Gaza boy amputee in a wheelchair carrying a flower in a small pot

Palestinian boy Rashad Nofal, 14, carries a small potted plant in his wheelchair on April 11, 2024 in Doha, Qatar, where medical evacuees from Gaza including numerous amputees are receiving treatment.

(Photo: Marcus Yam/Los Angeles Times via Getty Images)

Gaza Child Amputees Struggle to Recover Amid Israeli Destruction of Health System

Save the Children's Palestine director said that children wounded in Israeli attacks "are suffering unimaginable physical and mental harm."

Thousands of Palestinian children who have lost limbs and suffered other debilitating injuries to Israeli bombs and bullets are struggling to recover due to the destruction of Gaza's healthcare infrastructure and a lack of adequate treatment, medication, and equipment like wheelchairs, Save the Children said Tuesday.

The London-based international charity recently published an analysis concluding that "the rate of attacks on healthcare in Gaza has been higher than in any other recent conflict globally." The group cited figures from the United Nations Children's Fund (UNICEF), which found that more than 1,000 Gazan children had one or both legs amputated during just the first month of Israel's 208-day assault on the besieged coastal enclave. Many more children—the exact number is unknown—have had limbs amputated since then in what UNICEF called "the world's most dangerous place to be a child."

"Our pediatric staff say they are seeing lots of children with injuries caused by explosive weapons who are suffering unimaginable physical and mental harm," Xavier Joubert, Save the Children's country director for Palestine, said in a statement Tuesday.

The father of one 10-year-old boy who was playing outside when he was struck in the leg by shrapnel from an Israeli airstrike described how his wounded son "was left on the floor for four hours lying in his own blood before there was a bed available for him" at a desperately overcrowded hospital.

"My son witnessed things that children should not see. Scenes of blood, his leg being broken, scenes of children being killed around him," the father told Save the Children. "Now he talks about what happened to him all the time. He talks about his dead cousin and his other friends who died. He's always talking about missiles. He even talks about it in his sleep. The scenes he has seen are terrible. One of the girls had her head split open. His cousin had a severe head injury and was in the ambulance with Ahmed."

Ghassan Abu-Sittah, a London-based plastic-and-reconstructive surgeon who specializes in pediatric trauma, recently toldThe New Yorker that "this is the biggest cohort of pediatric amputees in history" and that he sometimes performs as many as six amputations per day in Gaza.

"Sometimes you have no other medical option," he explained. "The Israelis had surrounded the blood bank, so we couldn't do transfusions. If a limb was bleeding profusely, we had to amputate."

The story of 4-year-old Gazal Bakr, as told by The New Yorker's Eliza Griswold, is not atypical:

Gazal was wounded on November 10th, when, as her family fled Gaza City's al-Shifa hospital, shrapnel pierced her left calf. To stop the bleeding, a doctor, who had no access to antiseptic or anesthesia, heated the blade of a kitchen knife and cauterized the wound. Within days, the gash ran with pus and began to smell. By mid-December, when Gazal's family arrived at Nasser Medical Center—then Gaza's largest functioning healthcare facility—gangrene had set in, necessitating amputation at the hip. On December 17th, a projectile hit the children's ward of Nasser. Gazal and her mother watched it enter their room, decapitating Gazal's 12-year-old roommate and causing the ceiling to collapse... Gazal and her mother managed to crawl out of the rubble. The next day, their names were added to the list of evacuees who could cross the border into Egypt and then fly to Qatar for medical treatment. Gazal's mother was nine months pregnant; she gave birth to a baby girl while awaiting the airlift to Doha.

Other children have suffered worse fates. Dunia Abu Mohsen, 12, lost a leg in an October 27 Israeli airstrike on her family home in Khan Younis that killed six of her relatives, including her parents and two siblings. Undaunted, Abu Mohsen resolved to become a doctor so she could help other wounded children. She was recovering in the maternity ward of Nasser Hospital—site of recently discovered mass graves containing the bodies of hundreds of Palestinians—when a shell fired from an Israel tank came blasting into her room. It didn't explode but it hit Abu Mohsen in the head, killing her and wounding several other patients.

Israeli attacks on hospitals and other facilities have obliterated Gaza's healthcare infrastructure and medical workers' ability to adequately treat injured patients. According to the World Health Organization, Israeli forces carried out at least 435 attacks on health facilities or personnel during the first six months of the war on Gaza.

The WHO says only 10 of Gaza's 36 hospitals are at least partially functional, leaving around 350,000 Palestinians suffering from chronic illnesses unable to access essential medicines, supplies, and services.

In addition to the at least 34,568 Palestinians killed by Israeli forces in Gaza, more than 77,000 others have been wounded. Palestinian and international officials say the majority of casualties have been women and children. Overwhelmed and undersupplied hospitals have been forced to amputate arms, legs—and sometimes both—from children without anesthesia.

"We've recently seen an influx of children from other hospitals with wounds and lost limbs, often needing skin grafting and multiple operations, but even getting hold of simple things like strong pain relief is a major challenge," said Becky Platt, a nurse at Rafah field hospital.

"Children are psychologically destroyed by everything that's happened."

"When children have to undergo a procedure to save their limb and avoid infection, we are forced to do it with less pain relief than we'd normally use," she continued. "So, I brought bubbles and games on my phone to distract them, but the reality is that a lot of these procedures need strong pain relief. That is causing huge distress, and it will also add to long-term psychological damage."

"Children are psychologically destroyed by everything that's happened," Platt added. That includes the loss of parents and other relatives—sometimes their entire families. U.N. Women said last month that at least 19,000 children have been orphaned by the war, during which a new acronym has been coined: WCNSF, or wounded child, no surviving family.

Joubert said that "children who have suffered life-changing injuries don't have the sustained, specialist treatment they need—from effective pain relief to long-term rehabilitation—or even a safe home to go back to. They live in overcrowded displacement camps, sharing a tent with their whole family, and sanitation facilities with hundreds of people."

"After six months of unimaginable horror, the healthcare system in Gaza has been brought to its knees," he added. "Healthcare workers are risking their lives daily to give Palestinian children a chance at survival. The constant attacks on healthcare are simply unjustifiable and must stop."

On Tuesday, dozens of humanitarian organizations including Save the Children sent a letter to U.S. President Joe Biden urging his administration to "use all of its influence" to prevent an expected Israeli assault on Rafah, where more than 1.5 million people—most of them forcibly displaced from other parts of Gaza—are sheltering.

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