Gaza’s Child Amputees Struggle with Recovery, Especially after Israel’s Cutoff of Aid

 A doctor assists 13-year-old Palestinian Yamen Asfour as he learns to walk on a prosthetic leg at the Artificial Limbs and Polio Center in Gaza City on Tuesday, Feb. 18. 2025. (AP)
A doctor assists 13-year-old Palestinian Yamen Asfour as he learns to walk on a prosthetic leg at the Artificial Limbs and Polio Center in Gaza City on Tuesday, Feb. 18. 2025. (AP)
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Gaza’s Child Amputees Struggle with Recovery, Especially after Israel’s Cutoff of Aid

 A doctor assists 13-year-old Palestinian Yamen Asfour as he learns to walk on a prosthetic leg at the Artificial Limbs and Polio Center in Gaza City on Tuesday, Feb. 18. 2025. (AP)
A doctor assists 13-year-old Palestinian Yamen Asfour as he learns to walk on a prosthetic leg at the Artificial Limbs and Polio Center in Gaza City on Tuesday, Feb. 18. 2025. (AP)

Five-year-old Sila Abu Aqlan curled her lip in concentration as she practiced walking for the first time on a prosthetic leg at a clinic in Gaza City. The foot of the new leg had a little pink sneaker with a lacy frill, matching her pink hoodie.

It has been nearly 15 months since the little girl's leg was amputated after it was left severely burned from an Israeli airstrike. Finally, she is being fit for a prosthetic.

One of the most shocking sights in Gaza’s war has been the thousands of children with amputated limbs from Israel’s bombardment. The UN’s humanitarian aid organization OCHA called it the “largest cohort of child amputees in modern history.”

Throughout the 17-month war, supplies and services for children and adults with amputations have fallen far short of demand. Gaza’s ceasefire that began in mid-January offered a window for aid agencies to bring in an increased number of prosthetic limbs, wheelchairs, crutches and other devices.

Still, it only covered about 20% of the total need, said Loay Abu Saif, head of a disability program run by the aid group Medical Aid for Palestine, or MAP.

The window slammed shut when Israel barred entry of all medical supplies as well as food, fuel and other aid on March 2. Israel's resumption of its military campaign last week, killing hundreds of Palestinians, has only added to the ranks of amputees.

Children struggle with multiple traumas

With help limited, children wrestle with the psychological pain of losing a limb along with other traumas.

Sila's mother, father and sisters were all killed in an airstrike on her home in December 2023. Sila suffered severe burns to her right leg. A month of treatment had little effect, and Sila would scream in excruciating pain, her aunt Yasmine al-Ghofary said. Doctors amputated her leg above the knee.

“I try as much as I can to make her happy. But the truth is, there’s only so much she can be happy. Pain is pain, and amputation is amputation,” al-Ghofary said.

Sila sees other girls playing and tries to keep up with them using her walker but falls down. “She says, ’Why am I like this? Why am I not like them?” said al-Ghofary.

In October 2023, 11-year-old Reem lost her hand when an airstrike hit nearby as her family fled their home in Gaza City.

Reem can no longer dress on her own, brush her hair or tie her shoes. She gets angry and hits her siblings if she can’t find someone to help her, her mother said. Other times, she isolates herself and just watches other children playing.

“Once Reem told her dad that she wished to die,” said her mother, who goes by the traditional name, Umm Reem. “In another instance, we were talking about meat, and she said, ‘Slaughter me like a sheep,’ and she was laughing.”

Thousands need help

Some 3,000 to 4,000 children in Gaza had suffered amputations as of November 2024, according to Jamal al-Rozzi and Hussein ِAbu Mansour, two prominent experts with rehabilitation programs in the territory who spoke with The Associated Press.

Up to 17,500 adults and children suffered severe limb injuries, leaving them in need of rehabilitation and assistance, the World Health Organization estimated in September.

Throughout the war, hospitals lacked medicines that could have averted amputations. Doctors describe cutting off limbs because of infections that should have been easily treated.

In its campaign in Gaza, Israel has struck homes and shelters with families inside almost daily.

Gaza's Health Ministry on Monday put out a list of the names of more than 15,000 children, 17 and younger, killed by Israel’s offensive. The list included nearly 5,000 children younger than 6, including 876 infants who had not reached a year in age.

