‘It’s a lifelong injury’: From Gaza to Doha, children bear the scars of war 

Editor’s note: This story contains graphic descriptions of war.

Six-year-old Maryam Dheed-FarajAllah stands to greet visitors with such perfect balance that it takes a moment to realize she is missing her right leg.

Maryam survived an Israeli rocket attack in central Gaza on Jan. 9 that killed her parents and her little brother. After several surgeries and a risky medical evacuation out of the Gaza Strip, she is living in Doha, Qatar, with her surviving relatives. Her 19-year-old aunt, Fatima FarajAllah, is her caregiver.

“She’s all I have left of my sister — of my family,” FarajAllah said.

Children like Maryam are disproportionately bearing the scars of Israel’s bombardment of Gaza. An estimated 17,000 kids have been orphaned or separated from their parents, according to UNICEF, while at least 3,000 have lost a limb in an injury or amputation.

In Gaza, 41% of the population is under the age of 14, according to Palestinian government figures. A staggering number of people injured in the war have been children, but only a small fraction of them have been able to evacuate. On May 7, Israel took over the Rafah crossing, putting a halt to evacuations entirely.

The small Gulf nation of Qatar has taken in more than 1,600 Palestinians in recent months, including dozens of injured children like Maryam. 

Two blasts hit a family home

Click the audio player below to listen to part one of this five-part series:

On Jan. 8, FarajAllah’s extended family gathered in her mother’s home in central Gaza, listening to music and sharing memories. For one night, she said, it felt like there was no war. 

But as they looked out the window, they counted 16 Israeli drones in the sky above Nuseirat. 

Bombing started the next day, and the family sheltered in two rooms. One of FarajAllah’s sisters, Wafa, sat down to breastfeed her baby boy, Mohammed Suleiman. FarajAllah’s 17-year-old brother, Osama, went to the kitchen to make tea.

The house was hit with two blasts. The first threw FarajAllah out of the room. When she regained consciousness, her 27-year-old sister, Wafa, was dead, her body curled around her baby. The body of her 3-year-old son, Kamal, lay nearby. Maryam’s mother, Reem, was killed alongside her 2-year-old son, also named Mohammed. FarajAllah found her nephew’s body so mangled, she said, she could hardly recognize him.

Maryam was covered in blood, her leg nearly severed.

The World reached out to the Israeli military to ask whether this strike was an accident or intentional. In a statement, a spokesperson wrote, “The Israeli Defense Forces is operating to dismantle Hamas military and administrative capabilities. In stark contrast to Hamas’ intentional attacks on Israeli men, women and children, the IDF follows international law and takes feasible precautions to mitigate civilian harm.” 

According to the Gaza Health Ministry, 126 people in Gaza were killed that day. 

FarajAllah and her brother rushed Maryam to a nearby clinic. Eventually, Maryam was transferred to a hospital that could amputate her leg and stop the bleeding. Since no anesthesia was available, doctors had to amputate her leg without it. 

Doctors told the family they didn’t think Maryam would survive because there was blood in her chest, FarajAllah said. “The doctor said, ‘Don’t hurry to operate the leg. Just wait because you will bury her with the leg soon.’”

To get Maryam stabilized, FarajAllah knew she had to get her out of Gaza.

For most of the Israel-Hamas war, the only way for Palestinians to leave Gaza has been through the Rafah crossing into Egypt.

Everyone who does not have a foreign passport would have to get their name on “the list,” as it is referred to informally — of those approved by both Israeli and Egyptian authorities to evacuate. 

Maryam and FarajAllah are among the lucky ones who made it on the list before May 7, when the Israeli military took over the Rafah border crossing. The military claimed the crossing was being used for “terrorist” purposes. No medical evacuations have been permitted ever since. 

“Not because we don’t want to open it, but because it takes two for tango and you need Egypt to cooperate on this,” said Tal Heinrich, a spokesperson for Israeli Prime Minister Benjamin Netanyahu, in a press conference. 

The Egyptian government did not return a request for comment. 

Click the audio player below to listen to part two:

Tareq Hailat is a 28-year-old medical student in South Carolina who coordinates medical evacuations for a US-based nonprofit, the Palestinian Children’s Relief Fund.

PCRF submitted Maryam’s case for approval in January and worked with contacts behind the scenes to get her out quickly. A few days after submitting her file, her name appeared on the list for evacuation. FarajAllah accompanied her. 

