'No one looks at me': 12-year-old amputee in Gaza on what the war cost him
Desperate state of health system means unnecessary amputations being done on kids as young as 1, surgeon says
Before the war started in Gaza, Moustafa Ahmed Shehda would run around and play with his friends. Now, the 12-year-old is one of a growing number of Palestinians in the territory who've lost a limb in a bombing.
Moustafa is from Jabalia in northern Gaza, which has been hit particularly hard in the fighting. Early on in the war between Israel and Hamas, he was visiting his uncle when the apartment building was bombed.
"I was under the rubble. I couldn't feel anything. I couldn't breathe," Moustafa told Mohamed El Saife, a freelance journalist in Gaza working for CBC News.
His uncle was killed, and Moustafa was pulled from the rubble. Because of the extent of his injuries, his right leg had to later be amputated below the knee.
"Before the war, I used to play with my friends," he said. "I can't play because of my injury. I can't play, and I don't have friends, and I don't have anything."
Palestinian health officials said on Saturday that 26,257 Palestinians have been killed in Gaza since Israel began bombing the small enclave of 2.3 million people in retaliation for the Oct. 7 attack on southern Israel by Hamas-led militants while nearly 65,000 have been wounded.
It's unclear how many suffered amputations as a result, but UNICEF has estimated that since the start of the war through to the end of last November, about 1,000 children have had one or both of their legs amputated. The United Nations agency doesn't have updated numbers.
About 1,200 people were killed in Israel during the Oct. 7 attack, and about 250 were taken hostage, according to Israeli officials. Of the 132 remaining in Gaza, about 25 have been killed.
Moustafa was sent to Egypt for treatment but soon returned to Gaza. He ended up in the southern region of Rafah and now stays with his sister, her husband and two children in a makeshift camp. He said he's desperate to go home to see his parents, who are trapped in the north.
"We only have two mats, and we sleep on top of each other," Moustafa said. "No one looks at me. I want someone to come and take me out of here."
Moustafa requires additional treatment for his leg, but his uncle in Rafah said it's been a challenge getting him to a hospital in nearby Khan Younis.
Baby's leg had to be amputated
Aldo Rodriguez, a surgeon working with Doctors Without Borders, spent five weeks in Gaza at the end of last year. Most of his cases were traumatic amputations, meaning patients arrived at the hospital missing limbs from an explosion.
But, he said, it's the babies he can't get out of his mind. For the first time in his life, he had to amputate the leg of a one-year-old to the groin.
"I didn't understand why a patient ... one year, two years, baby had to suffer an amputation of the leg or the arm — and not just one or two patients. Many, many children with amputations," he said.
Rodriguez has worked in many war zones, including Sudan, Afghanistan and Yemen, but he said he's never seen as many injured children as he saw in Gaza.
"It was really shocking for me because I have never seen babies. So many babies victim of trauma, of war, with war wounds," he said.
Doctors at the European Hospital in Khan Younis say if they had more staff and more resources, they could have saved some of the limbs they've been forced to amputate.
"I have noticed a number of patients, it would have been possible not to amputate their limbs if it was possible to transfer them or there were resources available," said Ismail ElHams, the lead doctor at the hospital.
Sometimes there are complications after surgery, he said, which can also lead to amputations.
"The amount of injuries coming into the hospital is overwhelming, so it delays dealing with cases for days while we get through other cases, including amputations," ElHams said.
Gaza's health-care system 'destroyed completely'
Bassam Omar Mohamed Shaheen is from northern Gaza. On Nov. 3, he, his wife, their children and his mother were sheltering at the Osama bin Zaid school, in the Al-Saftawi area north of Gaza City, when it was attacked by Israeli forces. Shaheen's mother was killed, and his left hand and left leg were injured in the blast.
It took 30 minutes by ambulance to get to the Indonesian Hospital in the north.
"I arrived at the hospital and fainted," Shaheen said.
He said he waited about eight hours for medical care because hospital staff were busy dealing with other patients.
Doctors tried to save Shaheen's limbs by putting platinum inside his fingers and toes. He remained in the hospital for a month. Israeli forces then besieged the Indonesian Hospital, so he was transferred to the European Hospital in southern Gaza, where his leg was amputated.
"There was a lack of medications, and the platinum inserts failed, so the amputation happened," Shaheen said.
He said he desperately wants a prosthetic leg and a bone transplant so that his hand can function again, but that's not possible in Gaza.
"The health-care system in Gaza is destroyed. Destroyed completely," Shaheen said. "The makeshift hospitals are not even good enough for animals let alone humans."
Inside the hospital, he said, there's little food or medication, and if patients want either, they have to pay with their own money. But even then, they are in short supply.
"Every four days, medications come through the crossing," Shaheen said. "I and other patients need pills for the amputation, and we haven't gotten any in four days."
Hospitals lack ventilators, supplies: WHO official
The World Health Organization (WHO) said it's been very difficult getting medicine where it is needed in the Gaza Strip, especially in the north.
"We co-ordinate our movements with both parties to the conflict to try to be as safe as possible. In many cases, that means that our movements have unfortunately been denied," Sean Casey, WHO's emergency teams co-ordinator, said in an interview.
Casey, who recently spent five weeks in Gaza, said in some cases it took several days and even weeks to reach certain hospitals and pharmacies.
There was a period when WHO couldn't get access to the north for 12 days. That meant no medical supplies or fuel for generators were delivered to hospitals in that area.
"There's no lights. There's no machines that are working. There's no patient monitors, there's no ventilators, there's no operating theaters that can work in those conditions," Casey said.
He said the conditions in Gaza's hospitals are so deplorable that it's difficult to witness.
"It's hard to go into a hospital and see children on the floor bleeding and no health workers to care for them, to hear doctors crying out for a chest tube that isn't there, saying, 'I could save this person, but I don't have the supplies that I need.' It takes a toll," Casey said.
Health officials say that in some cases in northern hospitals, doctors have had to perform surgeries without anesthesia.
Rodriguez of Doctors Without Borders said the hospitals he worked at had drugs to put patients under, but not much else.
"After the surgery, we had no pain medication, no morphine, no tramadol or no medication for the pain," he said.
Pain without medication 'unimaginable'
Deirdre Nunan, a Canadian orthopedic surgeon from Saskatchewan, said she can't stomach the idea of patients who lost a limb not receiving pain medicine. She's been to Gaza three times between 2019 and 2022 with Doctors Without Borders.
"The degree of pain, unmanaged post-operatively, would be absolutely unimaginable," she said in an interview with CBC News from Afghanistan, where she is working with another non-governmental organization.
Nunan said recovery from an amputation is a long process — starting with initial surgery that would normally be done in a sterile environment.
"Those initial procedures aren't being done to the same standard that they would normally be done," she said. "That's setting up the child for having more complications and needing more surgeries in the future."
Children can have a normal life after an amputation, Nunan said, but only if a number of conditions are met: The surgery must be done right away, and their limb must be pain free; there is no infection; they have access to good prosthetics; and they have all of the social, emotional and environmental support they need.
"Absolutely none of that is something that exists in Gaza at the moment," she said.
Even before the war, Nunan said, there was a shortage of prosthetics because of Israel's blockade on Gaza that restricted what can be brought into the territory, including medical devices, medication and supplies.
She said children in particular will require multiple surgeries and numerous prosthetics as their bodies continue to grow.
For his part, Moustafa said he hopes that one day, he'll be able to get a prosthetic leg so he can run around and play like he used to.
"I just want that when I grow up, I can walk like other kids," he said. "I want to be a doctor so I can help sick and injured people."