UN estimates 42,000 adults and children in Gaza have life-changing injuries | BBC News

Key Concepts

• Humanitarian Impact: The severe consequences of the Gaza war on the civilian population, particularly children.
• Life-Changing Injuries: Injuries resulting in permanent disability or significant alteration of daily life.
• Child Amputees: Children who have lost one or more limbs, a population noted as the largest in modern history in Gaza.
• Medical Evacuations: The process of transporting critically injured or ill individuals out of a conflict zone for specialized medical treatment.
• Prosthetics and Assisted Devices: Artificial limbs and equipment designed to aid individuals with disabilities.
• Chronic Traumatic Stress: A state of persistent psychological distress resulting from ongoing or repeated exposure to traumatic events, distinguished from Post-Traumatic Stress Disorder (PTSD) which typically implies a "post" event phase.
• Mental Health Services: Therapeutic interventions including individual, group, and art therapy aimed at addressing psychological trauma.
• Heal Palestine: A nonprofit organization co-founded by Dr. Zena Salman, focused on supporting children in Gaza.

Humanitarian Crisis and Impact on Children

The war in Gaza has inflicted an enormous humanitarian toll, with a particularly devastating impact on children. The World Health Organization (WHO) estimates that 42,000 people in Gaza have suffered life-changing injuries, including approximately 10,000 children. A critical figure is that 3,800 children require specialist medical treatment outside of Gaza. The UN's WHO has urgently called for fuel, medical supplies, prosthetics, and assisted devices, emphasizing the need to prioritize medical evacuations.

Dr. Zena Salman, co-founder of Heal Palestine, highlights the unprecedented scale of suffering. Children have not only endured severe physical injuries but also "unimaginable trauma" over the past two years and even prior. Gaza now has the largest population of child amputees in modern history, with children losing one, two, three, or even four limbs. Many children have also been displaced multiple times from their homes, witnessing profound destruction and loss.

Challenges for Aid Workers

The humanitarian crisis extends to aid workers themselves. Dr. Salman describes the dire conditions faced by her team on the ground, who are "suffering just like everyone else." They are experiencing starvation, with instances where team members are unable to communicate effectively due to hunger, stating, "I'm sorry. I can't respond. I can barely think. I haven't eaten since yesterday." This underscores the pervasive nature of the suffering, affecting "100% of people" in Gaza, including those trying to provide assistance.

Medical Evacuations and Prioritization

Heal Palestine works in partnership with the World Health Organization to facilitate medical evacuations. To date, they have successfully brought 63 children out of Gaza. While the majority are amputees, others suffer from various injuries, congenital defects, or diseases for which care is unavailable due to the destruction of the healthcare system.

Prioritization for evacuation is "incredibly difficult," as physicians on the ground must decide between thousands of injured adults and children. Dr. Salman questions the ethical dilemma: "How can you decide who's worse, a child with cancer or a child with heart disease? ...a child who's missing one limb or two." This highlights the impossible choices faced by medical professionals in a collapsed system.

Psychological Trauma and Mental Health Support

The psychological impact on children is profound and widespread. Even those considered "lucky" enough to be evacuated for medical and mental health care remain "incredibly traumatized." Dr. Salman notes observable symptoms in children, including screaming in the middle of the night, bedwetting, difficulty functioning in school, and significant behavioral changes.

Statistics reveal the severity of the mental health crisis:

• Over 90% of the population is depressed.
• Over 80% exhibits anxiety symptoms.

Dr. Salman emphasizes that for these children, it's not "post-trauma" but "chronic traumatic stress," as the trauma is ongoing. Heal Palestine provides mental health services starting in Gaza, with a dedicated team offering group, individualized, and art therapy. For children evacuated through the Rafa border to Egypt and subsequently to the US for temporary medical care, mental health teams continue to provide treatment.

Ongoing Trauma: A Case Study

The persistent nature of the trauma is starkly illustrated by a specific case: a young boy who lost his leg in a bombing and was brought to the US for a prosthetic. He came with his mother, who had left behind six other children and her husband. Just as he completed his treatment and was preparing to return to Egypt to be closer to Gaza, a bomb struck their home. His father was killed, and two of his six siblings were severely injured. This incident tragically demonstrates that even when children receive critical medical care outside Gaza, the ongoing conflict ensures their trauma remains chronic and their families continue to endure immense suffering.

Conclusion

The war in Gaza has created an unprecedented humanitarian catastrophe, particularly for children, marked by widespread life-changing physical injuries, the largest population of child amputees in modern history, and a pervasive mental health crisis characterized by chronic traumatic stress. The healthcare system is decimated, making medical evacuations and prioritization agonizingly difficult. Organizations like Heal Palestine are providing vital, yet challenging, medical and mental health support, but the ongoing conflict ensures that trauma persists, affecting both the direct victims and the aid workers striving to help them. The situation underscores a profound and continuous cycle of suffering that demands urgent and sustained international attention.