Khan Younis, Gaza — On a hospital bed in Khan Younis’ Al-Nasser Medical Complex, eight-year-old Sila Madi lies motionless, her hollow eyes fixed on the space where her legs used to be.  

Her face, once full of childhood light, is now sunken by hunger and grief. After months of bombardment and weeks of deprivation, it is the loss of her limbs that has broken her spirit.

Sila’s trauma began on May 17, when an Israeli airstrike hit tents housing displaced families in Al-Mawasi, where her family had fled. The blast hurled her body dozens of metres. She was found unconscious—her right leg blown off. Days later, her detached limb was recovered in the rubble.

But the worst was yet to come.

A week after her first surgery, an infection spread rapidly through her remaining leg. With Gaza’s crippled health system offering no real recourse, doctors were forced to amputate her other limb. 

Breaking her silence, she whispers to her father a question she has asked many times before: “Where are they? Who took them?” while gesturing to her missing legs.

Tenderly, Nidal Madi tries to comfort her, despite his previous failed attempts. “They’re with God, my love. He will give you better ones.” Before he finished his words, Sila was already shaking her head, rejecting his attempts to console her. “God didn’t want my legs! Why did you cut them? How will I walk now?” she wails, heartbroken. 

Madi steps out, crushed under the weight of his daughter’s scream and the staggering grief he cannot shield her from.

Sila’s story is one among thousands.

As of April 2025, Gaza’s Health Ministry recorded at least 4,700 amputations since the war escalated in October 2023. Some 846 of those were children, according to the recorded cases. But officials stress these figures are incomplete—many victims cannot reach hospitals or register due to destroyed roads, displacement, or lack of documentation.

“These are not ordinary war injuries,” says Walid Hamdan, head of physical therapy services at the Ministry of Health. “Many children have lost limbs above the knee, and at least 200 are now permanently paralysed with spinal cord damage,” he tells TRT World.

In January, UNICEF declared Gaza as the place with the highest per capita number of child amputees globally. But the statistics alone don’t capture the depth of the humanitarian catastrophe.

In the same Israeli airstrike that took Sila’s limbs, her mother, Nesreen, lost several toes and suffered deep shrapnel wounds. Her sister Rahaf, just 18, had her left leg amputated. The family had been displaced from Rafah and was sheltering in makeshift tents like thousands of others when the bombs hit.

“We lost nine relatives in that attack,” Madi says, his voice trembling. “My mother, my brother, his wife... and others. Eleven more were wounded. It was a massacre.”

The collapse of care

Even before the war, Gaza’s health system struggled. But 19 months of Israeli destruction has only worsened the healthcare sector.

According to the World Health Organization (WHO), at least 94 per cent of hospitals in Gaza have been damaged or destroyed. A recent OCHA update stated that the functionality of health service points has severely deteriorated over the past two years. “Since May 14, four partially functional hospitals had to suspend operations, reducing the number of partially functional hospitals from 22 to 18,” OCHA’s report said.

The impact of the destroyed hospitals and the blocked medical aid has been deadly: routine injuries have become death sentences or life-altering amputations.

"Shrapnel wounds that would normally heal are now septic, leading to amputations,” Hamdan explains. “Children suffer the most. They can’t fight infections. Their bodies are weakened by months of hunger.”

Malnutrition, now rampant across Gaza, further undermines recovery. Starvation slows down healing, exacerbates bone deterioration, and increases the risk of surgical wound infections.

There are almost no prosthetics. Mobility aids—wheelchairs, crutches, walkers—are almost nonexistent. The Israeli blockade on essential goods means even basic wound care supplies are scarce. Three of Gaza’s prosthetic centres have shut down; only one still operates, and only intermittently.

“Children like Sila need urgent rehabilitation,” says Hamdan. “But there’s no equipment, no funding, no safe space to heal.”

Before her second amputation, Sila held onto hope. Doctors reassured her she could walk again. But as infection worsened and options dwindled, that hope was extinguished.

“She broke down when we told her,” Madi says. “Since then, she barely speaks, just silence or screams.”

He has tried everything—local NGOs, international agencies, health authorities—to get her a prosthetic or even a referral abroad. Every door has closed.

“They tell me nothing is available. Even if she could travel, no country is accepting Gazan patients now. I’m helpless.”

“He crawls through the sand”

In Al-Mawasi, 11-year-old Yaseen al-Ghalban moves across the dirt floor of his family’s tent on his elbows. Both of his legs were blown off in an Israeli airstrike on April 12, just days after his family returned to the ruins of their bombed home in Rafah.

His mother, Fadwa al-Ghalban, holds him close as he stares blankly into space. His father and older brother were killed on December 5, 2023, when a school shelter was hit by Israel. Another brother, Mohammed, also lost a leg and is now in the company of his uncle in Türkiye, where he’s being treated. Yaseen, however, remains trapped in Gaza.

“He was denied a travel permit because he’s a minor and can’t travel alone,” his mother says. “He needs multiple surgeries before he can even be fitted for prosthetics.”

Al-Ghalban, a physics PhD student, now divides her time between tending to her son’s wounds and feeding her three other children, all while living in a tent without running water or electricity.

“I try not to cry in front of him,” she says. “But he clings to me constantly. His trauma is unbearable.”

Yaseen’s donated wheelchair, a gift from the International Red Cross, lies broken and useless amid the sand dunes that now surround his tent. His wounds fester in the heat. “Without treatment, I don’t think he’ll survive.”

Children across Gaza now live with the dual wounds of physical disability and emotional trauma. Most have received no psychological support. The war has erased their schools, their homes, and now, for many, their limbs.

“These children don’t just need prosthetics,” says Dr. Jamal Al-Farra of Al-Amal Hospital. “They need therapy, education, medical follow-up, and hope.”

Al-Farra’s hospital, in partnership with the Red Crescent, is preparing to open Gaza’s first post-war prosthetics and rehabilitation centre. It will offer physiotherapy, speech and trauma therapy, and prosthetic services—if supplies arrive.

But it will not be enough.

“Most amputated children aren’t even registered,” he says. “Their families are scattered, unreachable. The real number of injured is far higher.”

As some countries in the world observe International Children’s Day today, declaring every child’s right to safety and care, Gaza’s amputated youth and their families feel abandoned and forgotten, lying in tents, in rubble, in overcrowded hospital wards. Screaming in pain or frozen in silence.

“We didn’t choose this war,” says Madi, holding Sila’s frail hand. “We are civilians. Fathers. Mothers. We just want our children to walk again.”

This piece was published in collaboration with Egab.