Ramallah, November 19, 2024—Palestinian children with severe injuries, who evacuated Gaza to receive treatment in Egypt, now face an unknown future.
Defense for Children International - Palestine visited hospitals in Cairo where Palestinian child patients are receiving treatment for serious injuries from Israeli airstrikes, shelling, and live ammunition attacks in Gaza. Several children, including 14-year-old Ziad and two-year-old Alia,* traveled to Egypt without their parents or any family members. Palestinians have been unable to travel to Egypt since Israel closed the southern Rafah crossing in May.
“Palestinian children forced to evacuate Gaza for medical treatment without any family members are vulnerable to exploitation and must be protected,” said Ayed Abu Eqtaish, accountability program director at DCIP. “Under international human rights law, Egypt has a legal obligation to protect these vulnerable children and support efforts to reunite them with their families.”
Ziad, 14, was struck six times with live ammunition fired by an Israeli quadcopter in the Al-Rimal area of Gaza City on November 16, 2023, around 7 a.m., according to documentation collected by DCIP. Ziad went to check on his family’s grocery store with his father when the quadcopter targeted him, striking him in the stomach, back, hand, foot, and wrist.
“I felt an electric shock in my hand and stomach as a result of the injuries,” Ziad told DCIP. “I looked at my stomach and saw thick blood coming out, and I felt as if my intestines had come out of their place. My father came to check on me and see what had happened to me. He saw the injury to my stomach and how my intestines were all out, so he immediately carried me in his arm, but the quadcopter fired three more bullets that hit my father in the hand, knocking both of us down. We tried to crawl, but the quadcopter fired at us again, striking me with two bullets in the left foot, one in the back, and another in the left wrist. If we had stayed like that, we would have died. My father and I had no choice but to run as fast as we could, so we ran in several directions, right and left, so as not to be hit [again]. I ran 300 meters until I reached the Al-Ahli Baptist Hospital. Once I entered the hospital, an explosion shocked the area outside, and I learned that a tank shell hit right in front of the hospital entrance.”
After doctors provided first aid to Ziad and his father, everyone was forced to evacuate the hospital due to Israeli attacks. They first went to a doctor at Al-Zahraa school, then a friend drove them to the Indonesian Hospital, where Ziad underwent surgery to close his abdomen. He stayed at the Indonesian Hospital for three days before he and his father went to a friend’s house in Jabalia.
Ziad’s mother came the next day, and they realized that stool was exiting the injury in his back. At first, they went to the Al-Ahli Baptist Hospital, but doctors sent them to the European Hospital in southern Gaza, as Israeli forces were intensifying their attacks in northern Gaza. Ziad and his father rode in an ambulance to the European Hospital and arrived after Israeli forces detained them for several hours at the Netzarim Corridor in central Gaza.
Ziad underwent several more surgeries to clean the bowels and close the abdomen, and stayed at the European Hospital from November 23 until January 23, during which time his family applied for a medical referral for Ziad to receive treatment in Egypt.
In order for Palestinian patients to evacuate Gaza, they must navigate a complex web of permits and referrals. Doctors and humanitarian organizations recommend patients to the Palestinian Ministry of Health, which forwards the referral to the World Health Organization, which sends it to COGAT (Coordinator of Government Activities in the Territories) for final approval. COGAT is a branch of the Israeli military that frequently rejects permits on an arbitrary basis, usually citing ‘security concerns.’ COGAT is currently approving the security screening for less than one percent of submitted patients, meaning they cannot travel, the WHO told Drop Site News on November 1.
“My father was forbidden from accompanying me, and my mother and siblings were in Gaza City, and no one was there to accompany me except an aunt,” Ziad told DCIP. “I had an aunt living in Al-Bureij and another one living in Al-Nuseirat. My aunt in Al-Bureij fled to my aunt's house in Al-Nuseirat, but the Israeli forces bombed the house and killed them both, along with their children and husbands. I no longer had anyone to accompany me to travel abroad, so I traveled to Egypt alone.”
Ziad traveled through the Rafah crossing to Al-Arish, an Egyptian city in the Sinai peninsula. He learned that Italy would accept him for treatment there, but doctors insisted he could not endure a plane or boat ride to Italy from Egypt given his critical condition. Instead, Ziad was transferred to the Italian hospital in the Al-Abbassia area of Cairo.
Ziad underwent a flank patch operation and doctors treated the injuries in his foot, right fingers, and left hand. After several delays, doctors finally completed the surgery to repair his abdomen and intestines.
“I hope everyone stands by me,” Ziad said. “Isn't it enough that I am alone in Egypt? My father and mother are not with me. I have not seen them or my siblings for many months because of the war on Gaza.”
Ziad’s abdominal surgery was completed on July 20 and he has recovered well from his injuries. Ziad’s father has still been unable to leave Gaza due to the closure of the Rafah crossing, meaning he is still alone in Egypt. For now, Ziad remains at the Italian hospital.
Another unaccompanied Palestinian child who received treatment in Egypt is two-year-old Alia, who stayed with a Palestinian family with Egyptian citizenship in Cairo.
“I received a call from one of my friends in Egypt who told me there was a little girl no more than two years old at the Palestinian embassy in Cairo with no companion. She was alone,” Nabil, father of four, told DCIP. “This girl’s house was bombed and she remained under the rubble for hours until she was found.”
Alia’s mother suffered critical injuries to her legs and had to travel, along with her husband, to Tunisia for treatment. Alia stayed in Gaza with displaced Palestinians living in a tent in Rafah for several months before the Palestinian Red Crescent Society and UNICEF coordinated her travel to Egypt.
When Alia traveled through the Rafah crossing without an escort, she was handed over to the Palestinian embassy in Cairo, which contacted Nabil to ask if his family could host Alia until travel arrangements to Tunisia were made.
“Without hesitation and after obtaining my wife’s approval, we agreed to host the child,” Nabil said. “When I went to the embassy to receive her, I was surprised to see she was very weak, just a skeleton, and she had signs of malnutrition.”
Nabil took Alia to a doctor, who said she needed nutrition, and that her stomach was swelling due to the presence of toxins and gasses due to malnutrition. Doctors and Nabil’s family have taken good care of Alia and her condition has improved considerably.
Nabil’s family cared for Alia for about two months before the Tunisian embassy arranged for Alia to travel to Tunisia to reunite with her parents.
There are no estimates for the total number of unaccompanied Palestinian children in Egypt. Of the several hundred Palestinian children who have left Gaza for treatment in Egypt, “very few” traveled alone, the Palestinian ambassador to Egypt, Diab Allouh, told the Washington Post in February. “We don’t have a detailed list,” he said.
Unaccompanied children, without the care and protection of their families, are at serious risk for trafficking, exploitation, and abuse, especially as they remain in legal limbo in Egypt. Israeli forces have shown no sign of ending the genocide in Gaza any time soon, heightening the risks to unaccompanied children.
Thousands of Palestinian children have been separated from their families due to Israel’s campaign of genocide in Gaza. Under the Convention on the Rights of the Child, Israel has an obligation to protect children’s right to life and development. Israel also had obligations under international humanitarian law to protect civilians, including children, which it has consistently failed to do.
Egypt, as the children’s host country and a state party to the CRC, is obligated to support and protect displaced children from Gaza residing in Egypt, to ensure they receive appropriate protection and humanitarian assistance to uphold their rights under international and domestic laws.
The State of Palestine, also a state party to the CRC, is also obligated to work toward the reunification of families.
*Alia is a pseudonym used to protect the child’s privacy. Her name is known to DCIP.
