Gaza Teen Amputee Recalls Nightmare of Losing Arms in Israeli Strike

Palestinian teenager Diaa Al-Adini, who had his both arms amputated after being wounded in an Israeli strike on August 13 and was transferred from Al-Aqsa hospital due to an Israeli evacuation order, is helped by his sister Aya to drink iced juice on a beach outside a field hospital, in Deir... Purchase Licensing Rights
Palestinian teenager Diaa Al-Adini, who had his both arms amputated after being wounded in an Israeli strike on August 13 and was transferred from Al-Aqsa hospital due to an Israeli evacuation order, is helped by his sister Aya to drink iced juice on a beach outside a field hospital, in Deir... Purchase Licensing Rights
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Gaza Teen Amputee Recalls Nightmare of Losing Arms in Israeli Strike

Palestinian teenager Diaa Al-Adini, who had his both arms amputated after being wounded in an Israeli strike on August 13 and was transferred from Al-Aqsa hospital due to an Israeli evacuation order, is helped by his sister Aya to drink iced juice on a beach outside a field hospital, in Deir... Purchase Licensing Rights
Palestinian teenager Diaa Al-Adini, who had his both arms amputated after being wounded in an Israeli strike on August 13 and was transferred from Al-Aqsa hospital due to an Israeli evacuation order, is helped by his sister Aya to drink iced juice on a beach outside a field hospital, in Deir... Purchase Licensing Rights

*Teenager Diaa al-Adini was one of the few Palestinians who found a functioning hospital in war-ravaged Gaza after he was wounded by an Israeli strike. But he did not have much time to recuperate after doctors amputated both of his arms.

Adini, 15, suddenly had to flee the overwhelmed medical facility after the Israeli military ordered people to leave before an attack in its war against the Palestinian militant group Hamas. He made it to an American field hospital.

Many Palestinians have been displaced during the conflict, moving up and down and across the Gaza Strip seeking safe shelter. They are unlucky most of the time.

Scrambling to save your life is especially difficult for Palestinians like Adini, who require urgent medical care but get caught up in the chaos of the war, which erupted after Hamas attacked Israel on Oct. 7.

Memories of better days provide limited relief from reality in Gaza. Israeli strikes have reduced most of one of the most crowded places on earth to rubble as rows and rows of homes are destroyed.

“We used to swim, challenge each other, and sleep, me and my friend Mohammed al-Serei. We used to jump in the water and float on it," Reuters quoted Adini, who walked on a beach with his sister Aya recalling the few distractions from before.

His sister placed a towel over the place where his arms used to be and wiped his mouth.

- 'I CANNOT REPLACE MY AUNT'

The strike hit when he was in a makeshift coffee house.

The teenager, who spent 12 days in hospital before he was displaced also lost his aunt, her children and grandchildren in the war.

"As for my arms, I can get other ones fitted but I cannot replace my aunt," he said.

Israel responded to the Hamas attack in October -- the country's bloodiest day in its 75-year history -- with a military offensive that has killed at least 40,500 people and wounded 93,778 others, according to Gaza health authorities.

Israel says it goes out of its way to avoid civilian casualties and has accused Hamas of using human shields, an allegation it denies.

The suffering is unlikely to end anytime soon unless mediation by the United States, Egypt and Qatar secures a ceasefire. And even then, there is a possibility hostilities will resume.

So all Palestinians can do is hope for treatment at the few functional hospitals as they face a humanitarian crisis -- severe shortages of food, fuel, power and medicine, as raw sewage increases the chance of disease.

“God willing, I will continue my treatment in the American hospital, and get limbs," said Adini.

He dreams of being like other children one day; to live a good life, get an education, drive cars and have fun. His sister Aya hopes that he can go back to his camera and iPad.



New Mpox Strain Is Changing Fast; African Scientists Are ‘Working Blind’ to Respond 

Dr. Robert Musole, medical director of the Kavumu hospital (R) consults an infant suffering from a severe form of mpox at the Kavumu hospital, 30 km north of Bukavu in eastern Democratic Republic of Congo, August 24, 2024. (AFP)
Dr. Robert Musole, medical director of the Kavumu hospital (R) consults an infant suffering from a severe form of mpox at the Kavumu hospital, 30 km north of Bukavu in eastern Democratic Republic of Congo, August 24, 2024. (AFP)
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New Mpox Strain Is Changing Fast; African Scientists Are ‘Working Blind’ to Respond 

Dr. Robert Musole, medical director of the Kavumu hospital (R) consults an infant suffering from a severe form of mpox at the Kavumu hospital, 30 km north of Bukavu in eastern Democratic Republic of Congo, August 24, 2024. (AFP)
Dr. Robert Musole, medical director of the Kavumu hospital (R) consults an infant suffering from a severe form of mpox at the Kavumu hospital, 30 km north of Bukavu in eastern Democratic Republic of Congo, August 24, 2024. (AFP)

Scientists studying the new mpox strain that has spread out of Democratic Republic of Congo say the virus is changing faster than expected, and often in areas where experts lack the funding and equipment to properly track it.

