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To find safety from Gaza, you need first to become the victim of a catastrophic injury and then be lucky enough to be identified, selected and extracted.

That’s one of the many brutal truths from this long war.

I have followed the stories of some of the few Palestinians who have left Gaza for medical care.

Less than 100 children have been granted permissions and temporary visas for the United States to receive treatment since the war began in October 2023.

In all, several hundred children have left Gaza for treatment in that time – most to other Middle Eastern countries. It has not been possible to confirm a precise number but we do know that the UK has not accepted any.

Eight Palestinian children were aboard Royal Jordanian flight 263
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Eight Palestinian children were aboard Royal Jordanian flight 263

A few weeks ago, at Chicago’s O’Hare airport, the largest single group of children from Gaza arrived in America for treatment.

Eight Palestinian children were aboard Royal Jordanian flight 263 from Amman.

The number, tiny though it is, reflects an enormous achievement by the charity that has made this happen – the Palestine Children’s Relief Fund (PCRF).

But it is also reflective of deep diplomatic and political failures; the fact that it was only possible to extract eight of many thousands who need urgent medical treatment.

The doors into the arrival hall at O’Hare opened to reveal a fleet of wheelchairs each carrying a child bearing the scars of the war they had left behind.

Among them, two brothers who survived the bombing that killed their sister.

Behind them, a boy who lost all his siblings and his arm. He is now his mother’s only child. She travelled with him. She too is now an amputee.

The last to emerge through the arrival door was a dot in her wheelchair.

Rahaf, just two, lost both her legs in an Israeli attack on her home in August, not long after she had learnt to walk.

Both Rafah's legs had to be amputated
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Both Rahaf’s legs had to be amputated

Rafah at home in Gaza
Image:
Rahaf at home in Gaza

All their stories reflect a collective horror. They are the civilian victims of Israel’s bombardment of Gaza which followed the Hamas attacks of 7 October 2023.

The children arrived in America after a massive collective effort involving the PCRF and Shriners – one of America’s largest non-profit children’s hospital networks.

Working with multiple governments they facilitated the extractions.

Israel controls all of Gaza’s borders and has only granted evacuations in rare circumstances, only in exceptional cases and only with one parent or guardian.

After their flight, the children travelled to Shriners Hospitals in different parts of the country – California, Oregon, Illinois, South Carolina, Kentucky and Missouri.

It was in Missouri this week that I spent a day with two-year-old Rahaf and her mother Israa Saed.

Rafah plays in the park near her new home in Missouri
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Rahaf Saed plays in the park near her new home in Missouri

Mother and daughter Israa and Rafah
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Rahaf with her mother Israa Saed

We met at the home of the American couple who have volunteered to be their hosts for their time in the US.

Six months since the bombing of Rahaf’s home and three weeks since she and her mother arrived in America, I’d come to see how a little life was now being rebuilt.

The first thing that hit me as we sat in the host family’s living room was how happy Rahaf now seems.

Her right leg is missing from below her knee and her left leg is almost completely gone – amputated just below her hip.

Yet she was darting around the floor in front of us chasing a blue balloon with shrieks of laughter. Her mum smiled as she watched.

The mood belied the enormity of their experience and the dilemma of their journey.

The family's apartment block before it was bombed
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The family’s apartment block before it was bombed

Israa and Rafah's apartment block as it was bombed in August
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The apartment building engulfed in flames as it was bombed in August

The apartment block after it was bombed
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The apartment block after the bombing

Until this month, Israa and Rahaf had never left Gaza. Now they are in America, without the language and without the rest of their family – Israa’s husband and her two young boys.

“My other two sons are still young and… do I need to stay with my other kids or do I need to come out?,” she said about her dilemma.

“Rahaf needs her mum. I could not let her go [to America] alone. And especially also with my fractures, my elbows, my arms. I was hoping for some treatment for myself.”

Israa was injured in the same attack on 1 August. Both her arms were badly damaged. New X-rays taken since she arrived in America show a section of bone still missing in her right forearm.

An x-ray shows a section of bone still missing in Rafah's right forearm
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Israa still has a section of bone missing in her right forearm

I asked about her family back in Gaza.

“Yes, we do talk but the internet is not the best. We still manage to have some conversations. The question that is always repeated is: ‘when can you come back? When will the little ones get you back? When can we meet again?'”

Israa sobbed. The pain was clear on her face.

