Ahmed al-Harsh’s heart ached while he waited at Nasser Medical Complex in Khan Younis for the bus bringing 2-year-old Mahmoud back from Egypt. Mahmoud was one of dozens of premature babies evacuated without his family to Egypt during Israel’s siege of Al-Shifa Hospital in November 2023. Ahmed pushed through the crowd, trying to reach the bus to hug his little boy. The crowd pressed around him and the child started crying uncontrollably. Ahmed reached out to hold him. He could hardly believe the boy was finally here.
Standing not far off, Mohammed Lubbad clung to the hope he would finally get a chance to reclaim the child he believed had been taken from him.
Each of the two men, al-Hirsh and Lubbad, is certain that Mahmoud is his son.
Neither man can prove his claim. The war eliminated the most basic records of birth, and the collapsed healthcare system cannot provide a DNA test. The baby’s identity is a question without an answer.
In October 2023, an Israeli airstrike hit Ahmed al-Hirsh’s home. He survived with serious injuries. Eleven of his relatives did not. His wife, Fatima, was eight months pregnant, and doctors delivered the baby by emergency caesarean at Al-Shifa hospital in Gaza City. Al-Hirsh was injured, so he wasn’t there for the birth. Fatima died two days later.
The day before al-Hirsh’s house was struck, Mohammad Lubbad’s house was hit. He was dangerously injured, too, and was also away when his wife gave birth. Her baby came the same way, at eight months, by emergency caesarean.
On November 11, Israeli forces besieged Al-Shifa, the largest hospital in Gaza. A strike hit the cardiac wing, the power failed, and the incubators and ventilators in the neonatal unit stopped. Around thirty-nine premature babies were inside. The World Health Organization called the hospital a “death zone.” Some of the infants died. On November 20, 28 were evacuated to Egypt, where they would stay for two years. Most arrived without their families, who had no way of knowing whether their babies were alive.
In conditions like these, registering a birth was almost impossible. Who was the mother? Who was the father? Was the family even alive? Often no one could say. The records were lost, or simply never made at all.
The war has overturned the lives of an entire generation of children in Gaza. Since October 2023, more than 73,000 Palestinians have been killed, more than 21,000 of them children, according to the latest figures from the Gaza Health Ministry.
From the children who lived, it took something harder to name. It took the knowledge of who they are, the families they come from, the names that were theirs. For thousands of children, the most basic facts of a life, a name, a family, a place to belong, have come loose, with no one left to set them right.
The difficult life of a ‘lone survivor’
Tasahil al-Akhras is a psychologist who works with an organization providing psychological support to orphans, particularly “sole survivors,” children who lost every member of their family. “One day, a child can be surrounded by the embrace of his family,” al-Akhras said. “The next, in an instant, he is left with no one.”
Gaza’s Ministry of Social Development counts 64,616 children who have lost one or both parents. Of those, 55,157 were orphaned in the most recent war.
In April 2024, UNICEF estimated that every child in Gaza needed mental health support.
One of the children al-Akhras works with, a 16-year-old girl named Yara (this is a pseudonym used to protect her privacy), lost her parents, her brothers and sisters, her grandparents, her aunts and uncles on both sides, all the roots and branches of her family. There is no one still alive for her.
Al-Akhras says Yara now lives in a small tent with another large family. The father of the family does not work because the war destroyed his livelihood, and he struggles with drug use as a result. There is never enough food. The tent floods in winter and overheats in summer. Yara has nowhere else to go.
Before the war, al-Akhras says, Yara was a sociable child and one of the strongest students in her class. That girl is hard to find now. Al-Akhras says she shows signs of post-traumatic stress. She has withdrawn into herself. She will not talk about what she lived through. She cannot walk past the ruins of her old home, and nightmares haunt her sleep.
She tries to keep up with online school, but the work of tent life leaves little room for it. There is cleaning and cooking and caring for children who are not her own. She has no one to play with and nowhere that feels safe.
Yara wishes she had been killed with her family.
An environment where children can never heal
Al-Akhras knows the limits of her work. She can offer a child a space to talk, a way to put words to fear and grief and anger. She can ease the symptoms that follow trauma, like anxiety, nightmares, and panic. And she can guide the people caring for the child. But these children are living through continuous trauma that does not end: the bombing, the displacement, loss after loss, and no ground that holds still beneath them.
In a place that is never safe, al-Akhras says, real recovery cannot begin. She cannot give a child a stable home. She cannot stop the fear or lift the threat. She cannot promise a routine or a school or a place that stays safe. “Sometimes,” she says, “I feel like I’m only easing the pain, inside a reality that won’t let it heal.”
Since the so-called ceasefire was announced in October 2025, the killings have not stopped. Gaza’s Health Ministry recorded more than 1,000 Palestinians killed in the months after the truce took effect, in airstrikes, shelling, and gunfire across all five of Gaza’s governorates, some far from the so-called Yellow Line that Israel has established to demarcate the new boundaries of Palestinian life and some in its shadow.
By May, the Israeli prime minister declared Israel controlled 60% of the Gaza Strip and ordered expansion to 70%.
Aid moves the way the gunfire does, in fits and starts. Between October and late June, only about a third of the trucks promised under the agreement made it in, and Israel kept out basic nutritious food like meat, dairy, and vegetables, while snacks and soft drinks passed through. What remains of the health system barely stands. More than half of Gaza’s hospitals function partially, and, according to the U.N., not one runs at full capacity.
There is nowhere to fall back to, no sheltering interior, no corner of Gaza the enemy will consent to leave alone.
Before the war, a child who lost his parents would rarely be left alone. Someone from the family would take him in. He stayed close to the people and places he knew, and he was raised, al-Akhras says, with the same love any family gives its own.
But the children who lose everybody often find themselves in the care of strangers. Gaza’s community remains tightly knit, but a stranger’s home is not always safe. Al-Akhras says some of them are treated harshly by the very people meant to care for them.
Orphanages do exist, but they’re small and few. By January, 2025, for example, SOS Children’s Villages was caring for just 33 children in Gaza, ranging from infants to 17-year-olds, in a displacement camp in Khan Younis after its Rafah site was destroyed. Formal alternative care is the responsibility of the Ministry of Social Development, whose capacity has been gutted.
The impacts on the child
Not every child breaks down. Some go quiet instead. They seem fine. They play, they even laugh, and the grief stays hidden underneath. A child rarely says, “I am sad.” The pain comes out in other ways: a nightmare, a wet bed, a drawing of the war, a long silence.
A deep wound does not have to determine a child’s whole life. Al-Akhras is clear about this. One steady, loving adult. Some sense of safety. Room to speak. A life that slowly settles. Any of these can change their path, even after the worst. A child needs a circle of support. But that is exactly what the war keeps out of reach.
Back at Nasser Medical Complex, Mahmoud knows none of this. He is two years old. He does not know that two men call him their son, or that neither can prove it, or that a war erased the record that could. He now lives with Ahmed al-Hirsh, but Mohammed Lubbad still believes Mahmoud is his son. Mahmoud is, in a way, the opposite of Yara. She lost everyone. He has been claimed by two. But both will grow up with the same question hanging over them: Who am I, and where do I belong?
So will tens of thousands of other children, each carrying a version of the same loss into a terrifying future that has already started unfolding.
This piece appears in the twenty-second issue of The New York War Crimes.