flechettes are known to bend, break or “tumble” on impact with human flesh. Such performances are often part of the flechettes design characteristic and are marketed as such. “Tumbling” in particular is adjudged to be a further determination of the projectiles “incapacitation” effect.487 The Mission notes, however, that flechettes can be designed to be free of these post-impact characteristics if it is desired that they should do so. C. Alleged use of munitions causing a specific type of injury 906. The Mission received reports from Palestinian and foreign doctors who operated in Gaza during the military operations of a strikingly high percentage of patients with severed legs as a result of the impact of projectiles launched by the Israeli armed forces. Dr. Mads Gilbert, a Norwegian anaesthetist, and Dr. Eric Fosse, a Norwegian surgeon, who carried out surgery in al-Shifa Hospital from 31 December 2008 to 10 January 2009,488 described to the Mission the characteristics of the wounds. The amputations mostly occurred at waist height in children, generally lower in adults, and were combined with skin-deep, third-degree burns, four to six fingers upward from the amputation. Where the amputation took place, the flesh was cauterized as a result of the heat. The patients with these amputations had no shrapnel wounds, but red flashes on the abdomen and chest. The excision of large pieces of flesh was not infrequent in these patients. Dr. Gilbert added that the patients also suffered internal burns. This description was confirmed to the Mission by Palestinian surgeons. 907. The Mission understands such injuries to be compatible with the impact of DIME weapons. DIME weapons consist of a carbon-fibre casing filled with a homogeneous mixture of an explosive material and small particles, basically a powder, of a heavy metal, for instance, a tungsten alloy. Upon detonation of the explosive, the casing disintegrates into extremely small, non-lethal fibres. The tungsten powder tears apart anything it hits. The impact of such weapons in general causes very severe wounds within a relatively limited diameter (compared to other projectiles) from the point of detonation. As the small heavy metal particles can slice through soft tissue and bone, survivors close to the lethal zone may have their limbs amputated and tungsten alloy particles embedded in their bodies. The probabilities of injuries to persons at a greater distance from the detonation point are reduced compared to more conventional projectiles. It is therefore also referred to as a “focused lethality munition”.489 486 See Abduldayem case in chapter XI. William Kokinakis and Joseph Sperrazza, “Criteria for incapacitating soldiers with fragments and flechettes (U)”, Ballistic Research Laboratories Report Number 1269, Aberdeen Proving Ground, Maryland (January 1965). 487 Mads Gilbert and Eric Fosse, “Inside Gaza’s al-Shifa hospital”, The Lancet, vol. 373, No. 9659 (17 January 2009), p. 200. 488 The DIME munitions subject of discussion here are distinct from the missile described, for example, in the al Maqadmah mosque case. In that case the missile had been fitted with a micro-shrapnel fragmentation sleeve. The 489