Gaza’s hidden crisis: inside the struggle for physical rehabilitation after war

Thousands of injured Palestinians and amputees face delays or treatment with basic, improvised equipment

Gazan Youssef Al Samri, 16, lost his legs in an Israeli air strike while fetching water. AP Photo

A silent crisis is unfolding in Gaza’s shattered health system – one that does not appear in casualty counts or battlefield footage from two years of war, but in overcrowded rehabilitation rooms and makeshift therapy centres where thousands are learning to walk, stand or move again.

Thousands of amputees and other injured Palestinians need long-term physiotherapy. But with hospitals damaged or destroyed and medical equipment scarce, even basic rehabilitation is almost impossible.

Dr Munir Al Bursh, director general of Gaza's Ministry of Health, described an overwhelming humanitarian emergency.

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“The genocide war has left more than 6,000 cases of amputation and thousands of other injuries that require physical therapy and rehabilitation just so patients can partially resume their lives,” he told The National.

“Treating these cases requires extensive equipment, specialised devices and expertise. None of this is available.”

Gaza’s healthcare system, already strained for years, has been pushed past collapse, particularly with the high influx of casualties and dwindling supplies, facilities and infrastructure that have been destroyed in Israeli strikes or remained unrepaired under a partial blockade on aid and equipment.

As with most conflicts, the most vulnerable people – children – suffer the most. The UN agency for children, Unicef, estimates that between 3,000 and 4,000 children have had at least one limb amputated. Some have had multiple amputations because of infections and the lack of medical supplies required for surgery. Dr Al Bursh called their situation “tragic”.

A physiotherapist treats an injured patient at a field hospital in Khan Younis, southern Gaza. Photo: Mohammed Abu Doon

At Sheikh Hamad Hospital, once the Gaza Strip’s main centre for prosthetics and physical rehabilitation, director Dr Ahmad Naeem says the difference between pre-war and post-war caseloads is staggering.

“Before the genocide war, we dealt with a limited number of cases but today, we have around 6,000 amputation cases.” That is triple the number before Israel's bombardment of the Strip began, he said.

The hospital, which was partially destroyed during the conflict, operates with the bare minimum. Rudimentary repairs have been made to some parts of the facility to accommodate more cases. But without proper reconstruction, Dr Naeem says it will take 20 years for all the amputees' needs to be met.

In Khan Younis, in southern Gaza, the Palestinian Red Crescent Society has set up a rehabilitation field hospital.

“We rely on local resources and locally manufactured tools,” physiotherapist Tareq Al Hanafi told The National. “The proper equipment simply does not exist.”

Modern devices available before the war have been replaced by improvised equipment such as wooden sticks, sandbags, metal bars, and other items assembled locally. The waiting list is long, and delays can permanently alter medical outcomes.

“Extending the time before treatment harms the patient,” Mr Al Hanafi said. “Some may never fully recover without timely rehabilitation.”

Still, the team works tirelessly with the simple tools and techniques available. “And many patients respond surprisingly well,” he said. “But we need far more than what we have.”

An injured patient is guided through rehabilitation exercises. Photo: Mohammed Abu Doon

Mahmoud Al Kafarneh, a 29-year-old father of two, is battling to heal every day. He sustained multiple fractures to his spine in an attack as he waited for humanitarian aid.

After weeks bedridden in a tent, doctors told him he urgently needed physiotherapy to regain mobility. But the capacity to treat him was limited.

“I visited several centres,” Mr Al Kafarneh told The National. “Doctors told me that because there were not enough devices, I had to rely mostly on exercises at home.”

They gave him a list of movements to practise daily. For two months, he has been doing them alone.

“I feel some improvement, but I’m nowhere near normal. If rehabilitation resources were available, I wouldn’t be suffering like this.”

Doctors told him he could have recovered in six weeks. Instead, he has yet to recover after 25 weeks.

In northern Gaza, Mureed Abu Ghneim, 24, continues to struggle with an injury sustained nearly two years ago. Shot by an Israeli quadcopter drone, he had to wait more than a month for surgery.

His leg was fitted with a brace, and he should have begun physical therapy six months later. That never happened. Now, crutches have become a fixture in his life. The closest treatment centre is a three-hour walk, and with Israel preventing enough fuel entering Gaza, car rides are expensive.

Therapists gave him improvised exercises using stones and a wooden stick. “I do them every day, hoping I can get rid of the crutch. If proper physical therapy were available, I would be walking normally today,” he says.

Medical professionals warn that without a major intervention, Gaza’s rehabilitation crisis could become a generational tragedy.