“God willing, my wish is for my kids to live safely far from any conflicts and war. Safely. That is my wish.”

We looked at photographs on Israa’s phone of Rahaf in a pink dress before the attack and a video of her walking up the steps of their apartment block.

“She loved to be a princess,” Israa said.

Rafah back in Gaza
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Rahaf back in Gaza

Israa then showed me a photograph of Rahaf on a hospital bed in Gaza a few weeks after the attack looking down at her amputated legs.

I asked if she understands what has happened to her.

“She did ask ‘my legs are destroyed, what happened?'” Israa said they told her it was a rocket. Now, Rahaf avoids the subject. “If we start the conversation, she will change the subject.”

The good news is that Rahaf’s amputations were done well given the situation.

Circumstance has ensured that Gazan medics have become among the best in the world at trauma surgery. But that’s where the care ends in Gaza. The shortage of doctors, equipment and functioning hospitals makes prolonged care impossible.

Amputations require ongoing work from doctors with various skills including orthopaedic surgeons, plastic surgeons, and prosthetists.

Children with lost limbs demand a whole extra layer of care because they are still growing. Rahaf will need new prosthetic limbs frequently as she gets bigger.

Prosthetists estimate that for every death in a war, there are likely to be three times as many surviving amputees. According to the Gaza health ministry the number of dead in the war has now topped 45,000.

According to analysis by the charity Oxfam more children have been killed in Gaza by the Israeli military than in the equivalent period in any other conflict of the past 18 years.

Those numbers give a sense of the number of amputees, adults and children, still inside Gaza.

Rafah

Through pressure from charities and commitments of treatment from hospitals, the United States has admitted a small number of Gazan children, but the key blocker is the Israeli government, which controls access to the strip through all the borders.

Josh Paul is a former US State Department official who resigned last year over the Gaza war.

Speaking to Sky News he said the situation with injured children represents a deep failure of American diplomacy.

“Even on something as humanitarian as saving the lives of children, getting them to critical care, it’s not that America isn’t willing to ask. It’s that America isn’t willing to press,” Mr Paul said.

“And it could be done in a second if they wanted to. If President Biden picked up the phone [to Israel] and said, ‘we are stopping our arms shipments until you let out children, until you let out critically injured children or critically sick children for care, we are not standing by you’.”

On why more hasn’t been done, Mr Paul said: “It’s the political costs… he believed he would pay. I think that is a severe miscalculation.

“I think American public opinion has shifted radically and is going to continue to shift.

“I also think that the geopolitical incentives here have also shifted and there is a cost, a clear cost, that we are paying for our unconditional support to Israel.”

Watch and read our other stories on Gaza’s children:
Stuck in Gaza with the rarest of diseases
Girl with rare disease leaves Gaza
Sky meets teenager whose uncle amputated her leg

Israa, Rafah and Sky correspondent Mark Stone
Image:
Israa, Rahaf and Sky correspondent Mark Stone

The next step for Rahaf is prosthetics. It is the kindness of strangers and their donations that will make all this happen.

Then it will be time for her to walk again. But a reunion with family is, for now, far less certain.

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Hurricane Melissa: What we know about the powerful storm approaching Jamaica

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Hurricane Melissa: What we know about the powerful storm approaching Jamaica

Hurricane Melissa, the world’s most powerful hurricane of the year so far, is closing in on Jamaica, with forecasters warning it could have a “catastrophic” impact.

The Category 5 hurricane has reached speeds of 175mph, already making it one of the strongest ever in the Atlantic basin.

A storm of Category 4 or higher has not hit Jamaica since records began 174 years ago.

It is expected to make landfall in the coming hours, continuing towards eastern Cuba and across the southeastern or central Bahamas.

Here’s what we know so far.

How bad could it be?

“Catastrophic” flash flooding and numerous landslides are likely when the hurricane hits, according to the US National Hurricane Centre, which warned of “total structural failure”.

Parts of the Caribbean island could see rainfall of up to 40 inches and it could cause a “life-threatening” storm surge on Jamaica’s southern coast, peaking around 13ft above ground level, the US centre said.

The storm is expected to be particularly bad along the coast of Kingston, which is home to critical infrastructure, including Jamaica’s main international airport and power plants.

Hurricane Melissa moves towards Jamaica and Cuba. Pic: CIRA/NOAA via Reuters
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Hurricane Melissa moves towards Jamaica and Cuba. Pic: CIRA/NOAA via Reuters

Live updates as hurricane approaches

Jamaica’s prime minister Andrew Holness said he expected “major damage to our road infrastructure, bridges, drains and possibly some damage to ports and airports” and warned it would take “far more resources than Jamaica has to recover”.

