March
25, 2024
This
is not a photo of a mummy or an embalmed body retrieved from one of Gaza’s
ancient cemeteries. This is a photo of Yazan Kafarneh, a child who died of
severe malnutrition during Israel’s genocidal war on the Gaza Strip.
Yazan’s
family now lives in the Rab’a School in the Tal al-Sultan neighborhood in Rafah
City. His father, Sharif Kafarneh, along with his mother, Marwa, and his three
younger brothers, had fled Beit Hanoun in northern Gaza early on in the war.
Yazan
Kafarneh died at the age of nine, the eldest of four brothers — Mouin, 6,
Ramzi, 4, and Muhammad, born during the war in a shelter four months ago.
Living
in conditions not fit for human habitation, the grieving family had witnessed
Yazan’s death before their eyes. It didn’t happen all at once but unfolded
gradually over time, his frail body wasting away one day after another until
there was nothing left of Yazan but skin and bones.
Sharif
was unable to do anything for his son. He died due to a congenital illness that
required a special dietary regimen to keep him healthy. Israel’s systematic
prevention of food from reaching the civilian population in Gaza meant that
severe malnutrition — suffered by most children in the besieged enclave — in
the case of Yazan meant death.
“We
first left from Beit Hanoun to Jabalia refugee camp,” Sharif told Mondoweiss.
“Then the occupation called us again and warned us against staying where we
were. So we left for Gaza City. Then, the occupation forced us to flee further
south, and we did.”
Sharif Kafarneh’ (left), his wife Marwa (right), and their three
surviving sons (center) in their shelter in Rafah. (Photo: Tareq
Hajjaj/Mondoweiss)
“If
it weren’t for Yazan, I would have never left my home,” Sharif maintained.
“Yazan required special care and nutrition.”
Yazan
suffered from a congenital form of muscular atrophy that made movement and
speech difficult, but Sharif said that it never caused him much grief in his
nine short years before the war.
“He
just had advanced nutritional needs,” Sharif explained. “But getting that food
for him was never an issue before the war.”
It
was a point of pride for Sharif that he, a taxi driver, had never left his
child wanting or deprived.
“That
changed in the war. The specific foods that he needed were cut off,” he said.
“For instance, Yazan had to have milk and bananas for dinner every day. He
can’t go a day without it, and sometimes he can have only bananas. This is what
the doctors told us.”
“After
the war, I couldn’t get a single banana,” Sharif continued. “And for lunch, he
had to have boiled vegetables and fruits that were pureed in a blender. We had
no electricity for the blender, and there were no fruits or vegetables
anymore.”
As
for breakfast, Yazan’s regimen demanded that he eat eggs. “Of course, there
aren’t any more eggs in Rafah City,” Sharif said. “No fruits, no vegetables, no
eggs, no bananas, nothing.”
“But
our child’s needs were never a problem for us,” Sharif rushed to add. “We loved
taking care of him. He was the spoiled child of the family, and his younger
brothers loved him and took care of him, too. God gave me a living so I could
take care of him.”
Due
to his special needs, charitable societies used to visit Yazan’s home in Beit
Hanoun before the war, providing various treatments such as physical therapy
and speech therapy. All in all, Yazan had a functional, happy childhood.
‘He
got thinner and thinner’
The
family continued to take care of Yazan throughout the war. They tried to make
do with what they could find, trying as much as possible to find alternatives
to the foods Yazan required. “I replaced bananas with halawa [a tahini-based
confection], and I replaced eggs with bread soaked in tea,” Sharif said. “But
these foods did not contain the nutrients that Yazan needed.”
In
addition to his nutritional needs, Yazan had specific medicines to take. Sharif
used to bring him brain and muscle stimulants that helped him stay alive and
mobile, allowing him to move around and crawl throughout their home. Those
medicines ran out during the second week of the war.
With
the lack of nutrition and medication, his health took a turn for the worse. “I
noticed him getting sick, and his body was becoming emaciated,” Sharif
recounts. “He got thinner and thinner.”
His
family took him to al-Najjar Hospital in Rafah, where his health continued to
deteriorate over the course of eleven days.
“Even
after we took him to the hospital, they couldn’t do anything for him,” Sharif
continued. “All they were able to give him were IV fluids, and when his
situation got worse, the hospital staff placed a feeding tube in his nose.”
“My
son required a tube with a 14-unit measurement, but all the hospital had was an
8-unit,” he added.
When
asked what was the most important factor that led to the deterioration of his
son’s condition, Sharif said that it was the environment he lived in. “Before
the war, he was in the right environment. After, everything was wrong. He was
in his own home, but then he was uprooted to a shelter in Rafah.”
