Geneva – The amputation of the limbs of hundreds of children as a result of Israeli attacks on the Gaza Strip, followed by the deliberate and ongoing disruption of their treatment and rehabilitation and restrictions on access to prosthetic limbs and assistive devices, is causing them severe physical and psychological harm and exacerbating the lasting consequences of their injuries. Causing these injuries and then undermining the means to treat them falls within the genocide Israel is committing against Palestinians in the Gaza Strip.
The effects of amputation and interrupted treatment reach beyond the injured children to their families, who must care for them while facing the loss of housing, income, and basic services. The harm also affects the Palestinian community as a whole: the scale of the injuries, lack of treatment, and destruction of the institutions and resources needed to care for the injured undermine the foundations of Palestinian society's survival and its capacity to recover.
As of 9 October 2026, 1,134 children have undergone amputation. Their care requires long-term medical follow-up and rehabilitation, including wound care, pain management, physiotherapy, and psychological support. It also involves fitting suitable prosthetic limbs and adjusting or replacing them as children grow. This requires continuity of care and access to essential supplies. Interruptions make it harder to prevent complications and help children achieve the greatest possible independence in movement and daily activities.
Because suitable prosthetic limbs are often unavailable, some children rely on PVC pipes and other rudimentary devices to walk, manage daily needs, and return to play with their peers, even though these devices can cause pain, make balancing difficult, and lead to repeated falls
Israel's restrictions on patient travel and obstruction of medical evacuations further limit children's access to specialised treatment unavailable inside the Gaza Strip. These barriers prolong interruptions in care and reduce their chances of preventing complications and regaining independence in movement and daily activities. Displacement also forces them to cross rubble and uneven ground and live in tents and shelters without accessible sanitation facilities. This makes it harder to reach treatment and use mobility aids, while forcing family members to carry them and help with basic needs.
According to the World Health Organization's May 2026 update on rehabilitation needs in Gaza, only 500 of the 2,300 people assessed after limb amputations between September 2024 and May 2026 had received permanent prosthetics. This is less than 25 per cent of those assessed, including both children and adults. When the update was published, all rehabilitation facilities were "operating with severe constraints in staffing, equipment or supplies", and none was fully functional.
The local capacity to provide these services remains constrained by shortages of staff and supplies. Humanity & Inclusion reported on 27 October that there were "only eight certified prosthetics and orthotics professionals currently available in Gaza" and that machinery and metal components needed to manufacture such devices were difficult to import, limiting the ability to fit, maintain, and adjust prosthetic limbs to the needs of injured people.
Losing one or both parents increases the protection and care needs of child amputees in an enclave where 71,846 children had been recorded as orphans, according to figures announced on 9 October. Children who have undergone amputation and lost parental care face added challenges in accessing treatment, attending rehabilitation, getting around, and meeting their daily needs. Their care may fall to relatives who are also displaced and dealing with poverty and housing loss.
Without stable family care and specialised support services, these children are at greater risk of dropping out of treatment and education and experiencing neglect, isolation, and exclusion. They need safe family care arrangements, along with financial, medical, and psychological support that meets their needs and protects their rights.
In a testimony to the field team at Euro-Med Human Rights Monitor, 36-year-old Fidaa Ahmad Al-Shaer said: "My son Mousa, 11, used to go to the American aid centre [Gaza Humanitarian Foundation] in Rafah to bring flour and food for his younger siblings, especially because his father is stranded abroad and he is my eldest child."
"On Thursday morning, 7 August 2025, he went to the centre as usual. While he was waiting for it to open, an Israeli artillery shell landed nearby and injured him. Shrapnel struck his back, fracturing the seventh thoracic vertebra (T7) and damaging his spinal cord. An exploding bullet also struck his right hand, which had to be amputated," said Al-Shaer. "Since then, Mousa's life has changed. He was completely paralysed and became bedridden. Before that, he was an active child who helped me fetch water and meet the family's needs. He now needs surgeries, medical rehabilitation, a prosthetic limb, and a referral for treatment abroad, but the closure of the crossings prevents him from travelling. All I hope for is that he can leave for treatment, regain his ability to move, and live."
In another testimony, Aya Fawaz Madi, 28, said: "On the night of 17 May 2025, we woke to the news that my sister-in-law, Nisreen Mahmoud Madi, 38, and her children had been injured when shell fragments struck their displacement tent in Al-Mawasi, Khan Yunis. The attack resulted in the amputation of Nisreen's left foot and several fingers on her right hand. Doctors also amputated the foot of her 17-year-old daughter, Rahaf. Her daughter Sila, 8, was injured in both feet, and doctors amputated her right foot. Later, after attempts to save it failed, they had to amputate her left foot as well, leaving the child without either foot."
