Mohammad al-Ajouri is a lanky teenager who loves to run, a medalist with ambitions to compete abroad.
But last month he was hit by a bullet when he participated in a protest along the border with Gaza fired by an Israeli soldier. He penetrated his calf and shattered his leg before leaving the tibia. Doctors tried to save the limb, but an infection spread soon. The leg had to be amputated.
During the past month of demonstrations along the border between Gaza and Israel, at least 17 Palestinians suffered gunshot wounds that eventually cost them their legs, according to the Palestinian Ministry of Health in Gaza  In at least three of the cases, the Israeli authorities refused to relocate injured According to lawyers and one of the families of the patients, they could receive medical care that could have saved their limbs.
Since the protests began, Israeli troops have killed 43 Palestinians and injured more than 3,500 with live ammunition, rubber bullets or shrapnel, the Ministry of Health said. Of these, about 2,200 have suffered injuries to the legs.
Israeli officials say the protests along the border fence are violent and cover militant attacks. Israeli media reports that troops have been ordered to first fire warning shots at protesters, after which they should hit the protesters' legs.
"IDF forces are acting on clear rules of engagement tailored to the scenarios they are fighting with." a spokesman for the Israeli armed forces said. The spokesman declined to clarify these rules, but said that the fire is a last resort.
The United Nations, however, says Israel is in an "excessive use of force" and human rights groups point to cases where soldiers have been targeting unarmed demonstrators or those who are not an immediate threat. [19659012"Theuseofsniperscarefulplanningandsignificantlowerlimbinjuriesreflectanobviouslimb-targetingpolicy"OmarShakirIsraeli-PalestinianLegendaryDirectorofHumanRightsWatchinNewYorkEsterLegs"makespoliticsnolessillegal"hesaid"Theuseofliveammunitionineachpartofthebodyinevitablycausesseriousinjuryandevendeath"
Doctors in Gaza are often unable to cope with such traumatic injuries, medical groups say, because the hospitals there are overburdened and understaffed. 19659002] "Even in the most modern hospital in Gaza, it felt like it was in the 1970s," said Salah Haj Yahia, head of the Mobile Clinic for Doctors for Human Rights in Israel. He recently visited Gaza as part of a medical delegation. "If things stay that way, most gunshot wounds will have to be amputated," he said in an e-mail.
Some of the amputations were made immediately after the victims were shot because of the severity of the injuries, the doctors said Victims stabilized, but had to be treated outside Gaza
The Israeli authorities, the To strictly restrict the movement of persons inside and outside the Strip for security reasons, refused the medical evacuation of patients across the Israeli territory to the West Bank.
"It was decided that any application for medical treatment by a terrorist or rioter involved in violent incidents would be denied," said a spokesman for the Coordinator of Government Activities in the Territories, an Israeli Ministry of Defense agency representing Gaza Policies monitored by e-mail
"However, exceptional humanitarian cases are investigated on the basis of an assessment of the security situation and at the discretion of the commander of the region," the statement said.
For some teenagers like Ajouri, the weekly protests were a welcome distraction, an escape from daily life in the Gaza Strip, where work and hope are both rare.
The soft-spoken 17-year-old said he had been injured in a protest on March 30 after he had done so to leave Urn. The bullet raced through his right leg, which was then amputated above the knee.
He is still smiling, his eyes curling as he remembers the medals he won for the 400-meter run. "I'm fast, and I love to walk," he said from his bed in a barren room in Jabalya's refugee camp, while friends and family kept watch. "My hope was to travel to the West Bank and participate in international games."
Alaa al-Daly, 21, was also an aspiring athlete who had hoped to free himself from life in Gaza. As a cyclist, he trained for this year's Asian Games.
On March 30, he participated in a demonstration near Rafah in the southern Gaza Strip. Daly said he drove to the border with friends who assured him that the demonstration was peaceful. After a rifle fire broke out, he hurried to another injured demonstrator. That, he said, was when the bullet pierced his knee.
"I saw my leg and my dreams vanished," Daly said as he stared at the ceiling of a hospital room in Gaza City. A single bullet had wreaked havoc. "I told myself: this was not a bullet, it was like a mini-grenade."
Doctors performed multiple surgeries to repair his blood vessels and restore blood flow to the limbs. After five operations, they amputated his right leg.
According to human rights groups and health experts, the damage to the limbs of the protesters was unusually strong. Doctors Without Borders, based in Paris, have recorded "an extreme level of destruction for bones and soft tissue and large exit wounds that may be the size of a fist".
Human Rights Watch says that there is evidence of gunfire being checked by Israeli forces causing "significant bodily injury," including "breaking bones … and cutting through veins and arteries."
Asked about the type of ammunition used, an Israeli military spokesman said: "In connection with the violent riots in Gaza, the IDF uses only standard weapons and ammunition that are legal under international law."
Israel says his armed response was appropriate to the threat posed by the Palestinians. Israeli officials are accusing the Palestinian militant group Hamas, which controls Gaza, of using civilian demonstrators as cover to "terrorize Israel."
Hamas are "cowardly leaders who hide behind women and children and send them away as human shields" Defense Minister Avigdor Liberman wrote on Twitter. "So that they can continue to carry out terrorist attacks against the state of Israel."
Protesters burned tires, threw rocks and flown dragons with Molotov cocktails over the fence.
Amputees in Gaza have little rehabilitation options. According to doctors for human rights in Israel, there are no doctors who could perform surgical procedures to modify stumps of amputees to receive artificial limbs
and the Gaza City Artificial Limbs and Polio Center, the only facility in Gaza Prosthesis manufactures technicians say that they are confronted with crippling raw material shortages. Insufficient power also hampers production, so many people need limbs without them.
"Working with limited tools, we have to be creative in how we lock the prostheses," said Abdel Karim al-Sabea, a center technician supported by the International Committee of the Red Cross. "Only with luck will we have the material we need."
Youssef al-Kronz, 19, was shot dead in both legs during the March 30 protests. His left leg was amputated while awaiting Israeli permission for treatment in the West Bank, and the doctors warned him not to lose his remaining leg.
In a ruling on April 16, the Supreme Court said Kronz posed no threat and allowed him to go to the West Bank, where he is now in a hospital. The verdict was only for Kron.
Kronz holds his thick, dark hair in a pompadour and has deep-set eyes that fall down in pain. He says he wants to travel to Turkey or Germany to get a prosthetic leg. Although West Bank medical care is better than in Gaza, the cost of a prosthesis is beyond the reach of his family, and he hopes that a foreign country will provide him with one.
At the moment, however, the top concern is his right leg.
"Our main concern now is to treat his remaining leg so that he can hold the rest of his body," said his father, Iyad al-Kronz, and grabbed his son's medical records.
Iyad was unable to escort his son to the West Bank, instead staying behind at the Bureij refugee camp, a slum of dirty lanes and corrugated-iron houses.
"We can not afford a prosthesis," he said. "He needs at least one leg to survive."
The Ruth Eglash of the Washington Post in Jerusalem contributed to this report.