Treating Children Injured in War

0:00Today on State of the World, treating children injured in war.

0:08You're listening to State of the World from NPR. We bring you the day's most vital international stories, up close, where they're happening. I'm Greg Dixon. In today's episode, we meet a doctor in Lebanon who is healing children injured in the war in Gaza. Nearly two years into Israel's invasion of Gaza following Hamas' deadly October 7th attack on Israel, UNICEF estimates more than 50 ,000 Palestinian children have been killed or injured. So, as reporter Ari Daniel tells us, the race is on to treat those that can be reached. It's clear in an instant. Dr. Hassan Abusitta is just really good with kids.

0:50Here at his weekly clinic at the American University of Beirut Medical Center, he's meeting six-year-old Kenzie Madhun for the first time. Kenzie has eyes the color of dark chocolate. Her face is framed beneath a pink straw hat that covers a scar above her hairline. On her left hand, I see the drawing of a little heart. Her right arm, though, is missing. Kenzie's dad, Adam Madhun, brought her here to Lebanon, hoping Abu Sittah and his colleagues can help his daughter have a normal life. What I wish for is for her to do whatever she wants to do. Like there are games that need two hands, or when she wants to wear her clothes, the simplest things.

1:34But these simple things will require many complexities. To start with, Dr. Abu Sittah says he's focusing on Kenzie's missing limb. The biggest question is, how can I improve the quality of that remnant of her upper arm? Because that is the determinant of the quality of the prosthetic that she'll get.

2:00The doctor escorts the father and daughter into an exam room. Kenzie walks confidently with the group of adults. Abu Sittah says that during his assessment, he'll not just be looking at Kenzie as the 6-year-old she is today, but also as the 18-year-old she'll become. You are trying to reconstruct a moving object, which is the growing body that always outgrows the injured part. And that means multiple surgeries over multiple years. It's work that Abu Sittah has mastered over three decades, repairing the wounds of thousands of children like Kenzie, caught in the crossfire of war. He chose this path as a teenager, he says, growing up in Kuwait in a Palestinian family.

2:47During the summer of 1982, he remembers watching Israel's invasion of Lebanon on the news. Seeing medical teams treating the wounded was a strong influence on not just wanting to become a doctor, but the kind of doctor that I wanted to become. That is, a reconstructive and plastic surgeon who treats those wounded in war. War injuries are probably the most complex of reconstructive challenges. An explosive will blow rubble, shrapnel into the body. the wave of the blast devitalizes tissues and kills them, and so that needs to all be removed before you can consider reconstructing the limb. Over the years, Abu Sittah has treated the wounded in numerous conflicts.

3:34But it's in Gaza where Abu Sittah has felt a particular calling to help when violence has flared there over and over again. October 7th was no exception, after Hamas-led militants led a surprise attack on communities in southern Israel, killing 1 ,200 and kidnapping 251 more, according to Israeli authorities. Powerful Israeli retaliatory attacks on Gaza followed. On the 9th of October, I went into Gaza. It was shortly thereafter when I first reached Abu Sittah by phone at one of the hospitals in the north. He told me he was hearing shelling every few minutes. A lot of the wounded are women and children.

4:15Sometimes the child is the only survivor. We're about to do another patient with a much bigger wound in his eye, a kind of blast injury. So I'm going to need to go take care. Bye-bye. Abu Sittah says the conditions in Gaza this time were unlike anything he'd ever seen. It's the difference between a flood and a tsunami. The scale, the intensity, the sheer ferociousness. There was only so much Abu Sittah could do from the inside. So after 43 days, he left Gaza and eventually made his way to Lebanon. The expertise in the management of war wounds in Lebanon doesn't exist anywhere else. And so I felt that this is really the place to bring wounded kids for complex reconstructive surgery.

5:00Meanwhile, in Lebanon, many were watching the suffering in Gaza, wanting to help, like Doreen Dandashli, a social activist and former banker. The fact that you cannot do anything to change what you feel, it's heavy. It's eating us, you know, the helpless feeling. And it's like cancer. She and a few others knew of Dr. Ghassan Abusitta, so in partnership with him, they formed a fund in his name with the idea of helping war-injured children who've made it out of Gaza. Children like Kenzie Madhun, the six-year-old with the pink hat. Do you like to dress fashionably? Yes. Yes, yes. Two weeks after October 7th, Kenzie tells me she was sitting in the garden with her grandfather in Deir al-Bala in central Gaza.

5:48We heard things and then we thought it was fireworks, but it wasn't. It was an airstrike. The force of the explosion propelled her into the air. The missile took me up. Kenzie felt like she was flying, like a superhero. When she landed, she lost consciousness. Her father, Adam Madhun, wasn't with her, but a journalist friend called to tell him of the attack, that Kenzie had been pulled from the rubble. They told me that Kenzie died. Madhun rushed to his daughter and arrived an hour later to discover Kenzie was still alive. Like a phoenix, he says. But she was severely wounded, a fractured pelvis and skull, and a missing arm.

6:37Since then, we stayed together. We've been like twins. I did not see her for any day. Kenzie and her dad managed to leave Gaza. And over the next year and a half, they alternated between Egypt and Turkey for treatment. But it became clear that she needed to see doctors practiced in healing the particular wounds of war. And so Kenzie and her dad arrived in Lebanon to meet with Abu Sittah and his team. Their first meeting was here at his weekly clinic.

7:11Abusita asks his colleagues to order an x-ray of Kenzie's right shoulder because he wants to see if distraction is possible, a procedure that would elongate what's left of her upper arm bone by first fracturing it into two parts. And then you move them away from each other by one millimeter every day, and that induces newborn formation. Ultimately, Abu Sittah's colleague, a world expert in bone distraction here, determines he can give Kenzie a critical three extra inches in her stump. It means that what she will end up with is a prosthesis that doesn't have to be secured to her body through a shoulder strap that goes to the other side, but is able to stick to her limb, which makes it better, more appealing physically and functionally.

8:02The process will be painful. The first step in a long medical journey ahead. Kenzie's father is ready. Kenzie is scared. I'm really afraid. I don't like needles. I understand you feel a little nervous now. Is that kind of how you're feeling? Of course. Of course. That was last Friday. Today was Kenzie's surgery. Abu Sittah sent me this message. It just went very well. We just finished now. It went very well. The phoenix has started to regrow her wing. For NPR News, I'm R.A. Daniel, Beirut.

8:47That's the State of the World from NPR. Thanks for listening.