Gaza paramedics executed with explosive bullets as aid blockade deepens crisis

[MIDDLE EAST] The doctor who performed the postmortems on the 15 paramedics and rescue workers murdered by Israeli troops in Gaza in March stated that they were largely killed by gunshots to the head and torso, as well as injuries from explosives. Last month, international outrage erupted when it was revealed that Israeli troops had launched a lethal strike on a group of paramedics from the Palestinian Red Crescent, civil defense, and United Nations officials who were conducting a rescue operation in southern Gaza.

The attack occurred near Al-Shifa Hospital, a facility that has been repeatedly targeted in the conflict, raising concerns about the deliberate targeting of medical personnel. International humanitarian law explicitly prohibits attacks on healthcare workers and infrastructure, yet violations have been repeatedly documented throughout the war.

Israeli forces buried the bodies of 15 workers, along with their crushed vehicles, in a mass grave in Gaza. After retrieving the bodies days later, the UN stated that the victims had been executed "one by one."

Ahmed Dhair, the forensic pathologist in Gaza who conducted autopsies on 14 of the 15 victims, told the Guardian that he found “lacerations, entry wounds from bullets, and wounds from explosive injuries,” mostly concentrated in the torso, including the chest, abdomen, back, and head.

The use of explosive bullets, designed to fragment upon impact, has been widely condemned under international law due to the severe and often fatal injuries they cause. Their use in this case has drawn comparisons to previous allegations of excessive force by Israeli forces in Gaza, although conclusive evidence of systematic use remains scarce.

Most of the victims died from gunshot wounds, including signs of “explosive bullets” or “butterfly bullets,” which explode upon impact, causing severe tissue and bone damage.

“We found remains of explosive bullets,” Dhair said. “In one instance, the bullet head had exploded in the chest, with bullet fragments scattered throughout the body. There was also shrapnel found on the back of one of the victims.” The Israel Defense Forces (IDF) did not immediately respond to allegations that explosive bullets had been used.

Human rights organizations, such as Human Rights Watch, have documented the use of such munitions in conflicts, highlighting their indiscriminate and inhumane effects. If confirmed, their use in this case could damage Israel’s diplomatic relations, particularly with European allies already critical of its military actions in Gaza.

Details about the incident remain disputed. Video footage from the onset of the attack shows ambulances being fired upon, but the circumstances leading to the burial of the 15 victims in a mass grave are still unclear.

Israel’s military admitted to carrying out the killings but revised its account after evidence contradicted its initial claim that the vehicles had been “moving suspiciously” without lights. Israel has alleged, without presenting evidence, that six of the workers were Hamas operatives, a claim denied by the Red Crescent.

The lack of transparency in Israeli investigations of similar incidents has fueled skepticism among international observers. Past inquiries into civilian casualties have often ended with little accountability, intensifying calls for an independent, international investigation into this latest attack.

Dhair noted that his findings did not suggest the paramedics were shot at close range but added that the presence of shrapnel in the bodies indicated they had been struck by some form of explosive device. “In some cases, the injuries appeared to be a combination of explosive and conventional gunfire wounds,” he said.

Regarding allegations that some of the bodies were found with their hands bound, suggesting they were captured before execution, Dhair said he had not observed visible signs of restraint. “Only in one case did we find discoloration and bruising on the wrists, which could possibly indicate restraints,” he said. All the victims were dressed in their work uniforms, and their bodies had begun to decompose.

These findings are likely to increase pressure on Israel to provide a full account of the incident, as accusations of war crimes mount. Israel has said the incident remains under investigation.

It has since been revealed that one of the two surviving paramedics, Assad al-Nsasrah, had been held in Israeli detention, with his whereabouts unknown until this week. Médecins Sans Frontières has warned that Gaza is becoming a “mass grave for Palestinians.” Israel has maintained a blockade on humanitarian aid, including food, fuel, water, and medicine, since 2 March—more than two weeks before the collapse of the ceasefire between Israel and Palestinian militants, followed by renewed air and ground attacks.

Israel has pledged to continue blocking aid from entering Gaza, asserting that its goal is to pressure Hamas into releasing the hostages taken in the 7 October 2023 attacks.

Israel’s defense minister, Israel Katz, stated: “Israel’s policy is clear: no humanitarian aid will enter Gaza, and blocking this aid is one of the primary levers to prevent Hamas from using it as a tool against the population.”

“No one is currently planning to allow any humanitarian aid into Gaza, and there are no preparations to enable such aid,” Katz added, threatening to escalate the conflict if Hamas does not return the hostages.

Amnesty International, along with other aid agencies, has denounced Israel’s blockade as a crime against humanity and a violation of international law. Israel has denied any violations.

More than 51,000 Palestinians have died since the conflict began, with over 1,600 killed since Israel resumed airstrikes and ground operations on 18 March. The Gaza Health Ministry, which does not distinguish between combatants and civilians, has reported that more than half of the deceased were women and children.

In addition, 13 people were killed overnight in airstrikes, including a prominent photographer, Fatema Hassouna, in the northern part of Gaza.

Doctors and aid groups have warned that the humanitarian crisis in Gaza is worsening. “The situation is the worst it has been in 18 months, with the deprivation of basic necessities and the continuation of attacks across Gaza,” said Mahmoud Shalabi, director at Medical Aid for Palestinians.

Israel has been accused of exacerbating the humanitarian situation by targeting hospitals and medical personnel. Two hospitals were hit by airstrikes this week, with Israel claiming Hamas used medical facilities to cover terrorist operations.

The question of resuming aid into Gaza has become a volatile political issue in Israel. There are 58 hostages still held in Gaza, with 24 believed to still be alive following the Hamas attacks on southern Israel in October 2023.

Far-right figures in Prime Minister Benjamin Netanyahu’s government have insisted that no aid be sent to Gaza until Hamas agrees to release the hostages. “As long as our hostages remain in captivity, there is no reason for a single gram of food or aid to enter Gaza,” said national security minister Itamar Ben-Gvir.