Children brought from Gaza to Lebanon to heal from their wounds are once again involved in war

BEIRUT (AP) — When Zarifa Nawfal’s family arrived in Beirut for her injured daughter’s surgery, one of the first things she wanted to do was go to the sea. The Mediterranean Sea had been a constant companion in their home in Gaza before the war.

“The moment I smelled the sea, I felt peaceful inside – like I was in Gaza,” she said.

But soon their sanctuary reminded her of home in much more disturbing ways.

Palestinian girl Halima Abou Yassine, 7, who was brought from the Gaza Strip to Lebanon for treatment after an Israeli attack left her near death with a gaping wound in her skull, plays with a toy car at a summer camp in Beirut, Lebanon, on Friday, 30 August 2024. (AP Photo/Bilal Hussein)

Nawfal’s 7-year-old daughter, Halima Abou Yassine, is one of dozens of seriously injured Palestinian children brought to Lebanon this year for treatment through a program launched by a British-Palestinian surgeon, Dr. Ghassan Abu Sitta.

But months after their arrival, Lebanon is itself embroiled in a war any fear will end in Gaza-like destruction.

In February, Nawfal was staying in an apartment in central Gaza with her five children and her mother. They had been driven from their home in the north and Nawfal’s husband was missing, presumed dead.

The children were outside filling water containers when two rockets hit, Nawfal said. She ran outside and found Halima, the youngest, lying in the street, her skull cracked open and her brain exposed.

Despite her shock, Nawfal said, “I was relieved that her body was intact.” In Gaza, explosions often tore people apart, leaving their loved ones without even a body to bury.

Halima’s brother lay unconscious next to her. He was quickly revived in the hospital. But staff at Al-Aqsa Martyrs Hospital confirmed Nawfal’s fears. She said: Halima was dead. Her small body was placed in the morgue.

But as the family prepared to bury her, the little girl’s uncle noticed faint signs of life, the family said.

Al-Aqsa Hospital officials could not be reached to confirm the story. But Abu Sitta, who worked in several Gaza hospitals during the war, said it was not unusual for patients to be wrongly identified as dead in the chaotic situation, as normal protocols for emergency room examinations were often abandoned.

Palestinian children brought to Lebanon from the Gaza Strip for treatment play at a summer camp in Beirut, Lebanon, Friday, August 30, 2024. (AP Photo/Bilal Hussein)

“Due to the sheer number of cases received in each airstrike, ambulance crews immediately took those they believed to be dead to the morgue,” he said.

In the days after her daughter was determined to be alive, Nawfal stayed with her, manually pumping oxygen into her lungs. After a week, the little girl began to breathe on her own. Finally she woke up.

Siwar Abou Yassine, right, combs the hair of her sister Halima, 7, who was brought from Gaza to Lebanon for treatment after an Israeli attack left her near death with a gaping wound in her skull, in Beirut, Lebanon, Friday, August 8 . August 30, 2024. (AP Photo/Bilal Hussein)

Palestinian Adam Afana, 5, who was brought from the Gaza Strip to Lebanon for treatment and who nearly lost his left arm in an Israeli airstrike that killed his father and sister, plays with a toy plane at a summer camp in Beirut, Lebanon, Friday, August 30 2024. (AP Photo/Bilal Hussein)

Palestinian children brought to Lebanon from the Gaza Strip for treatment join Lebanese children at a summer camp in Beirut, Lebanon, Friday, August 30, 2024. (AP Photo/Bilal Hussein)

“Some doctors were crying and saying this is a miracle,” Nawfal said.

But all they could do was keep the little girl alive. Her skull was still open and a piece of bone was missing. Her brain was ravaged by an infection.

The family was evacuated to Egypt in May. In July they boarded a plane to Lebanon.

An unlikely refuge

The first of the injured Palestinian children arrived in Lebanon in May. Five-year-old Adam Afana almost lost his left arm in an explosion that killed his father and sister. His arm was paralyzed and he required complex surgery to repair the nerve damage.

At the time, Lebanon was already involved in a simmering conflict between Israel and Hezbollah.

The Lebanese militant group began firing rockets across the border into Israel in support of his allyHamas, on October 8, 2023, a day after Palestinian militants staged the deadly surprise raid in southern Israel that sparked the ongoing war in Gaza. Israel responded with shelling and air strikes.

For months, the conflict in Lebanon was mainly limited to the border area, far from Beirut.

Abu Sitta said he chose Lebanon to treat injured children because the Mediterranean country has specialists with extensive experience in treating war injuries.

Lebanon has experienced numerous conflicts, including a fifteen-year civil war that ended in 1990 and a brutal, months-long war between Israel and Hezbollah in 2006, as well as spillover effects from other regional conflicts.

“Even after the end of the wars (in Lebanon), the wounded from Iraq and Syria would come here for such complex and multi-phase treatment,” Abu Sitta said.

