Abdul-Rahman al-Nashash, 11, holds onto the edge of a chair and pushes his left leg into a plastic prosthetic that doesn’t fit him anymore. The bone that was cut two years ago has kept growing inside, and it presses painfully against his skin.

His doctors told him to stop wearing it. He wears it anyway, every morning, pulling the straps tight and rolling his pants down so no one sees the plastic before he takes his first step. He bites his lip when it hurts and holds his shoulders straight so no one can tell he is limping.

“He forces himself to wear it,” his mother said, “just so no one knows he has a disability.”

Before the genocide, al-Nashash played for a local soccer club, and he would chase the ball across a dirt field until the sun went down. He is the eldest son in his family, and he was the one his mother leaned on at home. When she needed water, he was the one who ran to carry the heavy gallon of water, and he never got tired. Now, he is not able.

When he finally takes the prosthetic off, he sits curled up. He is waiting for his third surgery, and his mother said he will need one every year.

As a child grows, the bone in the amputated leg grows too, but the prosthetic doesn’t. At some point it stops fitting, and sometimes the child needs another operation before he can get a new one. In Gaza, that often means starting over with surgery, then rehabilitation, then a new limb if one can be made at all, because Israel restricts the parts and materials needed to make and repair them. Some children in Gaza have outgrown their limbs and are waiting for new ones. Others never received one, because there are none in Gaza that fit them.

Al-Nashash’s family was forced to evacuate from al-Bureij refugee camp in Central Gaza in 2023 and took shelter in UNRWA schools. His father stayed behind. Two days after they left, on October 20, the house was struck, and his father was killed along with several relatives. The three-wheeled motorcycle that had been the family’s only source of income was parked in the storeroom and was destroyed in the same strike.

From there, the family moved from school to school and tent to tent. They spent about three months in Rafah, then moved to schools in Nuseirat. With no money coming in, his mother opened a small stall with her brother-in-law, selling a variety of canned beans.

Around noon on July 16, 2024, her sister asked her to come light a fire and cook, so she left her son to mind the stall in her place. An Israeli airstrike hit the tents in the middle of al-Razi school, a UNRWA shelter in Nuseirat camp, killing 23 people, according to Gaza’s Government Media Office. A piece of shrapnel struck his leg directly. His mother said his injured left foot was split in two, the bones of his toes exposed, and she kept screaming that her son had been killed.

At first, she said, she was told doctors hoped to fix the leg with metal plates rather than amputate. At Al-Aqsa Hospital, one doctor told her the leg would have to be amputated, and she asked them to cut off her own leg and give it to him, because he was the one who took care of her. He was then taken by an ambulance to a hospital by the sea in Deir al-Balah where a foreign medical team was working. There they told her nothing more could be done. The amputation needed her consent. She signed, because there was no other choice.

When al-Nashash woke from the anesthesia, he kept staring at himself as if he were losing his mind. It was only after counselors came and he began to see other children like him that he slowly started to adjust.

After the amputation, therapists from local rehabilitation programs came to work with him regularly. But his natural childhood growth worked against his recovery. “My son grows fast,” his mother said. By March 2025, just eight months after he lost his leg, the bone had already grown too long.

They traveled to Jordan, where surgeons cut the bone back and fitted him with his first prosthetic, the one he still wears today. The trip lasted five months. When al-Nashash returned to Gaza, the boy who used to sprint on the soccer field had to start physical therapy from scratch, learning how to balance and walk all over again.

Today, that same cycle is about to restart. Once he manages to get his next surgery, he will face three more months of physical therapy before he can even begin training to walk again. His mother has applied for a medical evacuation out of Gaza, hoping he can be treated abroad. “I wish I could see my son walk like other children,” she told Mondoweiss.

Until that approval comes, al-Nashash also uses a pair of forearm crutches that are are breaking down. The soft material on the hand grips has completely worn away, leaving his hands to rub against the hard surface. “There are no spare parts for the grips,” his mother said.

The Indefinite Wait for Prosthetics

Mahmoud al-Darbali, 10, lost his right leg up to the hip when he was nine, and over a year later, he is still waiting to receive his first prosthetic.

Al-Darbali’s family home near the Zeitoun car market was bombed a week after they evacuated. After being displaced south more than ten times, the family returned north, squeezing into a single room in his grandmother’s house on Kishko Street, in the Zeitoun neighborhood of Gaza City. “We were happy,” his mother told Mondoweiss.

