A/HRC/23/21 children older than 7 years, there were reactivated haunting memories of the horrors experienced during operation “Cast Lead”. It was stressed that medical experts were themselves survivors of trauma-inducing situations who required counselling. While people in Gaza suffering from physical ailments seek help, those with mental difficulties tend not to, being culturally inhibited from acknowledging mental problems. Even taking this into account, it was reported that there was a treatment gap of 70 to 80 per cent between those who need help but do not receive it because of shortages in the health system. Added to this is the serious health concern relating to disease associated with contaminated water and inadequate nutrition that has led to widespread stunting in children. These impressions were elaborated upon in a meeting with Dr. Eyad El-Serraj, a psychiatrist, who confirmed the observations made by other health specialists and emphasized a variety of issues that were aggravating the situation, including refusals by Israeli hospitals to accept patients from Gaza who were unable to pay the exorbitant costs of treatment. He recommended the creation of a private patients’ fund that could be drawn upon for medical treatment outside of Gaza. D. Ceasefire implementation 25. The ceasefire agreement 11 between the de facto authorities in Gaza and Israel embodied an understanding that, beyond an immediate cessation of hostilities, Israel would refrain from incursions and targeted assassinations in Gaza and would also allow the movement of people and goods at the crossings. Despite the various interpretations of the ceasefire understanding, with some Israelis contending that it was only an agreement to be discussed, there was a general expectation, at least among Palestinians, that Israel would loosen its stranglehold over the civilian population and make life more tolerable. During the period under review, both sides largely refrained from resuming hostilities, although several developments suggested that Israel had not adhered to the spirit of the ceasefire agreement. There were few signs of a loosening of the blockade and, in latter weeks, targeted assassinations of suspected militants and incursions by the Israel Defense Forces into Gaza resumed. The excessive use of force by the Israeli security forces in the enforcement of access restricted areas continued with disturbing regularity. Several setbacks in recent weeks and months are highlighted below. 26. The Special Rapporteur is disturbed by excessive use of force in the enforcement of access restricted areas on land and at sea, as well as by military incursions with bulldozers into Gaza. He is also concerned at the punitive measures taken by Israel, such as rescinding the fishing zone and closing border crossings, which amount to the collective punishment of the civilian population. 27. On 22 February, the Israel Defense Forces reportedly fired live ammunition at a group of Palestinians enjoying a picnic approximately 400 metres from the border fence, resulting in three Palestinians being injured. On 9 and 19 February, a total of six fishermen were arrested in separate incidents less than six nautical miles off the coast. In both incidents, the fishermen were released the same day, but their boats were confiscated. On 18 and 21 February, a total of four fishermen were shot and injured by Israeli forces three nautical miles from shore. Two were shot by rubber bullets, while the remaining two, including one minor, were injured by shrapnel from live bullets. 28. Allegedly in response to a rocket fired on 26 February by the Al-Aqsa Martyrs Brigade, which caused no casualties, Israel closed the Kerem Shalom crossing and 11 12 See “Conflict along the Gaza Strip”, Reuters, 21 November 2012. Available from http://live.reuters.com/Event/Conflict_on_the_Gaza_Strip/57460762.