Curled up in his father’s lap, gripping his chest, 4-year-old Hussein Mikdad sobbed uncontrollably. He kicked the doctor with his uninjured foot and pushed him away with his arm that wasn’t in a cast. "My Dad! My Dad!" Hussein cried. "Make him leave me alone!" His father, with eyes filled with both relief and pain, reassured him and held him tighter.

Hussein and his father, Hassan, are the sole survivors of their family following an Israeli airstrike on their Beirut neighborhood last month. The brutal Israeli attack on a residential neighborhood killed at least 18 people, including Hussein's mother, three siblings, and six other relatives. Israeli airstrikes have mainly targeted residential areas across Lebanon, killing and wounding thousands.

"Can he now shower?" the father asked the doctor.

Ten days after surgery, doctors assessed Hussein’s injuries and confirmed that he was healing well. He has metal rods in his broken right thigh and stitches that have reattached the torn tendons in his right arm. The pain has eased, and Hussein is expected to walk again in two months, though with a permanent limp.

Hussein's struggle with invisible wounds after the attack

A prognosis for Hussein's emotional trauma is far more difficult to determine. He has reverted to wearing diapers and has started wetting the bed. He barely speaks and has not mentioned his mother, two sisters, or brother.

“The trauma is not limited to just the physical injuries. He is also suffering mentally,” said Imad Nahle, one of Hussein’s orthopedic surgeons.

Children are the main Israeli target

As airstrikes continue to hit homes and residential areas, doctors are seeing an increasing number of children affected by the brutal Israeli aggression. Over the past six weeks, more than 100 children have been killed in Lebanon, and hundreds more injured. Of the 14,000 people wounded since last year, about 10% are children. Many have suffered severed limbs, burns, and lost families—trauma that may last a lifetime.

Ghassan Abu Sittah, a prominent British-Palestinian surgeon who is also treating Hussein, sees a difficult future ahead. His concern is clear, "It leaves us with a generation of physically wounded children, children who are psychologically and emotionally wounded."

'What do they want from us?'

At the American University of Beirut Medical Center, which is handling a limited number of war casualties, Nahle reported that he has performed surgery on five children in the past five weeks—compared to none before. Most of the cases have been referred from southern and eastern Lebanon.

A few miles away, at the Lebanese Hospital Geitaoui, one of the country’s largest burn centers, its medical director Naji Abirached stated that the facility has expanded its capacity by nearly 180% since September to accommodate more war casualties. Around 20% of the newly admitted patients are children.

In one of the burn center’s ICU units is Ivana Skakye, who celebrated her second birthday in the hospital last week. Ivana is recovering from burns she sustained in an Israeli airstrike near their home in southern Lebanon on September 23. 

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Six weeks later, little Ivana is still covered in white gauze from head to toe, with the exception of her torso. She suffered third-degree burns over 40% of her body, including her hair, head, left side, arms, and chest. The ceiling of her family’s home was set on fire, and the valuables they had packed in their car while preparing to flee were also destroyed. Ivana's older sister, 7-year-old Rahaf, has recovered more quickly from burns on her face and hands.

Their mother, Fatima Zayoun, was in the kitchen when the explosion occurred. She rushed to grab her daughters, who were playing on the terrace.

Zayoun described the moment as feeling "as if something lifted me up so I could grab my kids." She recalled, "I have no idea how I managed to pull them in and throw them out of the window." Speaking from the ICU burns unit, she continued, "They were not on fire, but they were burned. Black ash covered them... (Ivana) was without any hair. I told myself, ‘That is not her.’”

Ivana's wound dressings are now changed every two days. Her doctor, Ziad Sleiman, mentioned that she could be discharged in a few days. She has started saying "Mama" and "Bye" again, a sign that she wants to go outside.

However, like Hussein, Ivana has no home to go back to. Her parents are worried that staying in collective shelters could cause her infection to return.

After seeing her children "sizzling on the floor," Zayoun, 35, said that even when their home is repaired, she wouldn't want to return. "I saw death with my own eyes," she said.

Zayoun was 17 during the July 2006 war and asserted that this war is different, saying, "But this war is hard. They are hitting everywhere," she said. "What do they want from us? Do they want to hurt our children? We are not what they are looking for."

How Israeli attacks on homes destroy children's sense of safety

Israeli attacks on homes can be especially difficult for children to cope with. Abu Sittah, the reconstructive surgeon, explained that most children's injuries result from blasts or falling rubble. Such an attack on a place they expect to be safe can have long-lasting consequences.

"Children feel safe at home," he said. "The injury makes them lose that sense of security for the first time—that their parents are keeping them safe, that their homes are invincible, and suddenly their homes become not so."

A generational trauma 

Maria Elizabeth Haddad, manager of psychosocial support programs in Beirut and surrounding areas for the US-based International Medical Corps, stated that parents in shelters have reported increased anxiety, hostility, and aggression in their children. The kids are defying their parents and disregarding rules; some have developed speech difficulties and clinginess. One child is even showing early signs of psychosis, according to the expert.

“There are going to be residual symptoms when they grow up, especially related to attachment ties, to feeling of security,” Haddad said. “It is a generational trauma. We have experienced it before with our parents. ... They don’t have stability or search for (extra) stability. This is not going to be easy to overcome.”

Children make up more than a third of the over 1 million people displaced by the war in Lebanon. As a result, hundreds of thousands of children in Lebanon are unable to attend school, either because their schools are unreachable or have been converted into shelters.

Hussein's father believes that he and his son must rebuild their lives from scratch. With help from relatives, the two have found temporary shelter in a home, offering the father a brief moment of relief. "I thank God he is not asking for or about his mother and his siblings," said Hassan Mikdad, 40.

He cannot explain what his son experienced, having witnessed the death of their family in their own home. His two sisters, Celine, 10, and Cila, 14, were recovered from the rubble the next day. His mother, Mona, was found three days later, holding her 6-year-old son, Ali, in a final embrace.

The October 21 strike also damaged one of Beirut’s main public hospitals, breaking solar panels and windows in the pharmacy and dialysis unit. Hassan survived because he had stepped out for coffee. He watched his building collapse in the late-night airstrike. In addition, he lost his shop, motorcycles, and car — everything representing 16 years of family life.

His friend, Hussein Hammoud, rushed to the scene to help sift through the debris. Hammoud noticed Hussein Mikdad’s fingers in the darkness behind their home. At first, he thought they were severed limbs until he heard the boy’s screams. He then dug him out, finding glass embedded in his leg and a metal bar in his shoulder. Hammoud said he didn’t recognize the boy at first but held Hussein’s nearly severed wrist in place.

Now in the hospital, Hussein Mikdad sipped on juice while listening to his father and friend. His father turned to him and asked if he wanted a toy — trying to prevent another outburst of tears. He added that he buys Hussein a toy every day.

“What I am living through seems like a big lie. ...The mind can’t comprehend,” he said. “I thank God for the blessing that is Hussein.”