The war that followed them

In July, Halima underwent successful surgery to repair her skull at the American University of Beirut Medical Center.

Nawfal said her daughter has persistent memory problems but is improving with therapy. A bright, cheerful child, Halima thrived in Beirut. She swam in the hotel pool, liked to color and played with the other children from Gaza. She walked with her siblings to pick fruit at the neighborhood vegetable stand, wearing a straw hat to cover the scar on the back of her head.

In mid-September, Israel launched one offensive against Hezbollah. It destroyed large parts of Lebanon with airstrikes including Beirut’s southern suburbs and some locations in the city center.

The children quickly fell back into war habits. They opened the balcony’s sliding glass doors to prevent the glass from breaking from the pressure of an explosion and began sleeping in the central sitting room of the family’s hotel suite, far away from the windows.

Palestinian girl Halima Abou Yassine, 7, who was brought from Gaza to Lebanon for treatment after an Israeli attack left her near death with a gaping wound in her skull, cries as she lies on a hospital bed ahead of surgery on her head in the hospital. American University of Beirut Medical Center (AUBMC), in Beirut, Lebanon, Monday, July 15, 2024. (AP Photo/Hussein Malla)

Nawfal said some organizations offered to evacuate the family from Lebanon to continue treatment elsewhere, but she “completely refused.”

“Lebanon is not just an Arab country or a country where we have come for treatment – Lebanon is a sister of Gaza,” she said. “We are like two souls in one body. … We live or die together.”

This was said by Adam Afana’s uncle, Eid Afana the escalation in Lebanon “reminds us of the beginning of the war in Gaza.” Afana said the sound of airstrikes scared Adam, who felt the war was following them.

“What we hope for Lebanon is that what happened in Gaza will not happen here – that the beginning and the end will not both be the same,” Afana said.

Halima Abou Yassine, 7, who was brought from Gaza to Lebanon for treatment after an Israeli attack left her near death with a gaping wound in her skull, walks with her mother before surgery at the American University of Beirut Medical Center in Beirut, Lebanon, Monday, July 15, 2024. (AP Photo/Hussein Malla)

Halima Abou Yassine, 7 years old, who was brought from Gaza to Lebanon for treatment after an Israeli attack left her near death with a gaping wound in her skull, lies on a hospital bed as she is moved by nurses to the operating room for surgery in the hospital. American University of Beirut Medical Center in Beirut, Lebanon, Monday, July 15, 2024. (AP Photo/Hussein Malla)

‘All wars are waged against children’

The Ghassan Abu Sitta Fund has stopped bringing injured Palestinian children to Lebanon, but continues to treat existing patients – with some challenges.

Since arriving in Beirut, Adam has undergone a procedure to clear the infection from his bones, neurosurgery and regular physiotherapy sessions. With difficulty he can now clench his hand slightly.

But the latest surgery – a muscle transfer and surgery to repair damaged nerves in his arm – is off.

Orthopedic and spine surgeon Dr. Rachid Haidar, left, checks on Adam Afana, 5, who was brought from Gaza to Lebanon for treatment after nearly losing his left arm in an Israeli airstrike that killed his father and sister, as does his uncle, Eid Afana, right, stands next to him at the American University of Beirut Medical Center, in Beirut, Lebanon, Monday, July 15, 2024. (AP Photo/Hussein Malla)

Adam Afana, 5, who was brought from the Strip to Lebanon for treatment after nearly losing his left arm in an Israeli airstrike that killed his father and sister, receives physical therapy Wednesday at a clinic in the Mar Elias Palestinian refugee camp in Beirut, Lebanon. September 4, 2024. (AP Photo/Bilal Hussein)

Adam Afana, 5, center, who was brought to Lebanon from the Gaza Strip for treatment after nearly losing his left arm in an Israeli airstrike that killed his father and sister, receives physical therapy at a clinic in the Mar Elias Palestinian refugee camp in Beirut, Lebanon, Wednesday, September 4, 2024. (AP Photo/Bilal Hussein)

“There are only a handful of people in the world who specialize in this, and we expected one of them to come to Lebanon,” Abu Sitta said. The trip has been delayed due to the escalation in Lebanon.

When he first launched the program, Abu Sitta hoped to treat 50 Palestinian children from Gaza at any one time. Failing to bring in more patients, the team is focusing its resources on treating Lebanese children.

The number of injured Lebanese children is still much lower than in Gaza. Last week, the Lebanese Health Ministry said 192 children have been killed and at least 1,255 injured since October 2023. In Gaza, more than 13,000 children have been killed and thousands injured, according to the Ministry of Health.

Abu Sitta said the wounds of children in Lebanon are “identical to the injuries suffered by Palestinian children from Gaza.” Most were injured while at home. They suffered “crush injuries to the limbs, blast injuries to the face” and often “several members of the family were killed at the same time,” he said.

“Just like in Gaza, this war is taking its toll on children,” he said. “All wars are waged against children.”