On July 5, 2025, three shells struck the house. The blast killed several relatives, including al-Darbali’s 14-year-old sister. “I didn’t get to say goodbye. She died hungry,” his mother said. The explosion severed Mahmoud’s right leg instantly and burned his left thigh. Shrapnel hit his seven-year-old brother’s lung and struck his mother’s knee. His 16-year-old brother still has shrapnel near his spine, and he cannot sleep without painkillers.

They spent over two months at Al-Ahli Arab Baptist Hospital, where al-Darbali was taken to the operating room daily just to change his bandages. The mother and her five surviving children shared a single hospital bed. In July 2025, the same month Mahmoud was injured, Doctors Without Borders (MSF) said injured patients at its clinics in Gaza were asking for food instead of medicine, because their wounds were not healing without enough protein.

After leaving the hospital, the family managed on the street. Al-Darbali relies on crutches and a wheelchair, yet he cannot walk more than a hundred meters on the crutches. Without electricity, he often loses his balance in the dark. “Many times I wake up to his terrified voice as he hits the ground,” his mother says.

He still feels the missing leg. “Mom, my heel hurts,” he tells her, his mother said. His brother holds the empty space where Mahmoud’s leg used to be and presses on it. “I feel better,” Mahmoud says. He receives no psychological support. When he is given paper, he draws tanks, missiles and blood.

Because the amputation reaches his pelvis, leaving only a tiny fraction of the thigh bone, the family has been told no prosthetic in Gaza can fit him. He has been referred for medical evacuation abroad, but no country has accepted his case yet. “The situation is hard,” his mother said, “and there is no food.”

A Shortage By Design

Dr. Mohammed Abu Mansi, a physical therapy and rehabilitation specialist at Sheikh Hamad Bin Khalifa Al Thani Hospital for Rehabilitation and Prosthetics in Gaza City, explained that while not every child requires annual revision surgeries, bone overgrowth causes complications in some children. For patients like al-Nashash, the growing bone creates a protrusion. “When the child puts weight on the prosthetic, this spot becomes very painful,” he said. “The pressure inside the prosthetic becomes unbearable.”

Revision surgeries can be done in Gaza, he said, but only within what is available in operating rooms, anesthesia and follow-up care. Complicated cases need to travel abroad.

For hip-level amputations like al-Darbali’s, the problem is the materials. “We used to fit this type of prosthetic inside Gaza before the war,” Dr. Abu Mansi told Mondoweiss. “But now the materials needed to make a prosthetic for an amputation up to the hip are not available.” Before the war, he said, prosthetic parts and materials came in regularly, and the hospital could provide steady care to amputees.

Children like al-Darbali, left without a prosthetic, he said, develop muscle weakness, muscle contractures, limited movement and changes in the shape of the amputated limb as their bodies continue to grow. Relying on crutches and wheelchairs for a long time also causes other complications.

Al-Nashash and al-Darbali are among thousands of amputees. The World Health Organization estimates that more than 5,000 people in Gaza have lost limbs since October 2023, and that one in five of them is a child. Of 2,277 amputees the WHO evaluated between September 2024 and May 2026, only 502 had been fitted with a prosthetic. Eighteen percent were children, and 32 percent had above-knee amputations. 225 needed revision surgery on what remained of their limb, and only eight prosthetists were working in the entire Strip.

According to the same report, no rehabilitation equipment entered Gaza between May 2024 and April 14, 2026. By that date, 18 shipments, including prosthetic limbs and children’s wheelchairs, were still waiting for clearance, for 136 days on average and 526 days in the longest case. In the six months before that, four shipments were rejected. In June, the UN Office for the Coordination of Humanitarian Affairs reported that Israeli authorities had denied prosthetic hand, knee and ankle joints, silicone liners and medical shoes, despite repeated requests.

Treatment abroad is not guaranteed either. A medical referral is only the first step. A host country has to select the patient, and the list then goes to Israeli authorities for clearance. By mid-September, 13,555 patients had been evacuated since October 2023, including 6,326 children. Before the war, 50 to 100 patients left Gaza every day for treatment. In January, WHO Director-General Tedros Adhanom Ghebreyesus said more than 18,500 patients, including 4,000 children, still needed urgent medical evacuation. Citing Gaza’s Ministry of Health, he said 1,092 patients had died while waiting between July 2024 and November 2025.

Al-Darbali turned 10 in July. His mother is still waiting for a call from the officials handling his referral to tell her that his evacuation has been approved. “Every second, I pray my phone will ring, and they’ll tell me to get ready,” she said.

Now, when al-Darbali is taken to the hospital, he refuses to be put to sleep. His left leg, the only one he has left, is scarred from the burns.

“I don’t want to sleep,” Mahmoud said. “They’ll cut off my other leg.”

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