Gaza's child amputees struggle with recovery, especially after Israel's cutoff of aid

GAZA CITY, Gaza Strip (AP) — Five-year-old Sila Abu Aqlan curled her lip in concentration as she practiced walking for the first time on a prosthetic leg at a clinic in Gaza City. The foot of the new leg had a little pink sneaker with a lacy frill, matching her pink hoodie.

It has been nearly 15 months since the little girl's leg was amputated after it was left severely burned from an Israeli airstrike. Finally, she is being fit for a prosthetic.

One of the most shocking sights in Gaza’s war has been the thousands of children with amputated limbs from Israel’s bombardment. The U.N.’s humanitarian aid organization OCHA called it the “largest cohort of child amputees in modern history.”

Throughout the 17-month war, supplies and services for children and adults with amputations have fallen far short of demand. Gaza’s ceasefire that began in mid-January offered a window for aid agencies to bring in an increased number of prosthetic limbs, wheelchairs, crutches and other devices.

Still, it only covered about 20% of the total need, said Loay Abu Saif, head of a disability program run by the aid group Medical Aid for Palestine, or MAP.

The window slammed shut when Israel barred entry of all medical supplies as well as food, fuel and other aid on March 2. Israel's resumpton of its military campaign last week, killing hundreds of Palestinians, has only added to the ranks of amputees.

With help limited, children wrestle with the psychological pain of losing a limb along with other traumas.

Sila's mother, father and sisters were all killed in an airstrike on her home in December 2023. Sila suffered severe burns to her right leg. A month of treatment had little effect, and Sila would scream in excruciating pain, her aunt Yasmine al-Ghofary said. Doctors amputated her leg above the knee.

“I try as much as I can to make her happy. But the truth is, there’s only so much she can be happy. Pain is pain, and amputation is amputation,” al-Ghofary said.

Sila sees other girls playing and tries to keep up with them using her walker but falls down. “She says, ’Why am I like this? Why am I not like them?” said al-Ghofary.

In October 2023, 11-year-old Reem lost her hand when an airstrike hit nearby as her family fled their home in Gaza City.

Reem can no longer dress on her own, brush her hair or tie her shoes. She gets angry and hits her siblings if she can’t find someone to help her, her mother said. Other times, she isolates herself and just watches other children playing.

“Once Reem told her dad that she wished to die,” said her mother, who goes by the traditional name, Umm Reem. “In another instance, we were talking about meat, and she said, ‘Slaughter me like a sheep,’ and she was laughing.”

Some 3,000 to 4,000 children in Gaza had suffered amputations as of November 2024, according to Jamal al-Rozzi and Hussein ِAbu Mansour, two prominent experts with rehabilitation programs in the territory who spoke with The Associated Press.

Up to 17,500 adults and children suffered severe limb injuries, leaving them in need of rehabilitation and assistance, the World Health Organization estimated in September.

Throughout the war, hospitals lacked medicines that could have averted amputations. Doctors describes cutting off limbs because of infections that should have been easily treated.

In its campaign in Gaza, Israel has struck homes and shelters with families inside almost daily.

Gaza's Health Ministry on Monday put out a list of the names of more than 15,000 children, 17 and younger, killed by Israel’s offensive. The list included nearly 5,000 children younger than 6, including 876 infants who had not reached a year in age.

Israel's offensive has killed more than 50,000 Palestinians of all ages and wounded more than 113,000, according to the ministry, which does not say how many were civilians or combatants. Nearly 90% of the population of some 2.3 million have been displaced, and vast areas of Gaza have been destroyed.

Israel launched the campaign vowing to destroy Hamas after its Oct. 7, 2023, attack on southern Israel, in which militants killed some 1,200 people, mostly civilians, and abducted 251 others. Israel says it is targeting Hamas and blames the group for civilian deaths because it operates in residential areas.

Last May, 13-year-old Moath Abdelaal's leg was amputated above the knee after an Israeli airstrike in the southern city of Rafah.

The family had to flee to a tent camp outside the neighboring city of Khan Younis. During the ceasefire, they moved back to their hometown Jabaliya in northern Gaza, but their home had been destroyed, so they live in a tent by the ruins, said his father, Hussein Abdelaal.

Moath’s psychological state is worsening, his father said. Moving with crutches around the rubble is difficult. Doctors had to amputate more from his leg, almost up to his hip, because of complications. The boy learned that a number of his friends in the neighborhood had been killed, Abdelaal said.

“He has been having a hard time coping with his new situation. He’s not sleeping well next to his siblings. It’s difficult to see our son like that,” said Abdelaal.

Sila is being treated at the Artificial Limbs and Polio Center in Gaza City, a program launched by the International Committee of the Red Cross that has provided physical therapy, wheelchairs and prosthetics to hundreds of Palestinians suffering from amputations or paralysis.

