Why Gaza's injured children face lasting struggles even after medical evacuation to Jordan

Arab News

2 days ago

AMMAN: Abdulhadi Al-Sayed will never forget the vivid details of what happened to him on March 30, the first day of Eid Al-Fitr, just two weeks after Israel resumed its bombing campaign across the Gaza Strip following the latest ceasefire collapse.
He had joined some friends at a cafe in Gaza City to play video games — a semblance of normality amid the grinding conflict. On his way home, the 14-year-old recalled passing a group of children playing in the street when a car pulled up.
Moments later, the first missile struck.
Seven children and everyone in the vehicle were killed instantly, while shrapnel from the blast tore through Abdulhadi's right arm and thigh. While he lay bleeding heavily on the ground, a second shell exploded, this one shattering his jaw.
Although he survived the attack, he will carry his wounds with him for the rest of his life.
'I remember that day vividly,' Abdulhadi told Arab News from his ward at Mouwasat Hospital, a facility run by Medecins Sans Frontieres in Amman, Jordan, specializing in reconstructive surgery and comprehensive rehabilitation for the war-wounded.
'For months in Gaza, I couldn't sleep. Every time I woke up, I lived the nightmare still unfolding around me.'
For two days after the attack, Abdulhadi said he lay on the floor of a hospital in Gaza among dozens of patients, with no bandages, painkillers, or even enough specialist staff to offer more than basic first aid.
Given the damage to his jaw, Abdulhadi said he could only be fed liquids through a syringe. But amid Gaza's severe food shortages under an Israeli aid blockade, his meals were typically tomato paste mixed with water.
Back in the makeshift camp where he had lived since being displaced from his home in the Shejaiya district of Gaza City, he said a nurse would occasionally come to check on him as he lay recuperating in unsanitary conditions.
It was three months before Abdulhadi was evacuated to Amman as part of the Jordanian medical corridor, an ongoing humanitarian mission launched by King Abdullah II in February to treat 2,000 critically ill and wounded Palestinian children in Jordanian hospitals.
He is one of 437 Palestinians, including 134 children, evacuated from Gaza to Jordan since the initiative began in March in coordination with the World Health Organization. The most recent group, 15 children and 47 companions, arrived on Aug. 6.
Since arriving in Amman on July 1, Abdulhadi has been receiving medical, rehabilitative, and psychological care.
After complex maxillofacial surgery to reconstruct his jaw with platinum implants, followed by plastic surgery to repair facial trauma, he can now eat, speak, and even smile again.
He will soon undergo further surgery to remove shrapnel from his hand, followed by reconstructive surgery on his right leg and a course of physiotherapy.
Although he now sleeps through the night on a clean bed, eats regularly, plays chess, and practices a little English daily, he carries the affliction of many war-wounded — survivor's guilt.
Accompanied by his father and grandmother, Abdulhadi longs to be back with his mother, who chose to remain in Gaza, refusing to leave her three older boys, despite persistent hunger and her own untreated injuries.
'I like being here, but not without my family,' said Abdulhadi, who maintains daily contact with his family. They have since found shelter close to Al-Shifa Hospital in northern Gaza.
Abdulhadi's father, Sobhi Al-Sayed, told Arab News he is likewise torn between gratitude for safety and guilt for leaving his other children.
'I feel helpless when my sons tell me they are hungry,' he said. 'The other day, I could not recognize my wife on a video call because of how much weight she had lost.'
Sobhi says his eldest son, 24-year-old Shaker, has also been injured by Israeli fire while trying to get flour for his siblings from an aid distribution center. 'Injured, killed, or starved,' he said. 'Those are the only three options in Gaza.'
The WHO, which coordinates medical evacuations with Gaza's Health Ministry and host countries, warned of 'catastrophic' conditions in the enclave, where fewer than half of hospitals are partially functioning, short of life-saving medicines, and overwhelmed with patients.
Nearly two years of war have devastated Gaza's critical sanitation, water, and electricity infrastructure, leaving most of the 1.9 million internally displaced people crowded in tents and exposed to mounting garbage, poor hygiene, and unclean water.
The crisis is compounded by a surge in hunger-related deaths now exceeding 240 — half of them children — according to Gaza authorities, as aid agencies warn of a worsening humanitarian catastrophe.
Since the war began in October 2023 until July 31 this year, the WHO has evacuated more than 7,500 Palestinians, including 5,200 children, for treatment in Egypt, Jordan, the UAE, Qatar, Turkiye, and European countries.
However, WHO officials say more than 14,800 remain in urgent need, calling for faster medical evacuations through all possible routes, including restoring referrals to the West Bank and East Jerusalem.
The small number evacuated compared to the scale of need reflects the long, complex process. Cases are first referred by doctors, then approved by Gaza's Health Ministry, which prioritizes and transfers them to the WHO for coordination with host countries and Israel.