There are 850 shelters across the island, he added, enough for more than 20,000 people. Jamaica has a population of roughly 2.8 million.

All of Jamaica is expected to experience hurricane-force winds, heavy rainfall and flooding.

Has anyone died because of the hurricane?

Officials have said the storm is already responsible for at least seven deaths in the Caribbean, including three in Jamaica, three in Haiti and one in the Dominican Republic, where another person remains missing.

The three deaths in Jamaica happened during preparations for the storm’s arrival as people were cutting trees, health minister Christopher Tufton said. Thirteen people were injured, mostly due to falling off ladders and rooftops.

He urged Jamaicans to be careful during preparations, adding they should ensure all homes are stocked with enough drinking water and non-perishable food.

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Jamaica braces for Hurricane Melissa

On Monday evening Matthew Samuda, the environment minister, said the time to prepare for the storm was over and that “the time now is to listen to instruction”, advising the public to start using resources sparingly.

Evacuation orders issued as power outages hit

Map showing areas of Jamaica which have evacuation orders
Image:
Map showing areas of Jamaica which have evacuation orders

Jamaica’s government has issued mandatory evacuation orders for at least seven areas in the southeast that are designated as high risk.

As of Monday night, many people had remained in their homes, according to Jamaica’s minister for science, energy, transport and telecommunication, Daryl Vaz.

“It’s very difficult, and it has always been a problem because people basically don’t take the event as seriously as they ought to,” Mr Vaz told Sky News.

He added that evacuation numbers were still “way below” the government’s targets.

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‘Very difficult’ to convince Jamaicans to evacuate

Colin Bogle, a Mercy Corps adviser based near Kingston, suggested many families were sheltering in their homes due to fears rather than complacency.

“Many have never experienced anything like this before, and the uncertainty is frightening,” he said.

“There is profound fear of losing homes and livelihoods, of injury, and of displacement.”

An estimated 52,000 people lost power as the hurricane approached, mostly in the western part of the country, the Jamaica Public Service said.

In the early hours of Tuesday morning, it said crews had managed to restore power for 30,000 of those affected and that they were continuing to work on the issues.

It added heavy rain and difficult terrain were “creating access challenges” and that “the safety of our crews and the public is our top priority”.

British holidaymakers locked down in hotels

Jamaica’s peak holiday season runs from mid-December to mid-April, but its tropical climate brings warmth all year round.

Hurricane season runs from June until November, but the country continues to attract tourists.

One of them is Andrew Tracey, a British holidaymaker who told Sky News he has been locked down in his hotel room until Wednesday at the earliest, having arrived on 20 October.

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Briton in Jamaica: ‘There is an undercurrent of panic’

He also estimated there were at least 200 people from the UK staying at the same complex.

With all airports in Jamaica closed, his flight was cancelled and there was “nothing really we could do”, he said.

“If I knew that the hurricane would hit while I was out here, I wouldn’t have gone at all,” he said.

“It’s hard to comprehend what we’re about to expect. I’ve never experienced any kind of hurricane, let alone a Category 5.

“The tension in the hotel last night when we went down for dinner was definitely one of nerves, even locals.”

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Hotel owner preparing for ‘catastrophic situation’

What route will Hurricane Melissa take?

Eastern Cuba is next in the path of Melissa, with tropical storm conditions expected to hit on Tuesday evening, including rainfall of up to 20 inches.

More than 500,000 people living in coastal and mountainous areas vulnerable to heavy winds and flooding have been evacuated, according to authorities.

Some 250,000 people were also accommodated in shelters around Santiago de Cuba, the second-largest city that lies right in the hurricane’s expected path.

A hurricane watch is in effect across the southeastern and central Bahamas, along with the British Overseas Territory, Turks and Caicos Islands.

They could be affected on Wednesday and the National Hurricane Centre expects flash floods with up to 8 inches of rainfall in tropical storm and hurricane conditions.

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Warships, the CIA and potential ‘precision attacks’ – the US-Venezuela crisis explained

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Warships, the CIA and potential 'precision attacks' - the US-Venezuela crisis explained

US warships in the region, the green light for covert operations, and deadly strikes on what the Trump administration claims are “narco terrorists” – could America’s next move be to strike Venezuela?