Every day that a patient waits matters, especially for an amputation like Maryam’s, Hailat said.

He said some people have been waiting for as long as six months to leave. 

“It gets really sad, honestly. Because they’re depending on you. They’re messaging me day and night, honestly, saying, ‘Please, pull us out.’”

Before the list stopped going out, the process to get out of Gaza took weeks, said Dr. Tanya Haj Hassan, a Canadian pediatrician who volunteered with Doctors Without Borders at Al-Aqsa Hospital — one of the facilities where Maryam was treated. 

“Every person I have tried to evacuate — at least adults — I have failed,” Haj Hassan said. 

She said she remembers one young mother who opened a can that she thought was a food ration, but was an unexploded mine. 

“She stayed alive for about three weeks in excruciating pain with extensive burns all over her body,” Haj Hassan said. 

The woman died while waiting on a medical evacuation in a deeply overwhelmed hospital. 

With routes into Gaza restricted and security inspections required for every aid truck, humanitarian assistance has barely trickled into Gaza. Shipments of medical supplies are regularly refused entry to the Gaza Strip, often with no clear reason. 

Hospitals don’t have enough supplies to clean wounds, change dressings or even clean bedsheets, leading to infections. With nothing to treat those infections, even minor injuries may require an amputation — often without anesthesia, Haj Hassan said.

“They would say, ‘We only have one vial left — is this really the patient you want to use it on?’ I don’t know how to make these decisions. I’ve never had to make them before.”

Haj Hassan said that amid all of this, children are often the only patients who can get out of Gaza in a medical evacuation. Children are permitted just one parent or guardian to travel with them — but the adult must pass a security clearance from both Egyptian authorities and COGAT, Israel’s ministry that controls civilian movements out of Gaza and the West Bank. 

This process predates the start of the Israel-Hamas war on Oct. 7. 

Aseel Aburass, a researcher for the Israeli group Physicians for Human Rights, said that her team found that patients seeking medical care in the West Bank, or even abroad, were regularly denied security clearances for no clear reason. 

“We were able to prove that this is an arbitrary system that claims it has security concerns,” Aburass said. “We see it as a collective punishment to the population of Gaza.” 

Previously, people could get on the list to leave Gaza more quickly by paying a private company with ties to Egyptian intelligence. This could cost up to $10,000 a person before it was suspended after the Israeli military took over the Rafah crossing. But even a private evacuation required a security clearance by both the Israeli and Egyptian authorities.

According to the government of Gaza, at least 11,000 injured people are still waiting to leave the Gaza Strip for medical care.

Inside the hospital in Qatar 

Sidra Medicine in Doha has received 160 children medically evacuated from Gaza — including Maryam — since December of last year, when the emir of Qatar pledged to provide treatment to 1,500 Palestinians wounded in the war. 

Click the audio player below to listen to part three:

Nine are still staying as inpatients in a quiet ward with a view. Among the hospital’s youngest patients is 18-month-old Sanad al-Arabi, whose cheeks are badly scarred.

His entire right hand and four fingers on his left hand are gone. An IV runs into the stump of Sanad’s right arm as his tiny body tries to fight off a drug-resistant infection. 

His grandmother, Marwa al-Arabi, is always by his side, smoothing his hair, tucking the blanket around him. Doctors tell her his body is being pumped with a powerful dose of antibiotics.

“This needs a very intense treatment. They just want to remove this infection from his body because it’s eating him, you know,” she said in Arabic through a translator. 

Arabi said the Israeli military bombed their home without warning on April 12 — the last day of Eid. They had been warned to evacuate to the south, Arabi said, but they couldn’t afford to pay for a donkey cart for transport. 

Arabi lost three grandchildren in the attack and 11 relatives in total. 

She had to dig herself out of the rubble of their home by following a patch of sunlight shining through the stones above her. She found Sanad’s face covered in blood. He was opening and closing his mouth — as if his soul was leaving his body, she said. 

Somehow, Sanad survived.

The Red Crescent and an American nonprofit, the Palestinian Children’s Relief Fund, pushed through a lengthy approval process to get Sanad and his grandmother evacuated out of Gaza and into Egypt in a matter of days. From there, they flew to Doha. 

Arabi said that at the hospital in Doha, she was finally able to hope that Sanad would be OK. That was what mattered. 

Doctors from seven different specialties got to work reconstructing Sanad’s crushed leg and cutting out the infection. 