That means there are numerous unknowns about the virus itself, its severity and how it is transmitting, complicating the response, half a dozen scientists in Africa, Europe and the United States told Reuters.

Mpox, formerly known as monkeypox, has been a public health problem in parts of Africa since 1970, but received little global attention until it surged internationally in 2022, prompting the World Health Organization to declare a global health emergency. That declaration ended 10 months later.

A new strain of the virus, known as clade Ib, has the world's attention again after the WHO declared a new health emergency.

The strain is a mutated version of clade I, a form of mpox spread by contact with infected animals that has been endemic in Congo for decades. Mpox typically causes flu-like symptoms and pus-filled lesions and can kill.

Congo has had more than 18,000 suspected clade I and clade Ib mpox cases and 615 deaths this year, according to the WHO. There have also been 222 confirmed clade Ib cases in four African countries in the last month, plus a case each in Sweden and Thailand in people with a travel history in Africa.

"I worry that in Africa, we are working blindly," said Dr. Dimie Ogoina, an infectious diseases expert at Niger Delta University Hospital in Nigeria who chairs the WHO's mpox emergency committee. He first raised the alarm about potential sexual transmission of mpox in 2017, now an accepted route of spread for the virus.

"We don’t understand our outbreak very well, and if we don't understand our outbreak very well, we will have difficulty addressing the problem in terms of transmission dynamics, the severity of the disease, risk factors of the disease," Ogoina said. "And I worry about the fact that the virus seems to be mutating and producing new strains."

He said it took clade IIb in Nigeria five years or more to evolve enough for sustained spread among humans, sparking the 2022 global outbreak. Clade Ib has done the same thing in less than a year.

MUTATING 'MORE RAPIDLY'

Mpox is an orthopoxvirus, from the family that causes smallpox. Population-wide protection from a global smallpox vaccine campaign 50 years ago has waned, as the vaccinating stopped when the disease was eradicated.

Genetic sequencing of clade Ib infections, which the WHO estimates emerged mid-September 2023, show they carry a mutation known as APOBEC3, a signature of adaptation in humans.

The virus that causes mpox has typically been fairly stable and slow to mutate, but APOBEC-driven mutations can accelerate viral evolution, said Dr. Miguel Paredes, who is studying the evolution of mpox and other viruses at Fred Hutchison Cancer Center in Seattle.

"All the human-to-human cases of mpox have this APOBEC signature of mutations, which means that it's mutating a little bit more rapidly than we would expect," he said.

Paredes and other scientists said a response was complicated by several mpox outbreaks happening at once.

In the past, mpox was predominantly acquired through human contact with infected animals. That is still driving a rise in Congo in clade I cases – also known as clade Ia - likely due in part to deforestation and increased consumption of bushmeat, scientists said.

The mutated versions, clade Ib and IIb, can now essentially be considered a sexually transmitted disease, said Dr. Salim Abdool Karim, a South African epidemiologist and chair of the Africa CDC’s mpox advisory committee. Most of the mutated clade Ib cases are among adults, driven at first by an epidemic among female sex workers in South Kivu, Congo.

The virus also can spread through close contact with an infected person, which is likely how clusters of children have been infected with clade Ib, particularly in Burundi and in eastern Congo’s displacement camps, where crowded living conditions may be contributing.

Children, pregnant women and people with weakened immune systems or other illnesses may be at greater risk of serious mpox disease and death, say the WHO and mpox scientists.

Clade I has typically caused more severe disease, with fatality rates of 4%-11%, compared to around 1% for clade II. Ogoina said data from Congo suggests few have died of the new Ib version, but he feared some data is being mixed up.

More research is urgently needed, but three teams tracking mpox outbreaks in Africa say they cannot even access chemicals needed for diagnostic tests. Clade Ib can also be missed by some diagnostic tests.

Planning a response, including vaccination strategies, without this is difficult, the scientists said.

Karim said around half of cases in eastern Congo, where Ib is particularly prevalent, are only being diagnosed by doctors, with no laboratory confirmation.

Getting samples to labs is difficult because the healthcare system is already under pressure, he said. And around 750,000 people have been displaced amid fighting between the M23 rebel group and the government.

Many African laboratories cannot get the supplies they need, said Dr. Emmanuel Nakoune, an mpox expert at the Institut Pasteur in Bangui, Central African Republic, which also has clade Ia cases.

"This is not a luxury," he said, but necessary to track deadly outbreaks.