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.
Image: 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.
Image: Both Rahaf’s legs had to be amputated
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.
Image: Rahaf Saed plays in the park near her new home in Missouri
Image: 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.
Image: The family’s apartment block before it was bombed
Image: The apartment building engulfed in flames as it was bombed in August
Image: 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.
Image: 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.
Image: 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.
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.”
Image: Waves splash in Kingston, Jamaica, as Hurricane Melissa hits. Pic: AP
Andrew Tracey had been due to fly home to the UK on Monday, but his flight was cancelled.
Mr Tracey told Sky News that food packages were being delivered to guests at his hotel. Deck chairs have been removed from the beach, and the swimming pools have been drained, at the Negril hotel where he is staying.
“The balcony and walls do feel as though they are vibrating just due to the strength of the wind,” said Mr Tracey.
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“I’m very nervous, it’s hard to comprehend what we are likely to expect.”
The US National Hurricane Centre in Miami said that Melissa was “one of the most powerful hurricane landfalls on record in the Atlantic basin” as it hit southwestern Jamaica near New Hope.
Image: People walk along a road during the passing of Hurricane Melissa in Rocky Point, Jamaica, on Tuesday. Pic: AP
In a social media post, the centre warned that it is an “extremely dangerous and life-threatening situation” – and told those in the area not to leave their shelter as the eye of the storm passes over.
‘It is a bit scary, but we’ve got each other’
A British-Jamaican couple who are sheltering inside as the storm passes over the island spoke to Sky News about their ordeal.
Shantell Nova Rochester and her Jamaican fiance Denva Wray are due to get married on the island next month.
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0:46
Floods tear through parts of Jamaica
They spoke of broken windows and water coming in where they are staying, but the couple believe they are “as safe as they can possibly be” in St Elizabeth.
Mr Wray said: “Where we are is quite strong, sturdy, but you can hear a lot of wind. It is a bit scary, but we’ve got each other, so we are strong.”
Asked about the wedding, Ms Rochester said: “We’re just worried about getting through tomorrow, but that’s a worry in the back of our heads.
“Where we’re plan to get married is flooded at this time.”
Government action ‘too late’ – British tourist
One British man who paid £3,500 for last-minute flights so he and his family could return home before the hurricane hit the island said that he felt “completely let down” by the government’s response.
David Rowe and his family, from Hertfordshire, had spent 10 days in Jamaica before deciding to fly back to the UK on Saturday.
Mr Rowe, 47, was critical of the response of the Foreign, Commonwealth and Development Office (FCDO).
Image: David Rowe with his wife Abby, daughter Cora, eight, and son Ethan, 12, during their holiday in Jamaica. Pic: PA/handout
Speaking to the PA news agency, IT manager Mr Rowe said: “It’s all too late, their reaction and their response to the storm has been too late – after the fact.
“The advice should have been last week, like on the Saturday – don’t travel – because a lot of the travel companies use the FCDO guidance on travel (for) all their planning and what decisions they make as an organisation.
“There should have been something done much sooner than this. A lot of the UK nationals, and people on holiday there, they are stranded.
“This could have been prevented with with better action from the UK government.”
Mr Rowe added that he and his wife had felt “very anxious” before they flew home – and “very sad” for those left in the country.
A Foreign Office spokesperson said: “We understand how worrying developments in Jamaica are for British nationals and their families.
“Our travel advice includes information about hurricane season, which runs from June to November. Last Thursday we updated our travel advice for Jamaica to include a warning about Tropical Storm Melissa and that it was expected to intensify over the coming days.
“The safety and security of British nationals is our top priority, and that is why we are urging any British nationals in Jamaica to follow the guidance of the local authorities and register their presence with us to receive updates.”
Blasts have been reported in Gaza after Israel’s prime minister Benjamin Netanyahu ordered his military to carry out “powerful” air strikes.
Witnesses said they saw explosions and heard tank fire in Gaza City and Deir al Balah.
An Associated Press reporter in Deir al Balah heard tanks firing from an area controlled by the Israeli army, and, in Gaza City, two health officials reported strikes, including near the Shifa hospital.
At least two people were killed, and four others wounded, by a strike on a neighbourhood south of Gaza City, according to Gaza’s Civil Defence.
The announcement of strikes came shortly after Israel said that Hamas had opened fire on its forces in southern Gaza on Tuesday.
Hamas has denied involvement in the attack in the city of Rafah. The militant Palestinian group also said in a statement that it remained committed to the US-backed ceasefire deal.