Israel's offensive has killed more than 50,000 Palestinians of all ages and wounded more than 113,000, according to the ministry, which does not say how many were civilians or combatants. Nearly 90% of the population of some 2.3 million have been displaced, and vast areas of Gaza have been destroyed.

Israel launched the campaign vowing to destroy Hamas after its Oct. 7, 2023, attack on southern Israel, in which gunmen killed some 1,200 people, mostly civilians, and abducted 251 others. Israel says it is targeting Hamas and blames the group for civilian deaths because it operates in residential areas.

Conditions in camps make it even harder for children

Last May, 13-year-old Moath Abdelaal's leg was amputated above the knee after an Israeli airstrike in the southern city of Rafah.

The family had to flee to a tent camp outside the neighboring city of Khan Younis. During the ceasefire, they moved back to their hometown Jabaliya in northern Gaza, but their home had been destroyed, so they live in a tent by the ruins, said his father, Hussein Abdelaal.

Moath’s psychological state is worsening, his father said. Moving with crutches around the rubble is difficult. Doctors had to amputate more from his leg, almost up to his hip, because of complications. The boy learned that a number of his friends in the neighborhood had been killed, Abdelaal said.

“He has been having a hard time coping with his new situation. He’s not sleeping well next to his siblings. It’s difficult to see our son like that,” said Abdelaal.

Aid agencies provide some services

Sila is being treated at the Artificial Limbs and Polio Center in Gaza City, a program launched by the International Committee of the Red Cross that has provided physical therapy, wheelchairs and prosthetics to hundreds of Palestinians suffering from amputations or paralysis.

But supplies are limited. Wheelchairs are urgently needed, with 50 to 60 people a day asking for them in northern Gaza alone, said Mahmoud Shalabi with MAP.

Al-Rozzi, executive director of the National Rehabilitation Society in the Gaza Strip, said Israel blocks materials to manufacture prosthetics from entering Gaza on grounds they could have dual or military uses.

COGAT, the Israeli military body overseeing aid, said there have never been limitations on medical supplies to Gaza, including wheelchairs, prosthetics and crutches.

Some hope for treatment abroad

Some child amputees have been evacuated out of Gaza for treatment. But the pace of medical evacuations has remained slow, at a few dozen a day, and was reduced after Israel's strikes last week. As many as 13,000 patients of all kinds are waiting their chance to get out.

Asmaa al-Nashash wants nothing more than for her 11-year-old son Abdulrahman to go abroad for a prosthetic leg.

The boy was selling items from a stand at a UN school-turned-shelter in the built-up Nuseirat refugee camp when an airstrike hit, she said. Shrapnel tore through his leg, and doctors couldn’t save it.

Since then, he often sits alone playing games on her phone because he can’t play football with other children, she said. Other kids bully him, calling him the “one-legged boy.”

“My heart gets torn into pieces when I see him like this and I can do nothing for him,” she said.



Syrians in Libya Struggle to Escape ‘Exile in Limbo’

A photo shows young Syrian men who drowned after their boat capsized off the coast of Libya. Credit: Rights activist Tarek Lamloum
A photo shows young Syrian men who drowned after their boat capsized off the coast of Libya. Credit: Rights activist Tarek Lamloum
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Syrians in Libya Struggle to Escape ‘Exile in Limbo’

A photo shows young Syrian men who drowned after their boat capsized off the coast of Libya. Credit: Rights activist Tarek Lamloum
A photo shows young Syrian men who drowned after their boat capsized off the coast of Libya. Credit: Rights activist Tarek Lamloum

About seven months ago, a group of 25 Syrian youths, including minors, set off from Libya on an irregular migration journey toward Europe. Only four made it back alive. The rest drowned in the Mediterranean.

The tragedy, which left a deep mark on Syrian communities both in Libya and abroad, has drawn renewed attention to the large and diverse Syrian population now living in the North African country, some fleeing the war in Syria under former President Bashar al-Assad, others settled there long before.

Syria’s presence in Libya is far from monolithic. It spans businessmen, migrant laborers, families who settled during the rule of Muammar Gaddafi, and former fighters now working as mercenaries. Many also see Libya as a temporary stop on the perilous path to Europe.

For most, Libya is not the destination but a gateway. The recent drowning of 21 Syrians in the Mediterranean was not an isolated tragedy, but part of a pattern of loss that has haunted the community for years.

