How the lives of the few child amputees allowed to leave Gaza are being rebuilt elsewhere

Warning: this story contains distressing images

To find safety from Gaza, you must first suffer a catastrophic injury, then be lucky enough to be identified, selected and extracted.

This is one of the many brutal truths of this long war.

I followed the stories of some of the few Palestinians who left Gaza for treatment.

Fewer than 100 children have been granted temporary permits and visas to seek treatment in the United States since the war began in October 2023.

In total, several hundred children left Gaza for treatment during this period, most to other countries in the Middle East. It has not been possible to confirm a precise number but we know that the UK has not accepted any.

A few weeks ago, at Chicago’s O’Hare Airport, the largest group of children from Gaza arrived in America for treatment.

Eight Palestinian children were on board Royal Jordanian Flight 263 from Amman.

This figure, small as it is, reflects a huge achievement by the charity that made this happen: the Palestinian Children’s Relief Fund (PCRF).

But it also reflects profound diplomatic and political failures; the fact that it was only possible to extract eight of the thousands of people who need urgent medical treatment.

The doors to O’Hare’s arrival hall opened to reveal a fleet of wheelchairs, each carrying a child bearing the scars of war they had left behind.

Among them, two brothers who survived the bombing that killed their sister.

Behind them, a boy who lost all his brothers and sisters and his arm. He is now his mother’s only child. She traveled with him. She too is now an amputee.

The last to pass through the arrival gate was a dot in her wheelchair.

Rahaf, aged just two, lost both of her legs in an Israeli attack on her home in August, shortly after learning to walk.

All their stories reflect a collective horror. These are the civilian victims of the Israeli bombings on Gaza which followed the Hamas attacks of October 7, 2023.

The children arrived in America after a massive collective effort involving PCRF and Shriners, one of the largest nonprofit children’s hospital networks in the United States.

By working with several governments, they made extractions easier.

Israel controls all of Gaza’s borders and has only authorized evacuations in rare circumstances, only in exceptional cases and only with a single parent or guardian.

After their flight, the children visited Shriners hospitals in different parts of the country: California, Oregon, Illinois, South Carolina, Kentucky and Missouri.

It was in Missouri this week that I spent a day with two-year-old Rahaf and her mother Israa Saed.

We met at the home of the American couple who volunteered to be their hosts during their stay in the United States.

Six months after the bombing of Rahaf’s house and three weeks since she arrived in America with her mother, I came to see how a little life was being rebuilt.

The first thing that struck me as we sat in the host family’s living room was how happy Rahaf now seemed.

His right leg is missing below his knee and his left leg is almost completely gone – amputated just below his hip.

Yet she was running on the ground in front of us, chasing a blue balloon with bursts of laughter. His mother smiled as she watched.

The ambiance belied the enormity of their experience and the dilemma of their journey.

Until this month, Israa and Rahaf had never left Gaza. They are now in America, without the language and without the rest of their family: Israa’s husband and two young boys.

“My other two sons are still young and… should I stay with my other children or should I come out?,” she said of her dilemma.

“Rahaf needs her mother. I couldn’t let her go (to America) alone. And especially with my broken bones, my elbows, my arms. I was hoping for treatment for myself.”

Israa was injured in the same attack on August 1. Both his arms were badly damaged. New X-rays taken since his arrival in America show a section of bone still missing in his right forearm.

I asked about his family in Gaza.

“Yes, we talk but the internet isn’t the best. We still manage to have a few conversations. The question that always comes up is: ‘When can you come back?’ When will the little ones bring you back? When can we meet again?'”

Israa sobbed. The pain was clearly visible on his face.

“God willing, my wish is that my children live in safety, away from all conflict and war. Safe. That is my wish.”

We watched photos on Israa’s phone of Rahaf in a pink dress before the attack and a video of her walking up the steps of their apartment building.

“She loved being a princess,” Israa said.

Israa then showed me a photo of Rahaf on a hospital bed in Gaza a few weeks after the attack, looking at her amputated legs.

I asked her if she understood what happened to her.

“She asked ‘my legs are destroyed, what happened?'” Israa said they told her it was a rocket. Now, Rahaf avoids the subject. “If we start the conversation, she’ll change the subject.”

The good news is that Rahaf’s amputations went well considering the situation.

Circumstances have ensured that Gazan doctors have become among the best in the world when it comes to trauma surgery. But that’s where the care in Gaza ends. The shortage of doctors, equipment and functioning hospitals makes prolonged care impossible.

Amputations require ongoing work by doctors with a variety of skills, including orthopedic surgeons, plastic surgeons and prosthetists.

Children who have lost a limb require a range of additional care because they are still growing. Rahaf will frequently need new prosthetics as she grows.

Prosthetists estimate that for every death in war, there will likely be three times as many surviving amputees. According to Gaza’s health ministry, the death toll in the war now exceeds 45,000.

More children have been killed in Gaza by the Israeli army than in the equivalent period in any other conflict in the past 18 years, according to an analysis by the charity Oxfam.

These figures give an idea of the number of amputees, adults and children, still in Gaza.

Thanks to pressure from charities and hospital treatment commitments, the United States has admitted a small number of Gazan children, but the main obstacle is the Israeli government, which controls access to the Gaza Strip through all borders.

Josh Paul is a former US State Department official who resigned last year over the war in Gaza.

Speaking to Sky News, he said the situation of the injured children represents a profound failure of US diplomacy.

“Even on something as humanitarian as saving children’s lives, getting them into intensive care, it’s not that America isn’t willing to ask. It’s that America isn’t willing to ask. not willing to put pressure on it,” Mr. Paul said.

“And it could be done in a second if they wanted to. If President Biden picked up the phone (to Israel) and said, ‘We’re stopping our arms shipments until you let the children out, until that you release seriously injured or seriously injured children’. Sick children must be treated, we are not on your side.

On why nothing was done, Mr Paul said: “It’s the political costs… he thought he would pay. I think this is a serious miscalculation.

“I think American public opinion has changed dramatically and will continue to change.

“I also think that the geopolitical incentives here have also changed and that we are paying a cost, an obvious cost, for our unconditional support for Israel.”

Watch and read our other stories about the children of Gaza:
Stuck in Gaza with the rarest of illnesses
Girl with rare disease leaves Gaza
Sky meets a teenager whose uncle amputated her leg

The next step for Rahaf is prosthetics. It is the kindness of strangers and their donations that will make all this possible.

Then it will be time for her to walk again. But family reunions are, for the moment, much less assured.