Abu-Sittah is the author of “
The War Injured Child,” the first medical textbook on the subject, which was published last May. In October and November, he spent forty-three days in Gaza, conducting emergency surgeries with Doctors Without Borders.
He shuttled between two hospitals: Al-Shifa and Al-Ahli, which is also known as the Baptist hospital. The casualty rate was so high that, during some intense periods, he didn’t leave the operating room for three days. “It felt like a scene from an American Civil War movie,” he said.
In Gaza, Abu-Sittah was performing as many as six amputations a day. “Sometimes you have no other medical option,” he explained. “
The Israelis had surrounded the blood bank, so we couldn’t do transfusions. If a limb was bleeding profusely, we had to amputate.” The dearth of basic medical supplies, owing to blockades, also contributed to the number of amputations. Without the ability to irrigate a wound immediately in an operating room, infection and gangrene often set in. “Every war wound is considered dirty,” Karin Huster, a nurse who leads medical teams in Gaza for Doctors Without Borders, told me. “It means that many get a ticket to the operating room.”
To mark the gravity of these procedures, and to mourn, Abu-Sittah and other medical staff placed the severed limbs of children in small cardboard boxes. They labelled the boxes with masking tape, on which they wrote a name and body part, and buried them. At the pub, he showed me a photograph he’d taken of one such box, which read, “Salahadin, Foot.”
Some wounded children were too young to know their own names, he added, telling the story of an amputee who’d been pulled from rubble as the sole survivor of an attack.
The number of child amputees carries long-term implications, Abu-Sittah told me, listing his concerns. Israeli forces destroyed Gaza’s only facility for manufacturing prosthetics and rehabilitation, the Hamad hospital, which was inaugurated in 2019 and funded by Qatar. The leading manufacturer of child prosthetics, the German company Ottobock, is working to supply the necessary components to children up to the age of sixteen, with donors in place to fund the project through its foundation.
Procuring prosthetics, however, is only the first step. “Child amputees need medical care every six months as they grow,” Abu-Sittah said. Because bone grows faster than soft tissue and severed nerves often reattach painfully to skin, child amputees require ongoing surgical interventions. In his experience, each limb requires eight to twelve more surgeries. To track this cohort, Abu-Sittah is consulting with the Centre for Blast Injury Studies at Imperial College London and the Global Health Institute at the American University of Beirut; their goal is to create a cloud-based database of medical records that can follow these kids wherever they go. For the rest of their lives, these amputees will need answers regarding their medical history. Abu-Sittah knows how this works: for years, as a pediatric trauma surgeon, he’s fielded calls from his former patients.
Abu-Sittah, who’d recently travelled to Qatar to consult,
recalled meeting a fourteen-year-old boy who’d lost his leg after being trapped under rubble. He’d spent a day beneath the debris holding the hand of his dead mother. “These are vulnerable people in the midst of the storm,” he said.
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