Reports from local and international migration watchdogs have documented repeated drownings and arrests of Syrians at sea, with many captured by Libya’s coastguard and detained in overcrowded jails.

Despite the risks, many Syrians have managed to adapt to life in Libya, integrating into local communities and participating in its economy.

Yet numerous challenges persist, particularly for undocumented workers and those living without valid residency papers. Many report facing discrimination, abuse, and difficult working conditions.

As thousands of Syrian refugees across the Middle East prepare to return home amid improving conditions and relaxed restrictions, Syrians in Libya remain stuck, unable to stay, and unable to leave.

“We’re caught in the middle,” said one Syrian resident in Tripoli. “We can’t endure much longer, but we also can’t afford to go back.”

Many Syrians in Libya say they are increasingly vulnerable to exploitation, including passport confiscation and harassment by armed groups and criminal gangs operating with impunity.

Several Syrian residents told Asharq Al-Awsat they are facing rising unemployment, frequent kidnappings, and demands for ransom by militias. For those who now wish to return to Syria, doing so has become financially prohibitive due to hefty fines for visa violations.

Steep Penalties for Overstaying

Under a revised Libyan immigration law enacted on March 14, 2024, foreigners who overstay their visas or residency permits are charged 500 Libyan dinars - around $90 - per month. The regulation adds a significant burden for many Syrians whose legal documents have expired and who lack the resources to renew them or pay the fines required to exit the country legally.

Due to the political division in Libya since 2014, no official statistics exist on the number of foreign residents. However, the UN refugee agency (UNHCR) reported in 2020 that approximately 14,500 Syrian refugees and asylum seekers were living in Libya.

Ten years after arriving in Libya, Ahmed Kamal Al-Fakhouri says he is now trapped, unable to afford life in the country or the high costs of leaving it.

“They’ve imposed fines on us that are beyond reason - nearly $1,500 per person,” said Fakhouri, a restaurant worker in Tripoli, echoing a growing outcry among Syrians in Libya burdened by mounting penalties and legal uncertainties. “Sometimes, I can’t even afford a day’s meal.”

Fakhouri fled Derna after the deadly floods of August 2023 and resettled in Tripoli.

“I saw death with my own eyes,” he told Asharq Al-Awsat, describing the trauma of losing his home. “Now we’re living in misery. We want the world to hear our voice - we want to go back to our country.”

Libya hosts thousands of Syrians, including doctors, engineers, university students, and day laborers who fill the country’s markets in search of work to support their families.

Yet many say they now find themselves stuck, facing visa penalties they can’t afford and no clear path home - even as the fall of Assad’s regime renews hopes for return.

“Exit Tax” Burdens Families

While Libya’s labor ministries have issued no formal statement on the matter, members of the Syrian community say they are being charged an "exit tax" calculated based on their overstay period. No official decree has been published, but testimonies suggest the fees are acting as a de facto barrier to departure.

Following Assad’s ouster, many Syrians are reconsidering return, describing exile as a “prison,” but are deterred by the financial burden of settling overstays.

Asharq Al-Awsat reached out to both of Libya’s rival labor ministries to clarify policies affecting Syrians and the reported fines for expired documents, but received no response.

Zekeriya Saadi, another Syrian living in Tripoli, has publicly called on authorities in both eastern and western Libya to cancel the exit tax and allow those wishing to return to Syria to do so.

“In these unbearable conditions, it’s unreasonable to ask refugees to pay such high fees just to leave the country,” he said. “This tax is a major obstacle, it exceeds our capacity, especially given our financial hardships.”

Saadi said most Syrians in Libya are low-income families without stable jobs. “Many are at risk of eviction, kidnapping, or exploitation. Leaving has become a matter of survival,” he said. “How can a displaced person be treated like a tourist or a wealthy expat?”

He urged Syria’s Foreign Ministry to take a clear stance and negotiate with Libyan authorities for fee exemptions and coordinated return efforts, while also working to protect Syrians who remain in the country.

Passport Problems Bar Education

Beyond financial barriers, expired passports are also stranding Syrians in legal limbo. Many have lost access to services, and the issue is now affecting the next generation.

According to Syrian media reports, education officials in Misrata barred at least 100 Syrian children from enrolling in public schools because their parents’ passports had expired, highlighting how bureaucratic obstacles are deepening the crisis for displaced families.