"The mother and her children now struggle every day to survive. All of them are amputees, unable to move, and in need of treatment, rehabilitation, and prosthetic limbs," Madi added. "What makes Sila's suffering worse is the deterioration of her mental health since she lost the ability to move. She now repeatedly says she wishes she had died rather than live paralysed and unable to move like her friends."
The right of child amputees to live with dignity requires access to care, mobility aids, and suitable facilities; protection of their privacy; appropriate treatment; and respect for their views and choices in decisions affecting their bodies and lives. Losing limbs does not diminish their inherent dignity. Denying them the means to care for themselves and subjecting them to living conditions that do not accommodate their needs violates that dignity and increases their forced dependence on others.
Continued denial of treatment, rehabilitation, and appropriate education risks turning the harm these children face now into lifelong deprivation. Gaps in medical follow-up and failure to adjust prosthetic limbs as the children grow may cause further complications, chronic pain, and increased difficulty moving.
Moreover, exclusion from education limits future opportunities to develop skills, find employment, and achieve economic independence. It also increases the risk of poverty, isolation, neglect, and exploitation, particularly for children who have lost parental care.
These risks are exacerbated by the destruction of services, continued restrictions on care, and the absence of arrangements that enable participation in society. Early, sustained intervention is essential to protect child amputees' development, rights, and future prospects.
The harm extends beyond the child to the family and wider community. Disrupted care and limited access to services affect a child's ability to learn, play, and take part in daily life, while exhausting the family's capacity to care for the child and meet the needs of other family members. These effects compound across the Palestinian community as injuries spread and the institutions and services that help injured people and their families recover are destroyed.
A UNICEF assessment issued in September 2026 concluded that the war in the Gaza Strip had led to the "near-total disruption of education, health, rehabilitation, and WASH services for many children with disabilities."
Because suitable prosthetic limbs are often unavailable, some children rely on PVC pipes and other rudimentary devices to walk, manage daily needs, and return to play with their peers, even though these devices can cause pain, make balancing difficult, and lead to repeated falls. Without proper medical fitting, these alternatives can create pressure and friction that cause wounds on the stump. These wounds may later prevent children from using a suitable prosthetic limb and hinder rehabilitation and the recovery of independence in daily activities.
In this context, R. Q., an 11-year-old from Beit Lahia in the northern Gaza Strip, told Euro-Med Monitor: "I was on my way with my mother and siblings to visit our relatives in Khan Yunis when we were bombed on 26 June 2026. My mother and my younger brother were killed, and I was seriously injured and taken to hospital, where I underwent several surgeries. Doctors had to amputate my leg to save my life."
"When I came out of the operating room and realised my leg was gone, I felt very sad. I could no longer play football with my friends and cousins as I used to," he said. "I tried to find a way to walk, making a substitute for my amputated leg from a plastic pipe despite the pain and repeated falls. All I hope for is to leave for treatment and get a prosthetic limb that will help me walk and return to playing football with my friends."
As the occupying power, Israel is required under Articles 55 and 56 of the Fourth Geneva Convention to ensure medical supplies and health services to the fullest extent possible. Under Article 59, it must agree to and facilitate relief operations by all available means when the population's supplies are inadequate.
Preventing or arbitrarily restricting access to surgical and rehabilitation supplies, prosthetic limbs, and assistive devices violates these obligations and makes Israel responsible for the additional harm caused, including worsening injuries and interrupted rehabilitation. This requires lifting the restrictions, ensuring that necessary supplies enter in sufficient quantities, and enabling specialised personnel to provide regular care tailored to injured people's needs.
Articles 23, 24, and 39 of the Convention on the Rights of the Child guarantee children with disabilities the rights to care, rehabilitation, education, participation in society, health, and physical and psychological recovery in an environment that upholds their dignity. The Convention on the Rights of Persons with Disabilities also requires measures to protect persons with disabilities during armed conflicts and humanitarian emergencies, ensure children enjoy their rights on an equal basis with others, and provide rehabilitation services as early as possible. Providing these services and removing barriers to them are legal obligations that require an ongoing response tailored to each child's needs, views, and stage of development.
When accompanied by the intent to destroy a group as such, causing serious bodily or mental harm to its members and deliberately inflicting conditions of life calculated to bring about its physical destruction, in whole or in part, are acts listed in Article II of the Genocide Convention.
This intent in Gaza is evidenced by the combination of official Israeli statements and a widespread, systematic pattern of killings, serious injuries, starvation, and the destruction of hospitals and homes. These practices have continued despite awareness of their consequences, repeated warnings, and orders from the International Court of Justice.
The amputation of children's limbs and the obstruction of their treatment and rehabilitation form part of this pattern, which combines harm to members of the group with the undermining of the conditions necessary for their survival.