“Getting the arteries to get the blood flowing — his limb survived, really, and even the fracture which looked like it would never heal, seems to be doing quite well,” said Dr. Farhan Ali, the acting chief of pediatric surgery at Sidra Medicine.

Sanad lost his right hand, Ali said, but he kept his legs. 

“Children are quite malleable, they do bounce back. They’ll make the most of what they have. But it’s a lifelong injury. These children will bear the scars of this war.”    

‘They are doing normal life’ 

While undergoing treatment at hospitals in Qatar, families — including the FarajAllahs — are settled at the Al-Thumama Complex, a large, gated compound of matching white apartment buildings on the southern edge of Doha, not far from the airport. 

Click the audio player below to listen to part four:

In a building that hosts kids’ programs daily, girls and boys clustered around a table and strung colorful beads into bracelets and necklaces. Volunteers wore bright blue vests for the Qatar Foundation, a nonprofit founded by Qatar’s royal family. 

“It’s to let them know they are doing normal life,” said Afrah Adem, a coordinator for the complex who is originally from Sudan. “That’s why we have these activities.” 

In many cases, Adem said, children are managing both the trauma of what they witnessed in Gaza and fears for their families back home. Many are staying with just one parent or another guardian.

The kids go to school and play outside, while a local Palestinian restaurant provides three meals a day. Some of the women staying at Al-Thumama have begun working at the restaurant, Adem said. Families with up to five members are assigned a two-bedroom apartment with a small kitchen, appliances and furniture. Larger families receive two. 

Nour Mahdi, 28, arrived a month ago with her three children. 

She hasn’t quite adjusted yet. Support staff are often workers from different countries who only speak English, not Arabic — it’s a world away from Gaza, where she was surrounded by extended family, Mahdi said.

She is still waiting for her husband, who is stuck in Gaza: “I need my husband here with me, because I’m so scared. I’m so afraid.”

Her 9-year-old son Yamen does his best to help, making funny faces at the baby, and feeding him with a bottle.

Yamen is recovering from a shrapnel wound to his abdomen. 

Back home, Yamen said that he and his brother had to go out and collect wood from bombed-out houses so they could burn it to keep warm. He remembers eating birdseed when they ran out of food. 

“I preferred to be outside during a bombing,” he said in Arabic through a translator. 

That way, he could see where the rockets fell. 

One day, when he was playing outside with his cousins, shrapnel from a nearby missile strike tore through his abdomen and caused major damage to his stomach and liver. In a photograph from the hospital in Gaza, his eyes are wide open in shock as doctors try to stabilize him. 

In Doha, Yamen has received additional reconstructive surgery and follow-ups. He said that he’s made friends — kids who are also recovering from their own injuries. 

‘We remember every single detail’

It’s one thing to meet the physical needs of an injured child. It’s another thing entirely to help them process what they lived through in Gaza — especially without their parents. 

“This is the thing about trauma — we cannot measure trauma only through what happens to individuals. It’s about the social fabric, how we view ourselves, how we view others,” said Dr. Samah Jabr, head of the mental health unit of the Palestinian Ministry of Health, in a March webinar organized by The University of British Columbia.

In 2020, a study funded by the Qatar National Research Fund found that more than half of Palestinian children surveyed suffered from PTSD. Western mental health techniques don’t work, in the context of Gaza, Jabr said. For example, if a therapist is trying to treat a child who’s being abused, the first step is to stop the abuse. 

“Everything else we can offer in psychiatry is palliative. It has a very small impact. It can be meaningless sometimes,” Jabr said. 

In Doha, evacuees have found their own ways to help their kids heal. 

Click the audio player below to listen to part five:

On the airplane from Egypt to Doha, Maryam woke up screaming. She was convinced that her little brother was in the airplane next to her, her aunt recalled. 

FarajAllah said that she fears that the trauma of losing her family will follow Maryam throughout her life. So, she does her best to stay calm — not to get lost in her grief. 

“I don’t want her to see the weakness inside of me,” FarajAllah said. 

She only has videos from her cellphone to show Maryam what her little brother and parents looked like. What her life was like before the war. 

But although Maryam asks to see them every night, FarajAllah said, she demurs. Instead, she tells her stories. About their garden — the parties their family would have together. The special maqluba, a rice and meat dish, which Maryam’s mother, Reem, would make. In that way, she keeps her memory alive.

“We remember every single detail,” she said.