Within just a few months, the Israeli war on Gaza introduced one of the most heartbreaking terms to modern emergency medicine, WCNSF: wounded child, no surviving family.

As the aggression continued into its second year, worsened by famine and forced displacement, the number of Gaza orphans has risen sharply. Yet, the chaos caused by ongoing Israeli bombing and repeated evacuation orders across the Gaza Strip made it nearly impossible to keep track of how many children have lost their families.

According to the Ministry of Health in Gaza, as cited by UNICEF in early September, 2,596 children had lost both parents, while 53,724 lost either their father or mother. There is no available data on how many of these children were also wounded, but Gaza now has the highest rate of child amputations in any modern conflict.

One such case is three-year-old Wesam. The Guardian reported that on 13 August, she was asleep in her home in Gaza City with her parents, pregnant mother, and grandparents when the building was bombed. Wesam was the only survivor, suffering severe injuries to her leg, abdomen, liver, and kidney. According to UNICEF, she urgently requires evacuation abroad to prevent the amputation of her left leg.

Children like Wesam are not rare, as the Israeli bombing of the besieged enclave left hundreds of wounded children in Gaza without surviving family members; exhausted trauma surgeons in field hospitals simply write “WCNSF” on their charts, a grim shorthand for a child alone in the world.

“It is the first conflict that such a term was needed,” Kieran King, head of the humanitarian agency War Child, told The Guardian. “It was born out of the emergency medical teams, people who have worked across every conflict since forever.”

The collapse of Gaza’s social fabric, medical system

Jacob Granger, an emergency coordinator with Doctors Without Borders in Deir al-Balah, told The Guardian that wounded children in Gaza are brought in without any family members all the time. While doctors treat injuries, there is often no next step, no one to care for the child, no social system left to support them.

“There’s not a social fabric or functioning institution that can absorb these children,” Granger told the UK-based daily. “What exists is a fragile community mechanism, people who informally take care of orphans, or humanitarian groups trying to trace remaining family.”

War Child receives emergency calls from clinics for WCNSF cases. Their teams search displacement camps for unaccompanied children and attempt to pair them with adults willing to care for them, a daunting task in a territory ravaged by siege and famine.

Psychological trauma and Gaza ceasefire’s limited impact

Among those children is 13-year-old Radeh, who lost both parents during the war, her father earlier in the war and her mother, shot by a sniper, in front of her. She now suffers from chronic anxiety, nightmares, physical pain, and isolation. War Child reports that she is slowly responding to emotional support provided through drawing and therapeutic activities.

“In a usual conflict, you'd find relatives to care for orphans,” King said. “In Gaza, the chaos makes it nearly impossible. Many children have no surviving family or can’t be located. And displacement camps are constantly being evacuated.”

Medical evacuations for amputees in Gaza are equally rare. A car trip to evacuate a wounded child south, as per "Israel’s" evacuation orders, may cost hundreds of dollars, a sum far out of reach for most.

Meanwhile, residents who remain in Gaza City have been declared by Israeli Security Minister Israel Katz as "terrorists or terrorist supporters," casting them as "legitimate military targets" in the eyes of the occupation forces; a categorization that dangerously endangers all civilians, especially children.

Read more: Parents helpless as famine strips Gaza’s children to skin and bone

Humanitarian aid struggles to reach amputees in Gaza

The humanitarian crisis in Gaza continues to deepen. Despite the announcement of a Gaza ceasefire deal, the psychological wounds left on children are irreparable. Many boys now roam the streets in groups, scavenging garbage for food or items to sell, while risking their lives at food distribution centers.

“There’s a lot of children on the street; whether they have a family or not is hard to determine,” Granger said. “Their behavior is increasingly aggressive. You’ll see a six-year-old yelling at a car like a grown man; that’s how trauma is manifesting.”

Some children still cling to dreams they once had. Ahmad Abu Hilal, 12, used to sell coffee to support his family in al-Mawasi camp. He hoped to one day become a doctor, buy a Jeep for his mother, and play football professionally.

All of that changed when an Israeli shell hit a crowd in Khan Younis, where he was visiting an aunt. Shrapnel tore through his thigh. Since then, he has relied on painkillers and needs daily wound care. His mother fears he may never walk again.

A future without safety or healing

“For a child with no family, the mental toll is unimaginable,” Granger said to The Guardian. “Each time they try to stand up or walk again, they relive the moment they lost everything. But the conditions needed to recover from trauma, safety, support, [and] stability don’t exist here. Nowhere is safe in Gaza.”

The stories of Gaza orphans reflect more than physical injury. They reveal a generation suffering emotional wounds that may never heal, growing up in a world where the most basic forms of care, security, and love have been bombed into absence.

Read more: ‘They are wasting away’: Gaza’s children face mass starvation