1 hour ago
2
Nuseirat, Gaza Strip – When Najwa Abu Atiwi opened her eyes on October 11, 2024, after weeks in a coma, her first thought was not the extent of her injuries, but her desire to see herself. She knew that something significant had changed, but she did not understand how much her appearance had been altered after the Israeli air strike that hit her home in central Gaza’s Nuseirat camp.
Najwa, now 42 years old, repeatedly asked those around her to let her see her face, but they delayed the moment, fearing the shock it would cause.
Recommended Stories
list of 3 items- list 1 of 3Five Palestinians killed in fire after Israeli attack in Gaza
- list 2 of 3‘Creeping death’: Israel weaponises ‘Yellow Line’ to annex Gaza
- list 3 of 3Key takeaways from Khalil al-Hayya’s first speech as Hamas leader
“I kept asking to see what I looked like, but they would give me painkillers and medication to calm me down,” Najwa says.
Later, doctors told her the truth: She had lost one of her eyes, and they were still trying to save the other, which had suffered internal bleeding.
When she finally looked in the mirror for the first time, it was almost as if someone else was staring back. Her face, marked by severe injuries and fractures, had changed dramatically.
“I looked at myself and did not recognise who I was. I felt as if I was looking at someone else, and I said: ‘Who is this?’” she recalls.
The trauma would only compound later, when Najwa learned that her daughter, Hajar, had also been killed in the air strike that put Najwa in hospital. Hajar had been only days away from celebrating her sixth birthday.
But for a month after she woke up from her coma, Najwa did not know about the tragic loss. During her time in intensive care, she dreamed of Hajar and repeatedly asked people around her to reassure her that her daughter was safe. She later learned the devastating truth, never having had the chance to see her daughter one last time or say goodbye, a loss that remains alongside the physical pain of her injuries.
Najwa has faced a long path of surgeries, treatment, and rehabilitation. Metal plates and meshes were placed in her face, and she continues to struggle to open her jaw, speak, and eat.
“I still cannot eat normally. My diet is limited to soups, water, juices, and milk,” Najwa says. She is still waiting for the opportunity to travel for specialised treatment after doctors told her that some of the procedures she needs are unavailable inside Gaza – a result of years of Israeli blockade and the destruction wrought by Israel’s genocidal war on Gaza, which has killed more than 73,000 people.
Najwa Abu Atiwa has faced a long path to recovery from her injuries, which is still ongoing [Lina Ghassan Abu Zayed/Al Jazeera]Complex injuries
Dr Ayman Saidam, a consultant in oculoplastic surgery, says Najwa’s case is among the most complex injuries he has treated, involving severe trauma to the eye, face, and jaw.
When she first arrived for treatment, Najwa had suffered injury to her right eye that resulted in its loss, in addition to facial bone fractures and torn eyelids. Her other eye was also injured around the socket, which impaired her ability to fully close her eyelid, creating an additional risk to her vision.
Saidam explains that treating such injuries cannot begin with cosmetic procedures alone, because the primary issue is the damaged facial structure.
“Eye cosmetic surgery in cases like these must first be built on maxillofacial reconstruction [restoring the face, jaw, neck, and mouth], because cosmetic procedures alone cannot correct structural deformities,” he says.
During Israel’s war, Saidam treated many injuries caused by shrapnel and explosions, including orbital fractures (broken bones around the eye), eyelid tears, loss of facial tissue, and injuries that resulted in eye loss or required complex reconstructive surgeries.
He explains that some patients require multiple stages of treatment before receiving an artificial eye or restoring part of their previous appearance. Facial reconstruction is not a single procedure, but rather a series of interventions in which each stage depends on the success of the previous one.
“In Gaza, there are skilled doctors with the knowledge and experience needed, but the main problem is the lack of resources, equipment, and medical supplies,” Saidam says.
He explains that shortages of certain materials used in surgeries, including some screws and eye drops, can delay treatment stages and slow the healing process. Many of these shortages are the result of Israeli restrictions on imports into Gaza, which have continued despite an October “ceasefire” that Israel regularly violates.
For Najwa, the treatment journey is still ongoing. She has received a referral for treatment abroad but continues to wait for permission to leave Gaza, while living every day with pain, difficulty moving, and challenges reaching hospitals.
Hers is not an isolated case. Israel’s war has left thousands of people in Gaza with complex injuries that require long-term treatment and rehabilitation.
According to the World Health Organization, about a quarter of recorded injuries in Gaza are classified as life-changing. More than 50,000 injuries require long-term rehabilitation services. They include limb loss, severe burns, and other complex trauma caused by bombardment and explosions.
Dr Ayman Saidam says that Najwa will struggle to receive the treatment she needs in Gaza, because of the medical supply shortages in the enclave [Lina Ghassan Abu Zayed/Al Jazeera]Psychological wounds of war
Najwa is not the only patient who required psychological support after her injury. Many people who suffered facial disfigurement caused by bombardment, including severe burns, facial fractures, loss of an eye, or shrapnel injuries, face psychological struggles that can be as painful as their physical wounds.
Dr Hassan Abu Shawish, a psychologist at the Deir el-Balah Mental Health Clinic who treated Najwa, says her case was among the most difficult because several traumatic experiences occurred at the same time: her physical injury, the loss of her daughter, and the dramatic change in her facial appearance.
He explains that such injuries can lead to post-traumatic stress disorder (PTSD), anxiety disorders, depression, and body image disturbance, in which patients struggle to accept their new appearance. This can lead some survivors to withdraw from social life or avoid interactions with others.
Psychological care, he says, is an essential part of recovery alongside reconstructive surgeries, helping patients adapt to physical changes, rebuild their confidence, and return to society.
Najwa Abu Atiwa is trying to move on with her life, but she is struggling to get past the suffering she has faced [Lina Ghassan Abu Zayed/Al Jazeera]Beyond survival
Before her injury, Najwa lived a completely different life. She worked, went out, and was surrounded by family and social connections. She is now trying to rebuild her life while carrying the pain of losing her daughter and coping with the profound changes to her face and body.
The loss of Hajar remains one of the deepest wounds Najwa carries. She describes her daughter as a joyful, intelligent, and hardworking child, and says she looked like her mother, a resemblance that makes her absence even more painful.
Najwa says she sees Hajar in her dreams constantly. “In my mind, my daughter is travelling and will return,” she says. “Every day I say: When will she come back?”
Najwa is trying to put the pain of her loss to one side. Her journey since the air strike has been a long one – reclaiming what can still be recovered in her life: her face, her ability to speak and eat, her confidence, and her connection with the world around her.
As she waits for the chance to travel and complete her treatment, she holds on to the hope that she will one day be able to regain some more of what the war has taken from her.
“I want to return to my previous life and regain the beautiful personality I used to know in myself,” she says.
