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GAZA (May 1, 2024)—In bombed-out Gaza, thousands of child amputees and injured children are struggling to recover without adequate pain relief and devices like wheelchairs, according to ��ɫ��Ƶemergency medical staff, as the looming Rafah incursion threatens to kill and maim more children.

Over six months of war in Gaza, the rate of attacks on healthcare in Gaza has been higher than in any other recent conflict globally, according to

UNICEF found that more than 1,000 children underwent leg amputations between October and November 2023. It’s likely that many more children have suffered leg and arm amputations since then, including as young as one year old.

Amid a decimated health system, doctors and nurses are adopting breathing and distraction techniques to try to avoid inflicting extra trauma on children by causing pain during treatment.

The life of 13-year-old Solave* changed when a bomb hit her aunt’s house, where she was sheltering, and doctors had to amputate her leg. Her family said Solave* was receiving treatment at Al Shifa hospital when fighting once again reached the hospital, forcing them to leave her on her own at the hospital for 15 days. Her mother Basema* said that during the hospital siege Solave’s* bandages weren’t changed regularly and her wounds became infected.    

Basema* said:

“The doctors decided to amputate her leg because they couldn’t save it with treatment. When I told my daughter her leg was gone, she was confused. She felt like her leg was still there, she was staring at me and my husband. She was in denial that her leg was gone.

“We tried to offer her support and reassure her that she would get a prosthetic leg. But she was asking how she would get to her classroom because it’s on the third floor of her school. Before the war, she loved to swim and draw, but since her injury all her thoughts are on her leg, and how she will walk again. Now she’s only thinking about how much pain she feels when they change the dressing.”

Ahmed,* 10, used to live near Gaza City with his family of eight. One afternoon in March, he was playing outside with other children when an airstrike hit a nearby area and some rocket shrapnel tore into his leg, breaking his right thigh. Ahmed’s* father Mohammed* said that after taking him to a crowded hospital, Ahmed* was left on the floor for four hours lying in his own blood before there was a bed available for him. Medical staff were carrying out operations in the same room so he had to cover his son’s eyes.

Mohammed* said:

“My son witnessed things that children should not see. Scenes of blood, his leg being broken, scenes of children being killed around him. 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.”

In any conflict involving explosive weapons, children are seven times more likely to die from blast injuries than adults. They tend to experience different types of injuries than adults and require specialist care that accounts for their physiology and growth.

Xavier Joubert, Save the Children’s Country Director in the occupied Palestinian territory, said:

“Our pediatric staff say they are seeing lots of children with injuries caused by explosive weapons who are suffering unimaginable physical and mental harm. 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.

“What is worse, over 600,000 children currently in Rafah are waiting for a potential ground incursion, which would leave absolutely no escape for children, likely exposing them to more explosive weapons. All parties to the conflict must end the use of explosive weapons in populated areas and reach an immediate and definitive ceasefire. It is the only way to save children’s lives.”

��ɫ��Ƶhas been providing essential services and support to Palestinian children impacted by the ongoing conflict since 1953. Our Emergency Health Unit (EHU) is in Gaza, working through a partner to provide specialized pediatric services for children in a field hospital established by a partner in Al-Mawasi. Pediatric staff are treating children with minor injuries, critically ill children, and newborns.  

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