Bureaucratic hurdles, host country requirements, and occasional Israeli rejections continue to block access to lifesaving care.
Once children complete their treatment in Jordan, they and their caregivers are returned to Gaza, making room for new patients to be evacuated for medical care.
Cyril Cappai, MSF's head of mission in Amman, told Arab News that while evacuations to Jordan were difficult at first, they have become more organized due to the presence of on the ground MSF teams and the Jordanian field hospital.
The MSF facility in Amman currently hosts 25 Palestinian children from Gaza with critical injuries, along with their companions.
Cappai said the comprehensive long-term treatment programs, which include orthopedic and reconstructive surgery, physiotherapy, occupational therapy, and mental health services, last more than four months.
'The injuries we see often require multiple surgeries and a long road to recovery,' he said. 'We also deal with post-surgery bone infections, which need close monitoring and prolonged courses of antibiotics.'
Rehabilitative and psychological care, which makes up 80 percent of the treatment program, is designed to help children and adolescents rebuild their sense of self-worth by providing adaptive tools that ease their daily life and support their reintegration into society.
'The key is to help young people live with their new condition as productive members of society who can get jobs, drive, and earn money,' said Cappai. 'Building mental resilience also accelerates physical progress.'
A 3D printing lab at the facility designs tailored medical devices, from upper-limb prosthetics to transparent facial orthoses for burn patients, which help skin heal through pressure therapy.
Psychotherapy sessions address pain management and help those who have suffered life-changing injuries cope with painful memories and trauma. These services extend to the children's companions, many of whom suffer from mental trauma and chronic illnesses.
Each patient is usually allowed one companion, but exceptions are made for families with young children, allowing mothers to bring them along.
'We cannot let a mother leave her babies behind, so they come with their wounded siblings to receive treatment,' said Cappai.
Young companions are kept engaged through play therapy, music, art classes, and schooling for those out of the classroom. A new hospital space provides a safe play area, while vocational training in skincare, barbering, and silver crafting is offered in collaboration with local agencies.
Ghada Al-Hams, a mother of six, said she could not leave her children Amr, 11, and Malak, 10, when she was contacted to accompany her 16-year-old son, Ammar, for treatment in Jordan, but she was forced to leave her three other children in Gaza — a decision that still haunts her.
'I left them with no food or water,' Al-Hams told Arab News at the Mouwasat Hospital in Amman. 'To be offered the best food while my kids starve is a tragedy for me.' Her son, desperate to get flour for his siblings, was injured twice while seeking aid.
'When I heard about his injury, I requested to go back to Gaza, but my wounded son here needs a companion,' she said.
Al-Hams said Ammar was injured in July 2024 when an artillery shell landed between him and his father as they walked to their old home in Muraj, north of Rafah, having been displaced to Khan Yunis. The blast killed his father and left Ammar's right arm dangling by a thread.
'He tried to carry his father to the nearest hospital but couldn't,' said Al-Hams. 'His father told him to leave him behind and go. His last words were, 'Don't look at your arm. Take care of your mother and siblings.' And then he was gone.'
Despite their limited medical supplies, Al-Hams said medics in Gaza were able to save Ammar's arm from amputation. But after months without proper care, his right palm was left paralyzed, with one nerve severed and two others damaged.
'Sleeping in an unsanitary tent left him in pain and unable to rest, which worsened his condition,' said Al-Hams.
MSF surgeons in Gaza operated to reconnect the severed nerve, but ongoing treatment was disrupted when Nasser Hospital in Khan Yunis was bombed and MSF staff were forced to withdraw.
Ammar was referred abroad in March and evacuated on July 1 in a challenging journey along bombed-out streets, past shell-damaged ambulances, and through multiple security checks to reach the Israeli-controlled Kerem Shalom border crossing.
MSF doctors at Jordan's Mouwasat Hospital said Ammar needs at least three months of physiotherapy and occupational therapy. If unresponsive to treatment, he will require a tendon transfer.
'Ammar was speechless for three months after watching his father die,' said Al-Hams. 'He was always silent and zoned out. It took him time to start interacting again.'
Meanwhile, her accompanying children are receiving schooling and psychotherapy sessions, slowly regaining their energy and confidence — though the trauma still lingers.
After two years out of school, they now have the strength to play and even compete for the highest grades in the hospital's classes. They feel safe at last, though the sound of airplanes still makes them flinch.
'Every day in Gaza is a struggle for survival,' said Al-Hams. 'My children would spend four hours in line for water, then another for flour. If we managed to get food that day, we never knew when we'd find any again.
'Now my kids are living their childhood again.'