“The
situation we’re living in isn’t fit for humans, let alone a sick child,” Sharif
explained. “In the camps, people would light fires to keep themselves warm, but
the smoke would cause Yazan to cough and suffocate, and we weren’t able to tell
them to turn their fires off because everyone was so cold.”
Dr.
Muhammad al-Sabe’, a pediatric surgeon in Rafah who works at the al-Awda,
al-Najjar, and al-Kuwaiti hospitals, took a special interest in Yazan’s case.
“The
harsh conditions Yazan had to endure, including malnutrition, were the main
factors contributing to the deterioration of his health and his ultimate
death,” Dr. al-Sabe’ told Mondoweiss. “This is a genetic and congenital
illness, and it requires special care every day, including specific proteins,
IV medicines, and daily physical therapy, which isn’t available at Rafah.”
Dr.
al-Sabe’ said that most foods administered to patients who cannot feed
themselves through feeding tubes are unavailable in Gaza. “The occupation
prevents these specific foods and medicines from coming in,” he explained.
“Including a medicine called Ensure.”
Ensure
is a special nutritional supplement used in medical settings for what is called
“enteral nutrition” — feeding patients through a nasal tube.
“Special
treatment for patients, especially children, is nonexistent,” Dr. al-Sabe’
added. “We don’t even have diapers, let alone baby formula and nutritional
supplements.”
“If
things don’t change, if they stay the way they are, we’re going to witness mass
death among children,” he stressed. “If any child doesn’t receive nutrition for
an entire week, that child will eventually die. And even if malnourished
children are eventually provided with nutrition, they will likely suffer
lifelong health consequences.”
“If
medicine is cut off from children who need it for one week, this will also
likely lead to their death,” he continued.
Children
disproportionately affected by famine
According
to a UNICEF humanitarian situation report on March 22, 2.23 million people in
Gaza suffer at least from “acute food insecurity,” while half of that
population (1.1 million people) suffers from “catastrophic food insecurity,”
meaning that “famine is imminent for half of the population.”
An
earlier report in December 2023 had already concluded that all children in Gaza
under five years old (estimated to be 335,000 children) are “at high risk of
severe malnutrition and preventable death.” UNICEF’s most recent March 22
report estimates that the famine threshold for “acute food insecurity” has
already been “far exceeded,” while it is highly likely that the famine
threshold for “acute malnutrition” has also been exceeded. Moreover, UNICEF
said that the Famine Review Committee predicted that famine would manifest in
Gaza anywhere between March and May of this year.
Dr.
al-Sabe’ stresses that such dire conditions disproportionately affect children,
who have advanced nutritional needs compared to adults.
“Their
bodies are weak, and they don’t have large stores of muscle and fat,” he
explained. “Even one day of no food for a young child will lead to consequences
that are difficult to control in the future.”
“An
adult male may go a week without food before signs of malnutrition begin to
show,” he continued. “Not so with children. Their muscle mass increases
whenever they eat, which in turn leads to a greater need for nutrients.”
The
lack of nutrients means that children will grow weak, the pediatric surgeon
said, and that they will quickly begin to exhibit symptoms such as fatigue,
sleepiness, diarrhea, vomiting, anemia, sunken eyes, and joint pains. For the
same reason, Dr. al-Sabe maintained, children also respond to treatment fairly
quickly — but “on the condition that they have not experienced malnutrition for
more than a week.”
After
one week, reversing the effects of malnutrition becomes much more difficult.
Al-Sabe’ asserts that children’s digestive tracts will slow down, they might
begin to suffer from kidney failure, and their bellies can swell with fluids.
That
is what is particularly devastating for Gaza — over 335,000 children have
undergone varying degrees of extreme malnutrition for months on end. The
consequences are difficult to fathom on a population-wide level and for future
generations. As of the time of writing, over 30 children have already died due
to malnutrition in northern Gaza, but the real number is likely much higher
given the lack of reporting in many areas in the north.
‘He
didn’t need a miracle to save him’
Yazan’s
mother, Marwa Kafarneh, could barely contain her tears as she spoke of her son.
“He
was a normal boy despite his illness,” she told Mondoweiss. “He played with his
brothers. He crawled and moved about, and he could open closets and use the
phone, and he would watch things on it for hours.”
“He
could have lived a long life, a normal life,” she continued. “His father would
have brought him everything that he needed. He wouldn’t have had to feel hungry
for even a single day.”
When
she saw that the images of her son’s emaciated body had gone viral on social
media, Marwa said that she preferred death over looking at the photos. “My
eldest son died in front of my eyes, in front of all of our eyes,” she said.
“We weren’t able to save him. And he didn’t need a miracle to save him either.
All he needed was the food that we’ve always been able to provide for him.”
Reflecting
as she cried, she added: “But finding that food in Gaza today takes nothing
less than a miracle.”
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