A Journey of 6,000 Miles

Rhana Natour | The Atavist Magazine | July 2024 | 1,385 words (5 minutes)

This is an excerpt from issue no. 153, “Coming to America.”

.أقرأ هذه الق��ة باللغة العربية

Dina Assaf sat in her car outside Chicago’s O’Hare International airport watching the terminal’s sliding doors open and close, open and close. She and her husband, Baha, had been scrambling to prepare for this moment and were exhausted, but in the back seat their three daughters were restless with excitement. Sara, Salma, and Sereen had circled this day—March 17, 2024—on their calendars weeks ago and were giddy that it had finally come. They jostled one another for the best view of the doors, hoping to be the first to spot the person they were there to pick up. She was a young girl like them—she had turned 14 just three days before—and from what the sisters had been told, she was very important.

The girl’s name was Layan Albaz, and she had a button nose and a soft voice. What the Assafs knew of her life came mostly from videos on the internet. In one clip, Layan described how she had lost two sisters, a niece, and a nephew in an Israeli air strike in Gaza. She used a wheelchair because injuries she sustained during the attack had forced doctors to amputate her legs. In another video, filmed by Agence France-Presse not long after the air strike, Layan’s face was mottled with burns. “I want them to give me real legs,” she whimpered, clutching an oxygen mask in one hand. “I don’t want fake legs.”

But if Layan was ever to walk again, prosthetics were exactly what she would need, and to get them she was coming to the United States. Shriners Children’s Chicago, a hospital specializing in pediatric orthopedics, had offered to provide her with free medical treatment. And despite being perfect strangers, the Assafs were opening their home to Layan for the duration of her stay.

Sara, the eldest Assaf daughter, was 12, which meant that Dina and Baha had firsthand experience with an adolescent girl navigating a swirl of transitions. But Layan was also grappling with a new and permanent disability. Over the months of Israel’s brutal siege on Gaza, she had lost people she loved and seen horrors one would expect only a frontline soldier to witness. Dina was under no illusion that hosting Layan would be easy. “But I expected more of, like, sadness,” she told me.

When Layan was finally rolled through the doors at O’Hare, Baha stowed her wheelchair in the trunk and placed Layan in the back seat of the car with his daughters. Dina, who was sitting in the driver’s seat, was shocked when Layan first spoke.

“What’s that beeping noise?” Layan asked in Arabic—she had come to America without a word of English. Her voice was laced with annoyance.

“Dina just needs to put her seat belt on,” Baha replied.

“Well, what the hell are you doing?” Layan yelled, locking her eyes on Dina. “Put the damn thing on. You’re giving me a headache.”

Sara, Salma, and Sereen’s eager smiles curved into frowns of concern. Dina thought, What did I get myself into? The Assafs were already learning that their guest was too angry to be sad.

In Arabic, the root of the word for “amputated,” mabtur, can mean “incomplete.” This feels like a nod to the idea that it’s possible to sever something so essential to a person that they can no longer be considered whole. Someone who has lost a limb has experienced a deviation from the blueprint of the body; like a novel with chapters ripped out, something crucial is missing.

In Gaza, all we have to go by are amputated stories, fragments of the whole truth. Even that most fundamental data point of any war—the death toll—is incomplete. As of this writing, Gaza’s health authority has tallied more than 39,000 fatalities, but with the devastation inflicted on the region’s health care infrastructure, and with many bodies buried too deep in the rubble to be counted, officials emphasize how deficient their figures are every time they issue a report. In early July, an article in The Lancet estimated that Israel’s siege could result in 186,000 deaths, or 7.9 percent of Gaza’s population. But it may be years before we know the true toll—if we ever know it at all.

As for the children, here is some of what we know: As of May, approximately 15,000 were dead, 12,000 were injured, and 21,000 were missing. Among the wounded, doctors have described treating children “shredded” by bombs, crushed by collapsing buildings, and suffering from gunshot wounds to the head. Many pediatric patients have lost arms or legs. For now we have only a single statistic when it comes to these young amputees: Between October 7 and November 29, 2023, Unicef reported that more than 1,000 children had lost one or more limbs. A spokesperson told me in June that the agency had been unable to gather more recent figures, “given the challenging circumstances on the ground.”

This isn’t unusual—authoritative, countrywide figures on the number of pediatric amputees in most conflicts are generally rare. What seems clear is that we are witnessing one of the fastest and most intense mass-disabling events of children in our lifetimes. When the dust settles, relative to population size, Gaza may be left with the largest cohort of children who’ve lost limbs in any war in modern history.

Dr. Ghassan Abu-Sittah is certain that this will be the case. A plastic and reconstructive surgeon who specializes in pediatric trauma sustained in conflict, Abu-Sittah spent more than a month in Gaza, working with Doctors Without Borders, in the early days of the war. The experience, which he also described to The New Yorker, left him determined to assess the full scale of the crisis he witnessed. “During those 43 days that I was there, I did more amputations than I’d ever done in my 20 years as a war surgeon,” Abu-Sittah told me, holding his hands to his temples during a video call from his home in London. “I just needed to understand what the bigger picture was.”

He began reaching out to other surgeons—some who had recently returned from stints in Gaza, and some who were still there. Person after person replied with details that mirrored his own experience. Abu-Sittah realized that what he and other doctors were seeing could be record setting. It was the worst kind of reality check. He now estimates the number of pediatric amputees in Gaza at somewhere between 4,000 and 4,500—so far.

To put this in perspective, the Associated Press has reported that, over two and a half years of conflict in Ukraine, some 20,000 people have lost limbs. Based on testimony from medical personnel, researchers at the Center for Pediatric Blast Injury Studies, a joint venture launched in 2023 by Imperial College London and Save the Children, believe that the number of pediatric amputees in Ukraine is around 1,200.

Here is another way of looking at Abu-Sittah’s Gaza estimate: The average U.S. public school has about 550 students. Imagine eight or nine schools in an area roughly the size of Philadelphia where every kid is missing at least one limb. Imagine also that their amputations happened alongside a torrent of other tragedies: the loss of family members, friends, neighbors, schools, houses.

Now imagine that the only hope to reclaim some semblance of physical normalcy required those children to leave home. Gaza’s sole manufacturer of prosthetics and its affiliated rehabilitation center were destroyed in an air strike months ago; as a result, many families of children who have lost limbs are trying to evacuate them so they can receive medical care abroad. Social media is brimming with their desperate pleas, and only a few get what amounts to a lucky ticket for the mortally unlucky: Countries willing to take pediatric amputees from Gaza are doing so in relatively small numbers.

The kids who do find a way out board planes for distant places. In Layan’s case, that place was more than 6,000 miles away from everything and everyone she knew.