Jordanian pediatric surgeon Bilal Azzam talks about the most difficult situations he faced during his work in Gaza, when a 5-year-old child asked him, “Uncle, will my hands grow with me when I grow up?”, thinking that his limbs would grow again after he underwent an amputation.
The doctor is moved and wonders: How will this child live 60 or 70 years without his hands?
As for French doctor Pascal Andre, after spending less than two weeks in the European Hospital in Khan Yunis in Gaza, he said , “Israeli snipers shoot adults in the heads and target children’s legs so that they cannot play again.”
While the British-based charity Save the Children explained, in a statement issued in January 2024, that the average number of children who were subjected to the amputation of one or both legs in Gaza every day exceeds 10 children, noting that many amputations are carried out. Without anesthesia.
How does amputation affect children psychologically and in the future? Can they adapt to amputation?
Traumatic experiences last a lifetime
Psychological consultant Dr. Wafa Abu Musa told Al Jazeera Net that the experience of loss among children is one of the most harsh conditions on their psyches, especially in light of the continuing war that raises feelings of fear and anxiety. “They are not safe to protect themselves, nor are their families able to protect them.”
She added, "The experience of a child losing a parent, a limb, or an organ of his body is a traumatic experience that affects his mind and psyche for life, but modern scientific theories provide ways to support and help him regain his psychological balance and protect him from post-traumatic stress disorder."
The counselor, who has been working in psychological support for children and adolescents in Palestine for more than 20 years, says that it is important for the child who has been bereaved to receive “safe means of support, such as being next to adults he trusts, knows and knows, and being in a place far from violence, whether bombing.” Or seeing scenes of blood or anything else.”
The magnitude of the shock is related to age
In her comment on children’s innocent questions, such as “Will my hand grow with me when I grow up?”, she says that this type of question means that “the child still does not realize what has happened to him, and this is a mercy from the Lord of the Worlds. The simple thought of a young child may suggest to him that his foot will return.” Again, later, when the wound heals and he begins to practice movement in a wheelchair or with prosthetic limbs, he will gradually accept it.”
She added, "If the child is over 10 years old, of course he will realize the extent of the loss he has suffered, and the loss in this case will be very painful and shocking."
Wafaa confirms that the psychological impact resulting from the process of loss depends greatly on the age of the child and the extent of the shock, “as the older child often realizes that his life will never be the same as it was, and here the child needs psychological support and treatment sessions until he is prepared to accept his new life, and he is alleviated through Fast installation of prosthetic limbs.
If the children are not compensated, “this will greatly affect their psychology, leave them frustrated and disappointed, make them feel helpless, and make their personalities shaky. It will also undoubtedly affect their future goals and plans. Attention and psychological care for this child after the shock of loss are among the things that prepare him the most.” To persevere and accept what is coming.”
Wafaa also points out that the morale of those with whom the child lives is very important, and “it helps a lot if it is positive and strong. Children do not only feel fear when they hear the sound of bombing or see bloody scenes, but this may turn into a feeling of panic when they see the fear on the faces of adults.” "Turn them around."
She continues, "The child usually looks to the adults around him as a source of protection. If he sees the source of protection shaken, he will feel afraid and the shock will greatly affect him. Therefore, it is important for the parents to stick together for the sake of the children, and not show their sadness over what has been lost as much as they care about those who survived." "From the children around them. The children of Gaza need to see people who are more courageous and more powerful in confrontation in order to overcome difficulties with safety and psychological peace."
Wafaa Abu Musa refers to simple psychological support activities, such as:
Patting on the shoulder.
Head scan.
Listen to the child's words.
Giving the child paper and colors to draw to express what is inside him.
Occupying time after an amputation or loss.
Sometimes a child may be unable to express feelings of shock through speech, and “therefore, we must play with him and push him to draw if possible, and we must receive all his expressions in a conscious and understanding manner regarding the circumstances he is going through.”
Amputation affects growth
Wafaa also says that play is a basic need for the child, as it “helps him in his mental, psychological and physical development. Running, climbing and jumping are actions that help in healthy growth, but in the case of amputation of limbs or loss of some motor organs, this limits movement and thus slows down the level of mental development.” And the body, or makes it grow at a less efficient rate.”
The five senses can play an effective role in compensation, as they have an effective impact on the completion of development. If the child holds toys, hears sounds, meditates with the sense of sight, and uses the sense of taste and touch well, then this contributes to the complete development of his senses and increases his auditory and visual coordination. Therefore “It is important to provide children with alternative prosthetic limbs, and train them to use them with quality, while providing psychological and dramatic play activities in psychological support programs for children who have survived war.”
The psychological counselor concludes by saying, "Of course, the child may not return to his normal life as it was before the shock of loss, but he can adapt and fully accept what he lost as long as an alternative party is available and helps him carry out some educational and social roles."