But supplies are limited. Wheelchairs are urgently needed, with 50 to 60 people a day asking for them in northern Gaza alone, said Mahmoud Shalabi with MAP.

Al-Rozzi, executive director of the National Rehabilitation Society in the Gaza Strip, said Israel blocks materials to manufacture prosthetics from entering Gaza on grounds they could have dual or military uses.

COGAT, the Israeli military body overseeing aid, said there have never been limitations on medical supplies to Gaza, including wheelchairs, prosthetics and crutches.

Some child amputees have been evacuated out of Gaza for treatment. But the pace of medical evacuations has remained slow, at a few dozen a day, and was reduced after Israel's strikes last week. As many as 13,000 patients of all kinds are waiting their chance to get out.

Asmaa al-Nashash wants nothing more than for her 11-year-old son Abdulrahman to go abroad for a prosthetic leg.

The boy was selling items from a stand at a U.N. school-turned-shelter in the built-up Nuseirat refugee camp when an airstrike hit, she said. Shrapnel tore through his leg, and doctors couldn’t save it.

Since then, he often sits alone playing games on her phone because he can’t play football with other children, she said. Other kids bully him, calling him the “one-legged boy.”

“My heart gets torn into pieces when I see him like this and I can do nothing for him,” she said.

Khaled reported from Cairo. Associated Press reporter Melanie Lidman in Tel Aviv, Israel, contributed to this report.

Yasmine al-Ghoufary takes her niece Sila Abu Aqlan, 5, to the Artificial Limbs and Polio Center in Gaza City to learn how to walk with a prosthetic leg, on Wednesday, Feb. 26, 2025. (AP Photo/Abdel Kareem Hana)

A doctor assists 13-year-old Palestinian Yamen Asfour as he learns to walk with a prosthetic leg at the Artificial Limbs and Polio Center in Gaza City on Tuesday, Feb. 18. 2025. (AP Photo/Abdel Kareem Hana)

Doctors assist Five-year-old Palestinian Sila Abu Aqlan to put on her new prosthetic leg at the Artificial Limbs and Polio Center in Gaza City, on Tuesday, Feb. 18, 2025, (AP Photo/Abdel Kareem Hana)

A man manufactures parts used for artificial limbs inside a room at the Artificial Limbs and Polio Center in Gaza City on Tuesday, Feb. 18. 2025. (AP Photo/Abdel Kareem Hana)

Five-year-old Palestinian Sila Abu Aqlan sits on her wheelchair as a doctor adjusts the cover on her right amputated leg at the Artificial Limbs and Polio Center in Gaza City, on Wednesday, Feb. 26, 2025, (AP Photo/Abdel Kareem Hana)

Five-year-old Palestinian amputee Sila Abu Aklan uses a walker to move around at her grandmother's house in Gaza City, Wednesday, Feb. 26, 2025, (AP Photo/Abdel Karem Hanna)

A doctor assists 13-year-old Palestinian Yamen Asfour as he learns to walk on a prosthetic leg at the Artificial Limbs and Polio Center in Gaza City on Tuesday, Feb. 18. 2025. (AP Photo/Abdel Kareem Hana)

DUBAI, United Arab Emirates (AP) — The death toll from nationwide protests in Iran spiked Tuesday to at least 2,000 people killed, activists said, as Iranians made phone calls abroad for the first time in days after authorities severed communications during a crackdown.

This level of violence around protests hasn’t been seen in Iran in decades.

The U.S.-based Human Rights Activists News Agency, which has been accurate in previous unrest in recent years, gave the latest toll. It relies on supporters in Iran cross-checking information.

The group said 1,847 of the dead over more than two weeks of protests were protesters and 135 were government-affiliated. Another nine children were killed, and nine civilians it said were not taking part in protests also were killed.

With the internet down in Iran, gauging the demonstrations from abroad has grown more difficult. The Associated Press has been unable to independently assess the toll. Iran’s government hasn’t offered overall casualty figures.

Iranians' calls gave a glimpse of life after being cut off from the outside world Thursday night.

Witnesses described a heavy security presence in central Tehran, burned-out government buildings, smashed ATMs and few passersby. Meanwhile, people remain concerned about what comes next, including the possibility of strikes after U.S. President Donald Trump said he could possibly use the military to defend peaceful protesters. Trump also has said Iran wants to negotiate with Washington.

“My customers talk about Trump’s reaction while wondering if he plans a military strike against the Islamic Republic,” said shopkeeper Mahmoud, who gave only his first name out of concerns for his safety. “I don’t expect Trump or any other foreign country cares about the interests of Iranians.”

Reza, a taxi driver who also gave just his first name, said protests remain on many people's minds. “People — particularly young ones — are hopeless but they talk about continuing the protests,” he said.

