Improved emergency health care for GMR injured in the Gaza Strip The project aims to contribute in reduction of the mortality and incidence of disability in case of injury of people participating in peaceful demonstration and also to improve the living conditions of people gained permanent disability due to injury. March of return demonstrations in the besieged Gaza Strip persist weekly on Fridays since march 2018 and overburdened the health system with massive casualties, and remains a major burden of disease on the health sector in Gaza. The project includes three components which are providing first aid to injured in site of injury, providing postoperative care to early discharged injured through disciplinary team and providing rehabilitation to injured with permanent disability.

Therefore, PMRS will continue providing first aid interventions at the sites of clashes to the injured through deploying 32 skilled and trained first aid workers (24 males and 8 females) in four sites of clashes Malaka, Abu Safiys Al-najar and Annahda. Their role is to provide first aid, evacuation to injured by live bullets, rubber bullets, Gas canister and excessive tear gas Inhalation. 
Also first aid workers help injured with more serious injury in place through applying immediate first aid actions that can be lifesaving like stope bleeding, CPR, fixation of neck fracture …etc in order to stabilize or minimise the deterioration of injured until they reach professional medical care. Other role for first aid workers is evacuation of injured from site of injury and transporting injured to the nearest ambulance and then to trauma stabilisation point. This is important as carrying injured from site of injury should be done safely and not hazardous as it used to be when no first aid worker available in place and people do this spontaneously. 
The first aid workers based in the previous experience projected to help each month at least 300 injured including 235 adult males and 23 females, 35 boys and 7 girls. 
Second component include providing appropriate follow-up care for new injured early discharged from hospitals and for old injured served by PMRS and in waiting list for limp reconstruction and other surgical operation. Care is given by multidisciplinary team including nurse, physiotherapist, psychosocial, and specialised doctors. The provision of services includes wound management at home through dressing sessions, physiotherapy and psychological first aid interventions, medications and assistive devices. Also injured during the process of treatment will be referred to PMRS centre to be checked up by vascular, orthopaedic and neurologist consultants were their recommendations will be followed by the MDTs.  
For this intervention PMRS will mobilise two health teams covering three governorates  (North, Gaza, Khan Younis). The project will cover and facilitate transportation of injured in need for spatiality consultation to PMRS health centre in Gaza.
PMRS started postoperative care on November 2018 through 2nd Standard allocation provided service to 490 injured at home were 304 of them completed their treatment, 123 still under treatment and 63 are waiting for limb reconstruction operation. 

In this project PMRS will expand services to continue treatment of 123 injured and providing wound care to 63 after limp reconstruction operations and adding 214 early discharged new injured patients. In total the postoperative care serve 400 injured including 300 adults' male, 20 females, 75 boys and 5 girls.
The third component include improving the living condition of injured acquired permanent disability mainly amputation through providing home adaptations including adaptation of bathrooms for 36 injured, adaptation of house entrance and stairs for 16 injured and furniture adaptation for 48 injured.