President Donald Trump has accused President Nicolas Maduro of leading an organised crime gang (without providing evidence) and declined to answer when questioned if the CIA has the authority to assassinate him.

In return, the Venezuelan leader has accused Mr Trump of seeking regime change and of “fabricating a new eternal war” against his country, as he appealed to the American people for peace.

The rhetoric coming out of the White House, coupled with the presence of military ships in the region, has raised questions about a possible armed conflict between the US and Venezuela.

The question in the air is: Will the US actually attack Venezuela?

The USS Gravely destroyer arrives in Port-of-Spain, Trinidad and Tobago, on 26 October. Pic: AP
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The USS Gravely destroyer arrives in Port-of-Spain, Trinidad and Tobago, on 26 October. Pic: AP

What are US warships doing?

The docking of the USS Gravely guided missile destroyer in the capital of Trinidad and Tobago – just 25 miles from the coast of Venezuela – is the latest incident to escalate tensions.

Venezuela’s government condemned the arrival and called it a provocation by Trinidad and Tobago and the US.

The USS Gerald R Ford aircraft carrier – the largest warship in the world – is also moving closer to Venezuela.

Satellite image shows USS Gerald R Ford on 25 October off the coast of Croatia, a day after the announcement it would be deployed to the Caribbean. Pic: EU Copernicus
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Satellite image shows USS Gerald R Ford on 25 October off the coast of Croatia, a day after the announcement it would be deployed to the Caribbean. Pic: EU Copernicus

It comes as the US has acknowledged carrying out at least seven strikes since September on vessels near Venezuela that it claims were transporting drugs, killing at least 32 people.

Venezuela’s government says the strikes are illegal, amount to murder, and are acts of aggression.

Earlier this month, Trump confirmed he has authorised the CIA to carry out covert operations – including lethal operations – in Venezuela.

The CIA has a long history of operations in Latin America, with actions varying widely from direct paramilitary engagement to intelligence gathering and support roles with little to no physical footprint.

What could happen?

To get an idea of what could happen next, Sky News spoke to Dr Carlos Solar, an expert on Latin American security at the RUSI defence thinktank.

He says the level of military strategy the US is applying around Venezuela seems “unproportionate” for the task of tackling drug trafficking.

In Venezuela, the government has civilians trained in the use of weapons to defend the country in the event of a US attack. Pic: AP
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In Venezuela, the government has civilians trained in the use of weapons to defend the country in the event of a US attack. Pic: AP

“A build-up this size can only suggest there’s a strategic military goal,” he added.

Dr Solar says the role of the CIA is “not surprising”, as the US often deploys spying capabilities in countries deemed adversarial.

“With the chances of a military conflict looming, having the most intelligence capable on the ground would be reasonable.”

The world's largest warship, the USS Gerald R Ford, has been tasked to the Caribbean. File pic: Reuters
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The world’s largest warship, the USS Gerald R Ford, has been tasked to the Caribbean. File pic: Reuters

Asked what could happen next, Dr Solar told Sky News: “One scenario is Trump authorises a round of long-range precision attacks in Venezuela’s territory linked to drug trafficking operations, eventually forcing Maduro to reciprocate later.

“We saw this early in the year when the US attacked Iran’s nuclear facilitates and Tehran returned missiles to US bases in Qatar.

“If the US decides to move more strongly, destroying all critical military targets from the Venezuelan forces, then the US could have Maduro surrender and leave the country immediately.

“This would be the least disruptive without causing greater destabilisation of the country.”

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Venezuelan President: ‘We don’t want a war’

What does Trump say about Venezuela?

Trump said his reasons for the strikes on vessels were the migration of Venezuelans, allegedly including former prisoners, to the US – and drug trafficking.

“I authorised for two reasons really,” he said. “Number one, they have emptied their prisons into the United States of America…they came in through the border. They came in because we had an open border,” he told reporters. “And the other thing are drugs.”

He has accused Venezuela of trafficking huge amounts of cocaine into the US, and alleged Mr Maduro is the leader of the Tren de Aragua gang – a claim most of his own intelligence agencies do not support.

President Donald Trump is currently on a tour of Asia. Pic: Reuters
Image:
President Donald Trump is currently on a tour of Asia. Pic: Reuters

The US leader has not provided evidence for the claim about prisoners, and Sky News chief correspondent Stuart Ramsay pointed out the fentanyl drug that is causing destruction in America is largely manufactured in Mexico, not Venezuela.

