Things are complicated by civilians whom you have to avoid opening fire on. If you do cause civilian casualties, you'll lose points, which I'd say is getting off rather lightly.
Another thing that makes this game tougher than a whack a mole clone is that your firearm runs out of ammunition. When that happens you have to reload, which leaves you defenceless, giving the bad guys a chance to shoot back - thus depleting your health bar.
With everything going on in troubled parts of the world, I felt somewhat uncomfortable. Then again, if you don't want to take things too seriously this could while away a few minutes here and there.