AILSA CHANG, HOST:
Nearly two years into the war in Gaza, UNICEF estimates that more than 50,000 Palestinian children have been killed or injured. Reporter Ari Daniel brings us the story from nearby Lebanon, where a doctor and his team are racing to heal the handful of kids they can reach.
ARI DANIEL, BYLINE: It's clear in an instant Dr. Ghassan Abu-Sittah is just really good with kids.
GHASSAN ABU-SITTAH: (Speaking Arabic).
KENZI MADHOUN: (Speaking Arabic).
DANIEL: Here at his weekly clinic at the American University of Beirut Medical Center, he's meeting 6-year-old Kenzi Madhoun for the first time.
KENZI: (Speaking Arabic).
DANIEL: Kenzi 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. Kenzi's dad, Adam Madhoun, brought her here to Lebanon, hoping Abu-Sittah and his colleagues can help his daughter have a normal life.
ADAM MADHOUN: (Through interpreter) 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.
DANIEL: But these simple things will require many complexities. To start with, Dr. Abu-Sittah says he's focusing on Kenzi's missing limb.
ABU-SITTAH: 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.
UNIDENTIFIED PERSON: (Speaking Arabic).
KENZI: (Speaking Arabic).
ABU-SITTAH: (Speaking Arabic).
UNIDENTIFIED PERSON: (Speaking Arabic).
DANIEL: The doctor escorts the father and daughter into an exam room. Kenzi walks confidently with the group of adults. Abu-Sittah says that during his assessment, he'll not just be looking at Kenzi as the 6-year-old she is today, but also as the 18-year-old she'll become.
ABU-SITTAH: You are trying to reconstruct a moving object, which is the growing body that always outgrows the injured part.
DANIEL: 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 Kenzi, caught in the crossfire of war. He chose this path as a teenager, he says, growing up in Kuwait in a Palestinian family. During the summer of 1982, he remembers watching Israel's invasion of Lebanon on the news.
ABU-SITTAH: 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.
DANIEL: That is a reconstructive and plastic surgeon who treats those wounded in war.
ABU-SITTAH: 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.
DANIEL: Over the years, Abu-Sittah has treated the wounded in numerous conflicts, but it's in Gaza where Abu-Sittah has felt a particular calling to help when violence has flared there over and over again. October 7 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.
ABU-SITTAH: On the 9 of October, I went into Gaza.
DANIEL: 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.
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ABU-SITTAH: A lot of the wounded are women and children. Sometimes the child is the only survivor. We're about to do another patient with much bigger wound in his thigh - a kind of blast injury, so I'm going to need to go. Take care. Bye-bye.
DANIEL: Abu-Sittah says the conditions in Gaza this time were unlike anything he'd ever seen.
ABU-SITTAH: It's the difference between a flood and a tsunami - the scale, the intensity, the sheer ferociousness.
DANIEL: 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.
ABU-SITTAH: 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.
DANIEL: Meanwhile, in Lebanon, many were watching the suffering in Gaza wanting to help, like Darine Dandachly, a social activist and former banker.
DARINE DANDACHLY: 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.
DANIEL: She and a few others knew of Dr. Ghassan Abu-Sittah, 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 Kenzi Madhoun, the 6-year-old with the pink hat.
Do you like to dress fashionably?
KENZI: Yes.
DANIEL: Yes. Yes.
Two weeks after October 7, Kenzi tells me she was sitting in the garden with her grandfather in Deir al Balah, in central Gaza.
KENZI: (Through interpreter) We heard things, and then we thought it was fireworks. But it wasn't.
DANIEL: It was an airstrike. The force of the explosion propelled her into the air.
KENZI: (Through interpreter) The missile took me up.
DANIEL: Kenzi felt like she was flying, like a superhero.
KENZI: Superman or Batman.
DANIEL: When she landed, she lost consciousness. Her father, Adam Madhoun, wasn't with her, but a journalist friend called to tell him of the attack - that Kenzi had been pulled from the rubble.
MADHOUN: (Through interpreter) They told me that Kenzi died.
DANIEL: Madhoun rushed to his daughter and arrived an hour later to discover Kenzi was still alive.
MADHOUN: (Speaking Arabic).
DANIEL: "Like a phoenix," he says.
MADHOUN: (Speaking Arabic).
DANIEL: But she was severely wounded - a fractured pelvis and skull, and a missing arm. Since then...
MADHOUN: (Through interpreter) We stayed together. We've been like twins. I didn't not see her for any day.
DANIEL: Kenzi 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 Kenzi and her dad arrived in Lebanon to meet with Abu-Sittah and his team. Their first meeting was here at his weekly clinic.
ABU-SITTAH: And truth is a distraction is a possibility (ph).
DANIEL: Here?
ABU-SITTAH: Ah.
DANIEL: Abu-Sittah asks his colleagues to order an X-ray of Kenzi'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.
ABU-SITTAH: And then you move them away from each other by one millimeter every day, and that induces new bone formation.
DANIEL: Ultimately, Abu-Sittah's colleague, a world expert in bone distraction here, determines he can give Kenzi a critical three extra inches in her stump.
ABU-SITTAH: 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.
DANIEL: The process will be painful - the first step in a long medical journey ahead. Kenzi's father is ready.
KENZI: (Speaking Arabic).
DANIEL: Kenzi is scared.
KENZI: (Through interpreter) I'm really afraid. I don't like needles.
DANIEL: I understand you feel a little nervous now. Is that kind of how you're feeling?
KENZI: Of course.
UNIDENTIFIED PERSON: Of course.
DANIEL: Of course.
That was last Friday. Today was Kenzi's surgery. Abu-Sittah sent me this message.
ABU-SITTAH: It just - it went very well. We just finished now. It went very well.
DANIEL: The phoenix has started to regrow her wing. For NPR News, I'm Ari Daniel, Beirut.
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