Several people in Tehran were able to call The Associated Press on Tuesday morning and speak to a journalist there. The AP bureau in Dubai, United Arab Emirates, was unable to call those numbers back. The witnesses said text messaging still was down and that internet users in Iran could connect to government-approved websites locally but nothing abroad.

Anti-riot police officers, wearing helmets and body armor, carried batons, shields, shotguns and tear gas launchers, according to the witnesses. Police stood watch at major intersections. Nearby, the witnesses saw members of the Revolutionary Guard's all-volunteer Basij force, who similarly carried firearms and batons. Security officials in plainclothes were visible in public spaces as well.

Several banks and government offices were burned during the unrest, they said. Banks struggled to complete transactions without the internet, the witnesses added.

However, shops were open, though there was little foot traffic in the capital. Tehran's Grand Bazaar, where the demonstrations began Dec. 28, was to open Tuesday. However, a witness described speaking to multiple shopkeepers who said the security forces ordered them to reopen no matter what. Iranian state media had not acknowledged that order.

The witnesses spoke on condition of anonymity for fear of reprisal.

It also appeared that security service personnel were searching for Starlink terminals as people in northern Tehran reported authorities raiding apartment buildings with satellite dishes. While satellite television dishes are illegal, many in the capital have them in their homes and officials broadly had given up on enforcing the law in recent years.

On the streets, people also could be seen challenging plainclothes security officials, who were stopping passersby at random.

State television also read a statement about mortuary and morgue services being free — a signal some likely charged high fees for the release of bodies amid the crackdown.

Supreme Leader Ayatollah Ali Khamenei, in a statement carried by state TV, praised the tens of thousands who took part in pro-government demonstrations nationwide on Monday.

“This was a warning to American politicians to stop their deceit and not rely on traitorous mercenaries,” he said. “The Iranian nation is strong and powerful and aware of the enemy.”

State TV on Monday aired chants from the crowd, which appeared in the tens of thousands, of “Death to America!” and “Death to Israel!” Others cried out, “Death to the enemies of God!” Iran’s attorney general has warned that anyone taking part in protests will be considered an “enemy of God,” a death-penalty charge.

Iranian Foreign Minister Abbas Araghchi, speaking to the Qatar-funded satellite news network Al Jazeera in an interview aired Monday night, said he continued to communicate with U.S. envoy Steve Witkoff.

The communication “continued before and after the protests and are still ongoing," Araghchi said. However, “Washington’s proposed ideas and threats against our country are incompatible.”

White House press secretary Karoline Leavitt said Iran’s public rhetoric diverges from the private messaging the administration has received from Tehran in recent days.

“I think the president has an interest in exploring those messages,” Leavitt said. “However, with that said, the president has shown he’s unafraid to use military options if and when he deems necessary, and nobody knows that better than Iran.”

Trump announced Monday that countries doing business with Iran will face 25% tariffs from the United States. Trump announced the tariffs in a social media posting, saying they would be “effective immediately.”

Trump believes exacting tariffs can be a useful tool in prodding friends and foes on the global stage to bend to his will.

Brazil, China, Russia, Turkey and the United Arab Emirates are among economies that do business with Tehran.

Trump said Sunday that his administration was in talks to set up a meeting with Tehran, but cautioned that he may have to act first as reports of the death toll in Iran mount and the government continues to arrest protesters.

“I think they’re tired of being beat up by the United States,” Trump said. “Iran wants to negotiate.”

Iran, through the country’s parliamentary speaker, warned Sunday that the U.S. military and Israel would be “legitimate targets” if Washington uses force to protect demonstrators.

More than 10,700 people have been detained over the two weeks of protests, said the U.S.-based Human Rights Activists News Agency.

This frame grab from videos taken between Jan. 9 and Jan. 11, 2026, and circulating on social media purportedly shows images from a morgue with dozens of bodies and mourners after crackdown on the outskirts of Iran's capital, in Kahrizak, Tehran Province. (UGC via AP)

A picture of Ayatollah Ali Khamenei is set alight by protesters outside the Iranian Embassy in London, Monday, Jan. 12, 2026. (AP Photo/Alastair Grant)

In this frame grab from footage circulating on social media shows protesters dancing and cheering around a bonfire as they take to the streets despite an intensifying crackdown as the Islamic Republic remains cut off from the rest of the world, in Tehran, Iran, Friday, Jan. 9, 2026.(UGC via AP)

In this frame grab from footage circulating on social media from Iran showed protesters once again taking to the streets of Tehran despite an intensifying crackdown as the Islamic Republic remains cut off from the rest of the world in Tehran, Iran, Saturday Jan. 10, 2026. (UGC via AP)

FILE - Protesters march on a bridge in Tehran, Iran, on Dec. 29, 2025. (Fars News Agency via AP, File)