Gaza City, Gaza Strip – Before Israel’s genocidal war on Gaza, 24-year-old Shurouq Khaira was an athlete, training regularly for her track races.

Athletics wasn’t just a hobby for her; it was a core part of her identity. She competed in youth championships, taking a national title in 2016. Her dream was to represent her country, Palestine, on the international stage.

“I wanted the whole world to know that people in Gaza live, dream, strive, and achieve,” she said. “I dreamed of competing in the Olympics.”

The future Shurouq envisioned was shattered on November 19, 2023 – just over a month into a war that is now approaching its three-year anniversary, with Israel killing more than 73,400 Palestinians.

Gaza City was the target of fierce Israeli attacks in those opening weeks of the war, and Shurouq woke up to the sound of shelling targeting her family’s home in the city’s Daraj neighbourhood. One shell hit the house.

Shurouq survived, but her injuries were so severe that doctors were forced to amputate her right leg below the knee. Her father, who had inspired her love for athletics, had both his legs amputated.

Following the shock of the injury, Shurouq’s life turned into a continuous daily struggle to perform the simplest tasks.

Inside the tent her family is forced to live in because of the destruction of their home and Israel’s refusal to allow proper reconstruction in Gaza, nights are particularly difficult. With no light available and the difficulty of using crutches in the dark, she feels stuck, afraid that she will trip and fall on her face.

Outside the tent, movement among streets that largely consist of sand and rubble is difficult, forcing her to hop on one leg to reach her destination.

“I live between pain, fear, darkness, and suffering, but my heart remains patient,” Shurouq said. “This difficulty in movement will be permanent. No matter what prosthetic I get, the feeling of loss will stay with me. It affects me deeply. At times, I feel weak and cry. But there are no solutions, so I try to adapt to this painful reality.”

Shurouq is hoping to get a prosthetic leg, which would make walking easier, but is still waiting. In the meantime, she has to regularly attend physical therapy appointments at various hospitals in Gaza, posing another challenge.

With the little transportation available in Gaza prohibitively expensive, Shurouq is forced to walk for kilometres on one leg. Sometimes she ends up being too late and missing her appointments.

“Everything in Gaza has become extremely difficult, almost impossible,” she said.

Shortages

Israel’s indiscriminate bombing of Gaza, and the resulting decimated healthcare system in the Palestinian enclave, has led to around 6,000 amputations since the war began, according to the Gaza Ministry of Health.

Around a quarter of the cases are children, making the war in Gaza the largest source of child amputees in modern history, according to the United Nations.

Orthopaedic surgeons in Gaza say that many of the amputation cases could have been avoided, but that the collapse of the Gaza Strip’s hospitals and the depletion of surgical supplies, antiseptics, and anaesthetics has often forced medical teams to resort to amputation as the fastest option to save lives and prevent gangrene.

Those shortages are largely the result of Israel’s restrictions on imports into Gaza, which it maintains despite an October 2025 ceasefire.

In addition to those supplies, there are also restrictions on the import of items that are vital in the production of prosthetics, causing the delays that amputees like Shurouq are suffering from.

Israel imposes strict controls on the importation of items, some of which are so-called “dual-use”, in the sense that Israel deems them to be used for military as well as civilian purposes. This includes silicone, thermoplastics, medical plasters, and mechanical joints.

And there is also a shortage of prosthetists, fitting specialists, and rehabilitation physicians.

The specialists who are still practicing in Gaza have attempted to find alternative solutions, assembling improvised prosthetics and crutches using plastic pipes, wood, and aluminium retrieved from under destroyed buildings.

But Jamal Kallab, a prosthetics and rehabilitation specialist in Gaza, explained that these were not proper replacements for the missing materials.

“These improvised devices are not designed according to the body’s specific needs,” Kallab said. “This leaves them incapable of providing the required support and balance, causing an uneven weight distribution that strains [other body parts].”

Kallab warned that an ill-fitting socket leads to “continuous friction and swelling, followed by severe surgical inflammatory ulcers that stop the limb from being used for long periods”.

Mental health difficulties

Aside from a lack of materials, the sheer number of amputees and the absence of sufficient facilities have led to patients often facing a delay in the start of their rehabilitation programs.

This, according to physical therapist Bissan Kloub, leads to severe weakness and atrophy in the muscles surrounding the amputation site, joint stiffness, a reduced range of motion, and skin swelling that prevents wound healing.

Kloub explained that delays in starting rehabilitation impair walking and cause issues such as incorrect joint postures, “weakening balance and directly affecting the future efficiency of using the prosthetic limb”.

She highlighted the importance of injury rehabilitation to a patient’s wellbeing, referring to the harsh environment in Gaza where a lack of mobility can be severely restricting, and the challenges to the mental health of a young person in particular.

“The challenge is deeper among youth and children because amputation touches their self-image and their relationship with society, requiring comprehensive physical, psychological, and social rehabilitation,” Kloub said.

The issues raised by Kloub are not foreign to 18-year-old Shireen Abu al-Qumsan, who was severely injured in an Israeli attack in May 2025 that led to the amputation of both of her legs.

She continues to wait for prosthetic legs and treatment abroad that requires approval from Israel. For now, she relies on a manual wheelchair for long-distance mobility.

From the home in central Gaza’s Bureij that she lives in with her surviving family – her brother was killed in a separate attack in June 2024 – she explained how difficult it was to travel.

“Moving around in a wheelchair is extremely exhausting,” Shireen said. “The streets of Gaza are completely destroyed, making it more difficult for a wheelchair to pass through.”

She is forced to rely on a companion whenever she leaves the house, and has a strong desire to be self-reliant inside it – not wanting to seem like a burden – but that requires double the effort to do things by herself.

For Shireen, as well as Shurouq, the mental challenge of living with amputated limbs in Gaza is bitter.

Shireen remembers the time her wheelchair flipped over in the street, her mind flashing back to the explosion that took her legs as she fell to the floor, helpless.

Shurouq, meanwhile, is fearful that without a proper prosthetic and rehabilitation, her injury will worsen, or that she will be attacked and injured again.

“I go to sleep curled into myself out of sheer terror,” Shurouq said. “I am constantly afraid another shell will hit us and take the rest of my leg or my arm. The sense of total insecurity makes me sleep clutching my body together from sorrow and pain.”