Ghena Jadili is 12 years old. Her sister says she has not smiled in weeks.

On December 28, when the world was gearing up to celebrate the arrival of the new year, Ghena and her three elder sisters had to flee to South Gaza in search of shelter.

The Israeli Defence Forces had warned residents to vacate the Nuseirat camp, located in Central Gaza. Nuseirat is one of the eight camps in the Gaza Strip that have, over the years, become permanent residences.

The four sisters moved into a relative’s house in South Gaza where the sound of bombardments keeps waking Ghena from her sleep.

“She cries all the time now,” her elder sister Rajaa Jadili said.

As Israeli forces advance from north to central and now southern Gaza, at least 19 lakh people in the Gaza Strip have been displaced and half of them are children like Ghena.

Twelve lakh of those displaced are staying at 155 facilities run by the United Nations Relief and Works Agency, Jonathan Crick, a spokesperson for the Unicef in Jerusalem, told Scroll in an email on January 4.

Another two lakh are sheltering in schools, wedding halls and hospitals while several thousands are sleeping on the streets. Israel’s assault on Gaza since October 7 has effectively put an end to schooling – for now.

The harsh winter, lack of adequate medical care, shortage of water and poor sanitation have exposed newborns and children to infections in refugee camps.

But a greater worry is the worsening mental health of displaced and orphaned children.

Even before the military assault on Gaza, a 2022 survey by the nonprofit Save the Children found that 80% of children in Gaza were in emotional distress due to the prolonged conflict with Israel. More than half of those surveyed contemplated suicide.

This figure has risen significantly in the present crisis, Bill Van Esveld, associate director in the children’s rights division of Human Rights Watch, told Scroll over the phone in December.

“We have situations where not just the child’s parents but entire families have been killed,” Esveld said. “In some cases, children do not know their own name or who their relative is.”

He added that many organisations devoted to supporting orphans are no longer functional in Gaza. “The problem is that those in position to save these orphans are themselves hit,” he said.

Rajaa Jadili, Ghena’s elder sister, who works with the relief agency of the United Nations, helped Scroll reach out to displaced children and the mothers of newborns in refugee camps.

“The situation is dire,” she told Scroll over the phone from South Gaza. “People have moved shelters multiple times, first from North to central Gaza, and now to South. After this, there is nowhere to go.”

The team of lawyers from South Africa, which has filed a case in the International Court of Justice accusing Israel of genocide, referred to the catastrophic toll on Gaza’s children during the public hearing in The Hague on January 11. Israel’s team of lawyers were heard on January 12.

Jadili's five-year-old nephew, Ali, while they family was preparing to leave from Central Gaza to South Gaza. Alid told her, "Come on, let's go before the planes start bombing us". Credit: Rajaa Jadili.

‘No room for grief’

Around the end of October, Israeli air strikes killed the parents and five-year-old sister of toddler Janna Ismail Haboub and destroyed their home in the Jabalia camp in northern Gaza. Haboub, 20 months old, was found in a pile of rubble near her neighbour’s rooftop the next day. She survived with multiple fractures.

The toddler was admitted to Kamal Odwan Hospital for three days, where she was labelled as “wounded child, no surviving family” – a tag given to many injured orphans in Gaza whose entire families have been killed in Israeli airstrikes. Blinne Ní Ghrálaigh, one of the lawyers representing South Africa, told the court that Israel’s military assault had led to the coining of this “terrible, new acronym” – WCNSF.

On the third day, Haboub’s grandmother Rehab Youssef Ibrahim Masoud reached the hospital in search of her. Masoud took Haboub back to her hometown Khan Younis in South Gaza, but within days had to vacate their home. They now live in a classroom of the Rafah Preparatory Girls School that has been converted into a refugee camp.

“The school is overcrowded,” Masoud said. “There is no room for grief, there is no space for contemplation. Every day, I wake up to the sounds of bombardment, destruction.”

Haneen Afana, a social worker with the UN relief agency, said she has noted that since Janna moved to the refugee camp, she has “excessive nervousness, tension, and emotional outbursts”. “She insists on being constantly accompanied by her grandmother, seeking solace and security in her presence,” Afana said.

Janna Haboub is held by her grandmother Rehab Masoud as she speaks to social worker Haneen Afana at the refugee camp. Credit: Rajaa Jadili.

Like Janna, Afana said many children in the camp show signs of distress – from wetting the bed involuntarily and getting aggressive towards each other.

Social workers Scroll spoke to said there is an increasing need to provide counselling to displaced and orphaned children, but the first priority for those providing aid is food, water and shelter.

Dr Santosh Kumar, medical director with Project Hope, which is running clinics for displaced refugees in Rafah and Deir al Balah, both cities in south Gaza, told Scroll that until the end of December or so, four hospitals were functional in the Gaza strip. “Now only two remain functional, both in Rafah,” said Kumar. “They are focussed on saving lives. Mental health is nobody’s priority.”

Project Hope started a mental health programme in their clinics but has been unable to expand their work, said Kumar. “We have other medical emergencies,” he said. “Maternal and neonatal mortality is rising, and there is no way to count or control them,” he said.

There are 50,000 pregnant women in the Gaza Strip, with more than 180 giving birth every day, data from the UN child agency shows. “Fifteen per cent of them are likely to experience pregnancy or birth-related complications and need additional medical care,” Crick, from the Unicef, told Scroll. But few hospitals remain functional.

Hungry and ill

On January 5, the UN children’s agency said its survey found that 96% of Gaza children under the age of two suffer severe food poverty. Families reported their children were consuming only milk and bread. That has led to a rise in malnutrition.

The displacement has also led to poor sanitation, unclean drinking water, and children forced to live in highly dense situations with hundreds occupying a room. Hundreds are forced to share a toilet.

The World Health Organisation has observed that upper respiratory infections, diarrhoea in children under the age of five, cases of lice and scabies, chickenpox, skin rash, and acute jaundice syndrome cases are also increasing.

Kumar said there is no power in Gaza to maintain a cold storage chain, making vaccination nearly impossible. “How do we store vaccines?” he asked.

Adila Hassim, another lawyer representing South Africa, told the International Court of Justice that even UN chiefs have described Gaza as a “graveyard for children”.

Arij Quaider with her newborn Sham and other children at the refugee camp. Credit: Rajaa Jadili.

‘Terrified children’

Two months ago, Arij Quaider, 20, began the arduous travel from Gaza city in the north to Rafah in the south when Israel began an attack in the northern part of Gaza Strip. Quaider, who was seven months pregnant then, travelled with her one-year-old son Hassan and four-year-old daughter Adlaa and began living in a refugee camp. Her husband lives in Turkey for work.

On December 21, when she developed labour pain, a staffer with the UN relief agency took her to a nearby hospital for delivery. When she returned with the newborn, she found herself in a room shared by 12 families, comprising 40 women and children.

Since her delivery, she and her newborn Sham have not been able to have a bath. “I couldn’t find water to take a shower,” Quaider said.

The biggest challenge remains diapers and milk for her children. “My son Hassan cries constantly because there is no milk,” she said. For now, she has managed to get her newborn vaccinated at the local UN relief agency-run clinic.

Inas Hamdas, spokesperson for the UN relief agency in Gaza, said children have been affected the worst. “They are terrified, depressed and fearful.”

Rajaa Jadili contributed reporting from Gaza.

This reporting was supported by a grant from the Thakur Family Foundation. Thakur Family Foundation has not exercised any editorial control over the contents of this article.