Gaza’s child amputees face further risks without expert care. The explosion in October that struck Noor’s home in Jabalia, Gaza, nearly severed her eleven-year-old left leg. Her right leg may now need to be amputated since it is equipped with a hefty metal rod and four screws that are bored into the bone.

“It pains me… Looking at her bulky fixation device, she spoke from her hospital bed, “I’m afraid they’ll have to cut off my other leg.”

“Before I lost my leg, I used to run and play and was content with my life. As a result, my life turned nasty and I became depressed. I’m hoping to receive a prosthetic limb.”

A generation of young amputees is growing in bomb-ravaged Gaza as Israel’s retaliation campaign following Hamas’s deadly strikes on October 7 has resulted in explosions and crush casualties as explosive weapons rip through tightly packed high-rise dwelling complexes.

Israeli officials have stated in the past that they try to minimize injuries to people. The military spokeswoman for Israel referred to Hamas’ “exploitation of civilian structures for terror purposes,” but she made no mention of kid amputees specifically. According to medical professionals and relief workers, Gaza’s crumbling healthcare system is not set up to provide youngsters with the complex aftercare required to preserve their still-developing, shortened bones. The World Health Organization reports that because of deaths, detentions, and displacements, just thirty percent of pre-conflict medics are still employed.

According to the U.N. children’s agency UNICEF, by the end of November, over 1,000 children had suffered limb amputations, sometimes more than once or on both legs, in a conflict where, according to Gaza health authorities, about a quarter of casualties were among children.

Lack of medication and poor cleanliness lead to further problems and amputations of pre-existing injuries, some of which may not be treatable, according to medical professionals.

“Many limbs that were thought to be preserved will eventually need to be amputated. Furthermore, a large number of individuals who had limbs amputated or believed to be rescued may yet die from the longer-term effects “Dr. Chris Hook, a British emergency medicine physician with the nonprofit organization MSF, who returned from Gaza in late December, warned.

DECAY AND FLIES

The staff at the triple-capacity European Hospital in Gaza, where Noor is receiving treatment, is unable to give her the replacement leg she desires.

According to workers, even medications for amputees experiencing chronic pain are running low. A Reuters journalist visited the ward and saw flies swarming about it.

“I try as much as I can to make things easier for them as a nurse, but no matter what you do, they have severe psychological problems, they feel incomplete with lots of pain,” Wafa Hamdan, a nurse, said.

According to Gaza health officials, the main prosthetic limb facility in the enclave, the Hamad Hospital in Gaza City, which receives funding from Qatar, closed a few weeks ago as a result of an attack by Israel.

The unit’s military spokeswoman did not immediately answer a request for comment about Hamad Hospital.

By the time they reach adulthood, children who have had limbs amputated due to war may require up to twelve procedures since the bone continues to grow, according to doctors.

Medical professionals claim that there was a scarcity of vascular and plastic surgeons before the conflict, and over 300 healthcare workers have died as a result, according to Palestinian health officials.

Noor is nevertheless fortunate compared to several kids whose limbs were amputated quickly owing to a lack of time or medical knowledge, often without anesthetics. Noor’s right leg may remain intact.

The WHO Emergency Medical Teams coordinator, Sean Casey, said that “sadly, many of them are really unnecessary.” In some cases, when injured youngsters arrive at the hospital days after the incident, amputation is the only option.

UNICEF spokesman James Elder reported seeing a youngster whose broken left leg had started to deteriorate after being stranded on a bus for over three days because of delays at military checkpoints.

According to Israel’s military spokesperson’s unit, an operational debrief was undertaken to extract quick lessons from the event, and it will be further investigated.

“NO ONE CAN SEE THEM.”

The UNICEF number of 1,000 is valid for the first two months of the fighting, but physicians and humanitarian workers say it has likely been significantly surpassed after that. This makes the amputation rates in Gaza extraordinarily high when compared to past conflicts and disasters, even though the Gaza health authorities do not maintain an official record.

As to the ombudsman’s office, there are thirty documented incidents of kid amputees in Ukraine, where missiles have also destroyed residential towers during Russia’s invasion. Dr. Ghassan Abu-Sittah, a British-Palestinian surgeon, claimed to have completed six amputations in one night in Gaza. He once had to remove pus from a child’s amputated thigh stump by reopening it.

Many patients with infected stumps also returned to MSF’s Hook wound care clinic in Rafah.

After visiting Gaza in December, Mirjana Spoljaric, the president of the International Committee of the Red Cross, said she would never forget the pictures she saw of children—often orphans—lying in hospital rooms with multiple amputations. “On top of the wounds that you see and the lack of pain medication, they are lying there and nobody’s coming to see them.”

When a limb becomes infected, it may need to be amputated again, as happened to 10-year-old Ritash in Gaza. When Gemma Connell met Ritash, she explained this on behalf of the U.N. Humanitarian Office (OCHA).

A picture depicted her scowling while seated in a wheelchair on a filthy hospital floor, her stump protruding upwards. “I think what I have seen would break anyone’s heart,” Connell remarked.