Image: Israeli prime minister Benjamin Netanyahu ordered his military to carry out air strikes on Gaza. Pic: Reuters
A statement from the prime minister’s office said: “Following the security consultations, Prime Minister Netanyahu instructed the military echelon to carry out powerful strikes in the Gaza Strip immediately.”
US Vice President JD Vance said the ceasefire, which began on 10 October, was holding, telling reporters: “That doesn’t mean there aren’t going to be little skirmishes here and there.
“We know that Hamas or somebody else within Gaza attacked an (Israeli military) soldier. We expect the Israelis are going to respond, but I think the president’s peace is going to hold despite that.”
Hamas on Tuesday said that it would postpone the planned handover of a body of a hostage it had recovered, claiming violations of the ceasefire by Israel.
In a sign of the fragility of the ceasefire, Israeli troops were shot at in Rafah, and returned fire, according to an Israeli military official.
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3:37
Analysis: Two events combine to threaten a fragile ceasefire
The official told him: “Hamas violated the ceasefire once again, carrying out an attack against IDF forces east to the yellow line, an area under Israeli control.
“This is yet another blatant violation of the ceasefire. This comes after Hamas has also shown their true face and the fact that are pretending to not know where the remaining hostages are.”
Image: Hamas militants carry a white bag believed to contain a body retrieved from a tunnel in southern Gaza on Tuesday. Pic: AP
Hamas said on the Telegram messaging app that any Israeli escalation of attacks in Gaza would hinder search and recovery operations, and delay the return of the bodies of Israeli soldiers.
There are thought to be 13 bodies of hostages still in Gaza.
Speaking to Sky News, Israeli government spokesman David Mencer said: “The first line of this agreement is that all of our hostages should have been returned on the first day of this agreement.
“They were supposed to give back all of our hostages, and there was supposed to be a ceasefire. There are still 13 of our murdered hostages (in Gaza).
“And secondly, Hamas are firing on our troops. That is not a ceasefire.”
After the ceasefire took effect, all 20 living hostages were freed in exchange for almost 2,000 Palestinian prisoners, but the remains of the dead have been slow to be repatriated.
Hamas has said there are problems finding them due to a lack of equipment to sift through the devastation and rubble in Gaza.
The search for hostage bodies had been stepped up over the past few days after the arrival of heavy machinery from Egypt.
Image: Hamas members and Egyptian workers search for the bodies of hostages in the southern Gaza Strip on Tuesday. Pic: AP
Bulldozers were working in Khan Younis, and further north in Nuseirat, with Hamas fighters deployed around them.
Some of the bodies are believed to be in Hamas’ network of tunnels below Gaza.
Eleven people have been killed after a plane carrying tourists to a Kenyan safari reserve crashed.
According to officials, the aircraft burst into flames and was reduced to charred wreckage at the hilly and forested area in which it crashed.
The plane had been travelling from Diani Airport, on the coast, to the Maasai Mara National Reserve.
The dead included eight Hungarian passengers, two Germans and the Kenyan pilot. There were no survivors.
Authorities initially said the crash happened at 5:30am local time. Later, the Kenyan transport minister gave the time of the incident as 8:35am.
Image: Kenyan officials inspect the scene of a plane crash near Diani, Kenya. Pic: AP
Kenya’s ministry of roads and transport said the aircraft was destroyed by the impact of the crash and an ensuing fire.
Investigators from the country’s aircraft accident investigation department have been deployed to the site to begin an inquiry, they said.
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The department added that the Kenyan government’s “highest priority” remains aviation safety.
In a statement, John Cleave, the chairman of Mombasa Air Safari, said “our hearts and prayers” were with all those affected by the crash.
He wrote that the company had activated its emergency response team and was “fully cooperating” with the relevant authorities, who have already begun investigating.
“Our primary focus right now is on providing all possible support to the families affected,” Mr Cleave continued, adding that a family assistance team had been established to offer counselling, logistical coordination and any required assistance to the relatives of the victims.
The Maasai Mara National Reserve is a two-hour direct flight from Diani, a popular coastal town known for its sandy beaches.
Image: Kenyan security officials secure the wreckage of an aircraft which crashed with 11 people onboard. Pic: Reuters
The reserve attracts a large number of tourists as it features the annual wildebeest migration from the Serengeti in Tanzania.
Hungarian Prime Minister Viktor Orbán wrote on social media on Tuesday that his foreign ministry had been in contact with authorities in Kenya concerning the Hungarian victims of the plane crash.
He said: “What a tragedy! Our sincere condolences to families of the Hungarians who died in the plane crash in Kenya.”