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Gaza City, Gaza Strip

Patients with gunshot wounds filled wards and hallways in Gaza’s under-equipped and overwhelmed main hospital Tuesday, with dozens still waiting in line for surgery a day after Israeli soldiers shot and killed 59 Palestinians and wounded hundreds in mass protests on the Gaza border.

The high casualty toll triggered a diplomatic backlash against Israel and new charges of excessive use of force against unarmed protesters. The U.N. Security Council began its session Tuesday with a moment of silence for the dead, and the U.N.’s special Mideast envoy said there was “no justification for the killing.”

Turkey expelled Israel’s ambassador, and several European countries called for an international investigation.

Israel said it has the right to protect its border and nearby communities, accusing Gaza’s ruling militant group Hamas of carrying out several attacks under the guise of the protests. The U.S. ambassador to the U.N., Nikki Haley, came to Israel’s defense, saying no member “would act with more restraint than Israel has.”

Monday’s border confrontation was the culmination of a weeks-long protest campaign to break a border blockade that Israel and Egypt imposed after a Hamas took over Gaza by force in 2007. The protests were led by Hamas, but fueled by the growing despair among Gaza’s 2 million people who face worsening poverty, unemployment, 22-hour-a-day power cuts and sweeping bans on travel and trade.

The protests were also driven by anger over the relocation Monday of the U.S. Embassy in Israel from Tel Aviv to contested Jerusalem. Palestinians seek Israeli-annexed east Jerusalem as a future capital.

Even before the latest round of bloodshed, Gaza’s health system of 13 public hospitals and 14 clinics run by NGOs had buckled under persistent blockade-linked shortages of medicines and surgical supplies. At Shifa Hospital in Gaza City, the main health facility in the strip, these woes were magnified this week.

Anticipating a major influx of casualties ahead of Monday’s mass march, Shifa had set up an outdoor triage station under a green and blue tarp in the hospital courtyard, setting up 30 beds and stretchers there.

Throughout the day Monday, Shifa received about 500 injured people, more than 90 percent with gunshot wounds, said hospital director Ayman Sahbani. Of those, 192 needed surgery, including 120 who needed orthopedic surgery, he said.

By mid-afternoon Tuesday, overwhelmed surgeons working in 12 operating theaters had only performed 40 orthopedic operations, with 80 others still waiting their turn.

In the orthopedics department, nerves were frayed Tuesday as relatives worried about wounded family members amid fears their conditions might deteriorate.

Nickolay Mladenov, the special U.N. envoy to the region, told the Security Council on Tuesday that hospitals in Gaza were “reporting an unfolding crisis of essential medical supplies, drugs and equipment needed to treat the injured.”

On Monday, Israeli forces shot and killed 59 Palestinians and wounded more than 1,300. Two more Palestinians were shot dead in scattered border protests Tuesday, bring the total since late March to more than 100.

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