When Zarifa Nawfal’s family arrived in Beirut for her wounded daughter’s surgery, one of the first things she wanted to do was go to the sea. The Mediterranean had been a constant companion at their home in Gaza before the war.
“The moment I smelled the sea, I felt at peace inside — as if I were in Gaza,” she said.
But soon their place of refuge reminded her of home in far more distressing ways.
Nawfal’s 7-year-old daughter, Halima Abou Yassine, is one of a dozen severely wounded Palestinian children brought to Lebanon this year for treatment through a program launched by a British-Palestinian surgeon, Dr. Ghassan Abu Sitta.
But months after their arrival, Lebanon is itself embroiled in a war some fear will end in Gaza-like destruction.
In February, Nawfal was staying with her five children and her mother in an apartment in central Gaza. They had been displaced from their home in the north and Nawfal’s husband was missing, likely dead.
The children were filling water containers outside when two missiles struck, Nawfal said. She rushed outside and found Halima, the youngest, lying in the street, her skull cracked open, her brain exposed.
Through her shock, Nawfal said, “I was relieved that her body was in one piece.” In Gaza, blasts often ripped people apart, leaving their loved ones without even a body to bury.
Halima’s brother was unconscious next to her. He was quickly revived at the hospital. But staff at Al-Aqsa Martyrs Hospital confirmed Nawfal’s fears, she said: Halima was dead. Her small body was placed in the morgue.
But as the family was preparing to bury her, the little girl’s uncle noticed faint signs of life, the family said.
Officials at Al-Aqsa hospital could not be reached to confirm the account. But Abu Sitta, who has worked in several Gaza hospitals during the war, said in the chaotic situation it was not uncommon for patients to be misidentified as dead because normal protocols for emergency room examinations were often abandoned.
“Because of the sheer number of cases that would come in with each air raid ... the ambulance staff would take to the morgue immediately those who they thought were dead," he said.
In the days after her daughter was determined to be alive, Nawfal stayed with her, manually pumping oxygen into her lungs. After a week, the little girl began to breathe on her own. Finally, she woke up.
“Some of the doctors cried and said this is a miracle,” Nawfal said.
But they were unable to do more than keep the little girl alive. Her skull was still gaping open, a shard of bone missing. Her brain was beset by infection.
The family was evacuated to Egypt in May. In July, they boarded a plane for Lebanon.
An unlikely refuge
The first of the wounded Palestinian children arrived in Lebanon in May. Five-year-old Adam Afana had nearly lost his left arm in a blast that killed his father and sister. His arm was paralyzed and he needed a complex surgery to correct the nerve damage.
At the time, Lebanon was already embroiled in a low-simmering conflict between Israel and Hezbollah.
The Lebanese militant group began firing rockets across the border into Israel in support of its ally, Hamas, on Oct. 8, 2023, a day after Palestinian militants staged the deadly surprise incursion into southern Israel that sparked the ongoing war in Gaza. Israel responded with shelling and airstrikes.
For months, the conflict in Lebanon was mainly confined to the border area, far from Beirut.
Abu Sitta said he chose Lebanon for the wounded children's treatment because the Mediterranean country has specialists with wide experience treating war injuries.
Lebanon has been through its share of conflicts, including a 15-year civil war that ended in 1990 and a brutal monthlong war between Israel and Hezbollah in 2006, as well as spillover effects from other regional conflicts.
“Even after the end of the wars (in Lebanon), the wounded from Iraq and Syria would come here for that kind of complex and multistage treatment,” Abu Sitta said.
The war that followed them
In July, Halima underwent successful surgery to repair her skull at the American University of Beirut Medical Center.
Nawfal said her daughter has lingering memory problems but is improving with therapy. A chipper, happy-go-lucky child, Halima thrived in Beirut. She swam in the hotel pool, loved to color and played with the other children from Gaza. She walked with her siblings to pick out fruit at the neighborhood produce stand, a straw hat covering the scar on the back of her head.
In mid-September, Israel launched an offensive against Hezbollah. It pummeled wide swathes of Lebanon with airstrikes, including Beirut’s southern suburbs and some sites within the city center.
The children quickly snapped back into wartime habits. They cracked open the balcony's sliding glass doors to prevent the glass shattering from the pressure of a blast and began sleeping in the central sitting room in the family’s hotel suite, away from windows.
Nawfal said some organizations offered to evacuate the family from Lebanon to continue treatment elsewhere, but she “completely refused.”
“Lebanon isn’t just another Arab country or a country we came to for treatment — Lebanon is a sister to Gaza,” she said. “We are like two souls in one body. ... We live or die together.”
Adam Afana's uncle, Eid Afana, said the escalation in Lebanon “reminds us of the beginning of the war in Gaza.” Afana said the sound of airstrikes frightened Adam, who felt the war was pursuing them.
“What we hope for Lebanon is that what happened in Gaza won’t happen here — that the beginning and the ending won’t both be the same,” Afana said.
‘All wars are waged on children’
The Ghassan Abu Sitta Fund halted bringing wounded Palestinian children to Lebanon but continues to treat the existing patients — with some challenges.
Since arriving in Beirut, Adam has undergone a procedure to clear infection from his bones, a neurosurgery and regular physiotherapy sessions. With effort, he can now slightly clench his hand.
But the final operation — a muscle transfer and surgery to repair the damaged nerves to his arm — is on hold.
“There’s just a handful of people who specialize in this globally, and we were expecting one of them to come to Lebanon,” Abu Sitta said. The trip has been delayed by the escalation in Lebanon.
When he first launched the program, Abu Sitta hoped to treat 50 Palestinian children from Gaza at any given time. Unable to bring more patients in, the team is turning its resources to treating Lebanese children.
The numbers of wounded Lebanese children are still far lower than in Gaza. As of last week, Lebanon’s Ministry of Public Health said 192 children had been killed and at least 1,255 wounded since October 2023. In Gaza, more than 13,000 children have been killed and thousands more have been wounded, according to Gaza's Health Ministry.
Abu Sitta said the wounds of children in Lebanon are “identical to the injuries of Palestinian children from Gaza.” Most were wounded while at home. They suffered “crush injuries to the limbs, blast injuries to the face” and often “multiple members of the family killed at the same time,” he said.
“As in Gaza, this war takes its toll on children,” he said. “All wars are waged on children.”
