Half the people sheltering in Rafah are children, and the world has forgotten them

More than half of the Gaza Strip’s population of 2.3 million is sheltering in Rafah – a town of 150,000 that has been transformed over the course of Israel’s war into a last refuge for displaced civilians . Among the city’s huddled masses are 600,000 children, all of them with an uncertain future and nowhere else to go . Unicef, the UN’s children’s agency , has described these children as being “at the edge of survival”. The picture the agency’s staff paint is stark. More than a tenth of the children are thought to have a “pre-existing disability, including difficulties seeing, hearing, walking, understanding and learning”. Out of the 195,000 who are under the age of five, 90 per cent are affected by one or more infectious diseases. These can have catastrophic effects on their health. For instance, empyema, a potentially fatal condition caused by pus pooling around the lungs, is extremely rare in children around the world; doctors in Rafah report it is frighteningly common among those they treat, as a side effect of communicable disease. Many of these children are also alone. In February, Unicef estimated that 17,000 minors in Gaza were either unaccompanied or separated from their parents. That is a grim situation especially as health and survival outcomes for children in conflict zones left without their parents are statistically much worse. Unborn children suffer in equal measure. Gaza’s healthcare infrastructure has all but collapsed , along with the prenatal care system. Fewer than a third of the territory’s hospitals are partially functioning – the rest are not functioning at all. Miscarriages, stillbirths, congenital anomalies and infant mortality rates (to say nothing of maternal mortality) have skyrocketed. All this physical trauma is, of course, accompanied by psychological trauma. The effects of armed conflict on short-term and long-term child mental health are well-established. Anxiety, emotional withdrawal and aggression are common – often long-term – side effects of a childhood in war. Some studies of conflict zones have shown the psychological trauma is particularly acute when children are attacked at school. Israel has directly bombed more than 200 schools in Gaza, the UN says, and in the first three months of the war, according to Gaza Education Ministry officials, more than 4,000 pupils were killed and at least 7,000 more were injured. The rights of Gazan children “are being gravely violated at a level that has rarely been seen in recent history”, in the words of Ann Skelton, chair of the UN Committee on the Rights of the Child. Ms Skelton has suggested that depriving children of care during conflict could constitute a war crime under international law. Indeed, Israel’s refusal to allow Gazan civilians access to aid for most of the war is thought to be the subject of an investigation by the International Criminal Court. For Gazans themselves, a greater concern than the pursuit of a day in court may be what an entire generation of maimed and traumatised children – the heirs to Gaza, by and large – means for their community’s future. It is a question Israelis should be asking themselves as well. It can sometimes be hard for children to grasp concepts like forgiveness and reconciliation; the wisdom needed lies in the years ahead of them. But for adults whose formative years were marred by unspeakable violence, it is even harder.