“We are looking at land now, because we’ve got the sea very well under control,” Mr Trump added. It is not clear what actions this could entail.

The Pentagon recently disclosed to US Congress that the president has determined the US is engaged in “a non-international armed conflict” with drug cartels.

When asked if the CIA has the authority to execute Maduro, which would be a massive intervention, Trump declined to answer. Instead, he said: “I think Venezuela is feeling heat.”

Read more:
Venezuela opposition leader wins Nobel Peace Prize

Trump may have another motive in escalation of war on drugs

Venezuela's President Nicolas Maduro. Pic: Reuters
Image:
Venezuela’s President Nicolas Maduro. Pic: Reuters

What does Venezuela’s leader say?

Maduro has been in power since 2013, including re-elections in contests marred by accusations of fraud.

The last decade has seen his country gripped by spiralling hyperinflation and a humanitarian crisis that has seen an estimated eight million Venezuelans flee the country.

As the USS Gerald R Ford aircraft carrier moved closer to Venezuela, Maduro accused the US government of “fabricating a new eternal war” against his country.

Venezuelan ambassador to the UN, Samuel Moncada, holds a newspaper article about a recent US military strike. Pic: Reuters
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Venezuelan ambassador to the UN, Samuel Moncada, holds a newspaper article about a recent US military strike. Pic: Reuters

“They promised they would never again get involved in a war, and they are fabricating a war that we will avoid,” he said in a national address.

“They are fabricating an extravagant narrative, a vulgar, criminal and totally fake one,” he added, perhaps a reference to Trump’s claim that he is the leader of the Tren de Aragua gang and that his country trafficks cocaine into the US.

“Venezuela is a country that does not produce cocaine leaves.”

Members of Venezuela's Bolivarian National Guard. Pic: Reuters
Image:
Members of Venezuela’s Bolivarian National Guard. Pic: Reuters

Tren de Aragua, which traces its roots to a Venezuelan prison, is not known for having a big role in global drug trafficking but instead for its involvement in contract killings, extortion, and people smuggling.

Venezuela has raised a complaint to the UN Security Council and demanded accountability from the US.

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Over 1.2m people a week talk to ChatGPT about suicide

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Over 1.2m people a week talk to ChatGPT about suicide

An estimated 1.2 million people a week have conversations with ChatGPT that indicate they are planning to take their own lives.

The figure comes from its parent company OpenAI, which revealed 0.15% of users send messages including “explicit indicators of potential suicide planning or intent”.

Earlier this month, the company’s chief executive Sam Altman estimated that ChatGPT now has more than 800 million weekly active users.

While the tech giant does aim to direct vulnerable people to crisis helplines, it admitted “in some rare cases, the model may not behave as intended in these sensitive situations”.

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OpenAI launches web browser

OpenAI evaluated over 1,000 “challenging self-harm and suicide conversations” with its latest model GPT-5 and found it was compliant with “desired behaviours” 91% of the time.

But this would potentially mean that tens of thousands of people are being exposed to AI content that could exacerbate mental health problems.

The company has previously warned that safeguards designed to protect users can be weakened in longer conversations – and work is under way to address this.

“ChatGPT may correctly point to a suicide hotline when someone first mentions intent, but after many messages over a long period of time, it might eventually offer an answer that goes against our safeguards,” OpenAI explained.

OpenAI’s blog post added: “Mental health symptoms and emotional distress are universally present in human societies, and an increasing user base means that some portion of ChatGPT conversations include these situations.”

Read more from Sky News:
King heckled over Prince Andrew
British airline suspends operations

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Parents suing OpenAI after death of son

A grieving family is currently in the process of suing OpenAI – and allege ChatGPT was to blame for their 16-year-old boy’s death.

Adam Raine’s parents claim the tool “actively helped him explore suicide methods” and offered to draft a note to his relatives.

Court filings suggest that, hours before he died, the teenager uploaded a photo that appeared to show his suicide plan – and when he asked whether it would work, ChatGPT offered to help him “upgrade” it.

Last week, the Raines updated their lawsuit and accused OpenAI of weakening the safeguards to prevent self-harm in the weeks before his death in April this year.

In a statement, the company said: “Our deepest sympathies are with the Raine family for their unthinkable loss. Teen wellbeing is a top priority for us – minors deserve strong protections, especially in sensitive moments.”

Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK.

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