In its report on children, issued in June 2026, the Independent International Commission of Inquiry on the Occupied Palestinian Territory, including East Jerusalem, and Israel concluded that a significant portion of the harm inflicted on Palestinian children was intended to destroy Palestinians in Gaza as a group. It also found reasonable grounds to conclude that these acts were part of a deliberate strategy to destroy the group's future by targeting its children, the basis of its biological and social continuity. The Commission linked this targeting to weakening the Palestinian people's ability to survive and exercise their right to self-determination.
The Commission specifically addressed the lasting harm caused by injuries. It concluded that Israeli attacks had created a generation of children needing repeated surgeries and rehabilitation as they grew, despite the widespread absence of these services. It also found that the deliberate targeting of hospitals had systematically deprived children of access to life-saving care, causing long-term physical and psychological harm and preventable deaths. The Commission thus linked the infliction of injuries with the destruction of the means to treat them and lessen their effects.
The Commission's latest report, submitted to the General Assembly on 14 October, concluded that Israeli authorities and forces continued to commit acts of genocide with the intent to destroy Palestinians in Gaza, in whole or in part. In its statement issued on 26 October, the Commission reaffirmed this conclusion and stressed that these acts continued even after the ceasefire agreement. This confirms that the crime and genocidal intent persist, and requires an end to acts that cause or worsen children's injuries, guaranteed access to care and the necessities of survival, and accountability for those responsible for the ongoing harm.
Israeli responsibility includes unlawful attacks on children, including attacks that cause them to lose limbs. It also encompasses acts and policies that worsen their injuries and deprive them of treatment, rehabilitation, education, appropriate shelter, and mobility aids, while affecting their rights to life, development, and participation in society. Accountability must therefore address both the immediate and lasting harm caused by these practices, while reparation must ensure continued care and remove barriers that prevent children from enjoying their rights throughout every stage of life.
The international community must use every means available under international law to stop the genocide Israel is committing against Palestinians in the Gaza Strip. This includes ending attacks, starvation policies, forced displacement, and the destruction of the means of survival, as well as compelling Israel to end its unlawful presence in the occupied Palestinian territory, in accordance with the International Court of Justice's advisory opinion of 19 July 2024. It also requires a full withdrawal from the Gaza Strip, the lifting of the blockade, and enabling the Palestinian people to exercise their right to self-determination and rebuild their society and institutions without placing the means of their survival under Israeli control.
All states must fulfil their obligations to prevent the genocide Israel is committing against Palestinians in the Gaza Strip and to stop it from continuing. They must ban the supply of weapons, ammunition, and military equipment to Israel, as well as imports from Israel; halt military, security, and economic assistance and cooperation that contribute to its crimes; impose diplomatic and economic sanctions on Israel and the officials responsible; and ensure that no aid or assistance helps maintain Israel's unlawful presence in the occupied Palestinian territory or the violations associated with it.
Israel must be held accountable for unlawful attacks that killed or injured children, as well as for acts and restrictions that denied them treatment and worsened their harm. This requires support for international investigations, cooperation with the International Criminal Court and implementation of its orders, independent investigations, preservation of evidence and medical records, and ensuring that victims and their families can access justice. Reparation must include compensation, treatment, rehabilitation, and guarantees of non-recurrence, tailored to children's changing needs as they grow.
Regular, unhindered humanitarian access must be ensured across the Gaza Strip. This includes bringing in sufficient quantities of food, water, medicines, fuel, and medical equipment; protecting health facilities and their staff; and rebuilding hospitals and surgical, rehabilitation, and psychological care services.
Restrictions on the entry of prosthetic limbs and their components, assistive devices, and materials required for their manufacture and maintenance must be removed. The entry of specialised personnel must also be ensured so they can work and train local teams.
The international community must compel Israel to lift restrictions that prevent or obstruct children who need treatment unavailable in the Gaza Strip, and their companions, from leaving. It must ensure their evacuation without arbitrary delay and according to medical priority and enable them to reach health facilities in the West Bank, including East Jerusalem, and in receiving countries. Treatment, accommodation, and necessary support must be provided; family unity preserved; their right to return guaranteed; and follow-up and rehabilitation continued after their return.
The international community should fund specialised, sustainable programmes for children who have lost limbs and help implement them in partnership with specialised Palestinian institutions. These programmes should guarantee continuous medical, rehabilitative, and psychological care; provide prosthetic limbs, along with maintenance, adjustments, and replacements as children grow; ensure transport to access services; offer financial and social support to families and caregivers; and provide safe, stable family care for children who have lost their parents or caregivers.
International donors and humanitarian organisations, working with the relevant Palestinian bodies, should adapt shelters, homes, schools, water and sanitation facilities, and transport to ensure children with disabilities can access and use them safely and independently. They should also provide the reasonable accommodations needed to support children's return to education and their participation in learning, play, and community life.
Children with disabilities must be protected from neglect, violence, exploitation, and discrimination. Their families must also be included in decisions about their care and rehabilitation, in ways that uphold their dignity and independence and prevent their continued exclusion from essential services and opportunities.
