📰GAZA’S AMPUTATION CRISIS Painting "Amputation" by Bashir Qonqar - Palestinian artist from Bethlehem The operation may take minutes. The consequences can last a lifetime. Three years after October 2023, Gaza is facing an extraordinary crisis of traumatic injury and permanent disability. A Palestinian-led rehabilitation assessment published in 2026 records more than 5,000 limb amputations, with approximately one in five involving children. Other Palestinian health reporting has put the number of people requiring prosthetic limbs above 6,000. More than 43,000 Palestinians are estimated to be living with life-changing injuries, including major limb trauma, spinal-cord injuries and traumatic brain injuries. Yet only eight prosthetists remain working in Gaza, and no rehabilitation facility is fully functional. Those figures describe far more than what happened at the moment people were injured. Some Palestinians lost limbs immediately because of catastrophic trauma. Others underwent amputations later because damaged limbs could not be saved. Palestinian vascular surgeon Dr Tayseer al-Tanna gave one of the clearest examples after patients were transferred from Al-Shifa Hospital following the Israeli military siege in 2024. Of 60 transferred patients, 15 required amputations. Al-Tanna told Medical Aid for Palestinians that at least ten of those amputations had become necessary because the patients had been deprived of proper medical treatment during the siege. In other words, the original injury alone did not determine whether those people would lose a limb; the absence of timely medical care became part of the outcome. British surgeon Professor Nick Maynard, who has repeatedly worked in Gaza with Medical Aid for Palestinians, was warning about the scale of this crisis from the first months of the war. At Al-Aqsa Hospital in January 2024, he described blast and shrapnel injuries overwhelmingly affecting limbs and reported adults, children and babies arriving with traumatic amputations. His accounts from successive deployments describe hospitals attempting to manage large numbers of severely injured people while struggling with shortages of beds, medicines, equipment and staff. The shortage of anaesthetic and adequate pain relief has produced some of the most disturbing testimony from international surgeons who have worked inside Gaza. British transplant surgeon Professor Nizam Mamode, who volunteered at Nasser Hospital, told the UK Parliament that there were periods when operations were being performed without sterile gloves or sterile drapes because basic supplies had run out. He then described the post-operative pain relief available to some of his amputees: “I did amputations on people who just had to take paracetamol after the operation as pain relief.” Mamode told MPs that medical supplies needed by hospitals were sitting at the border and were not being allowed in. There are also documented cases in which urgent procedures were carried out with no anaesthetic at all. Medical Aid for Palestinians recorded the testimony of 15-year-old Tala, who said retained shrapnel had to be removed from her leg without anaesthesia because none was available. American orthopaedic surgeon Dr Mark Perlmutter, after working in Gaza, described amputating the leg of a five-year-old girl after anaesthetic supplies had run out. These cases should not be misrepresented as evidence that every amputation in Gaza has occurred without anaesthetic; many have been performed under anaesthesia when functioning theatres and supplies were available. What they establish is serious enough without exaggeration: shortages became so severe that some patients, including children, underwent major or urgent procedures with little or no adequate anaesthesia or pain control. Amputation, however, is not the end of treatment. In many ways it is the beginning of another medical journey. A person may require further surgery, continuing wound care and infection control before rehabilitation can even begin. Physiotherapy is needed to maintain strength and balance, while a prosthetic limb must be individually manufactured, fitted, adjusted and periodically replaced. Patients then have to learn how to move safely with it and may need continuing physical, occupational and psychological support. Taawon’s Gaza Rehab Care programme describes rehabilitation as a continuum from clinical assessment and pre-fitting therapy through prosthetic fitting, post-fitting training and eventual reintegration into school, work and family life. For children this process is particularly demanding because their bodies are still growing. A prosthetic limb that fits a child today will not simply continue fitting throughout adolescence. It must be reassessed, modified and ultimately replaced as the child grows and their weight, gait and physical needs change. Yet rehabilitation reporting in August 2026 said Gaza had no paediatric rehabilitation services available, while equipment shortages were contributing to preventable complications and forcing some patients to leave specialist rehabilitation beds earlier than clinicians considered ideal. The shortage extends far beyond artificial limbs. Wheelchairs, crutches, walkers, orthotic devices, specialist footwear, shower chairs, commodes and replacement parts are all essential components of disability care. Palestinian authorities reported in 2026 that 83% of people with disabilities in Gaza had lost their assistive devices, while less than 15% of rehabilitation needs were being met. Losing a wheelchair during repeated displacement is not a minor inconvenience. For someone with limited mobility, it can mean losing independent access to food distribution, medical appointments, toilets, education, information and basic participation in family life. Israeli restrictions on the entry of rehabilitation equipment have compounded that crisis. JVP Health’s June 2026 review reported that Israeli authorities rejected requests to bring rehabilitation items into Gaza on the grounds that equipment classified as fitness equipment did not comply with humanitarian policy. The same review reported that prosthetic hands, knee and ankle joints, silicone locking liners and medical shoes had been denied entry despite repeated submissions. These are not decorative or optional products: they are components used to construct, fit and maintain artificial limbs. Wheelchairs illustrate the mismatch between what has entered Gaza and what is required. WHO was able to bring in 120 wheelchairs, while more than 3,000 people with complex trauma were assessed as urgently requiring them. Rehabilitation organisations estimated that more than 20,000 mobility-aid products were needed overall. Because roads and pavements have been destroyed and many displaced people are moving through rubble, damaged streets and temporary shelters, an actively used wheelchair in Gaza may last less than three months. This turns even a replacement tyre, bearing or footrest into an essential medical supply. Rehabilitation reporting in August 2026 said that no rehabilitation equipment intended for rehab facilities entered Gaza between May 2024 and April 2026, while pending shipments of assistive products were facing an average wait of 136 days. Earlier reporting also documented restrictions on prosthetics, wheelchairs and mobility devices for children under Israeli “dual-use” or humanitarian-entry rules. All of this changes how the headline figure of more than 5,000 amputations should be understood. These are not thousands of completed medical cases. Each person may face years, and often a lifetime, of repeated prosthetic fittings, physiotherapy, pain management, replacement equipment and medical review. At the same time, Gaza’s rehabilitation workforce and infrastructure have been severely reduced, leaving thousands of people competing for specialist care that was inadequate for the scale of need even before many of these new injuries occurred. The original injury may happen in seconds, but its consequences can continue for decades. After surgery comes the risk of infection, continuing pain, attempts to obtain a suitable prosthesis or wheelchair, repairs when equipment breaks, physiotherapy, and the difficult process of relearning ordinary activities. Recovering a degree of independence depends on a chain of medical, rehabilitation and social services that has itself been badly damaged and repeatedly deprived of equipment. That is why Gaza’s amputation crisis cannot be understood solely by counting missing limbs. It is also a crisis of everything required afterwards: anaesthesia during surgery, adequate pain medication after it, antibiotics and reconstructive care to prevent avoidable amputations, physiotherapy, artificial limbs, wheelchairs, specialist equipment and trained rehabilitation staff. When these are unavailable, delayed or prevented from entering in sufficient quantities, the consequences of the original injury are extended far beyond the moment it occurred. For thousands of Palestinians, surviving the injury was only the beginning. The much longer struggle is being able to move again, manage pain, attend school, return to work and regain some independence in a place where the medical system required to make those things possible has itself been devastated. —Zara Zhar