“All That Remains”: As Gaza Faces Child Amputee Crisis, New Film Tells Story of 13-Year-Old Leyan

AMY GOODMAN: This is Democracy Now!, democracynow.org, The War and Peace Report. I’m Amy Goodman.

We turn now to a grim statistic from Gaza. On Monday, U.N. Secretary-General António Guterres said Gaza now has the highest number of child amputees per capita anywhere in the world, with many children forced to endure surgery without anesthesia. In September, the U.N. Relief and Works Agency, UNRWA, said each day in Gaza 10 children are losing one or both of their legs.

Last weekend, after months of waiting for approval from Israel, eight injured Palestinian children from Gaza arrived in Chicago for medical treatment. It was the largest medical evacuation of injured Palestinian children to the United States.

We turn now to a new film from Al Jazeera’s Fault Lines that brings this story to life. It’s called All That Remains. It follows the story of Leyan, Leyan Abu al-Atta, 13-year-old girl whose leg was amputated after she was severely injured in an Israeli strike on Deir al-Balah, in Gaza, last December.

RAGHDA ABU AL-ATTA: [translated] Leyan was like a butterfly. She flew here and there. She was very active and didn’t like to stay put.

AYOUB ABU AL-ATTA: [translated] Leyan loves fashion. She loves to dress up.

LEYAN ABU AL-ATTA: [translated] Today I have for you a poem by Tamim Al-Barghouti.

AYOUB ABU AL-ATTA: [translated] She likes to write and recite poetry.

LEYAN ABU AL-ATTA: [translated] “In Jerusalem graves are arranged, as if they are lines of the city’s history.”

Hi, guys. I’m getting ready for school because we have a test: math.

AYOUB ABU AL-ATTA: [translated] Leyan was injured on a Saturday, December 2nd.

LEYAN ABU AL-ATTA: [translated] Check this out, people. This is after I got myself ready.

AYOUB ABU AL-ATTA: [translated] The doctor told us we had to choose between the girl or her leg.

ALI ABU AL-ATTA: [translated] What happened to Leyan weighs very heavily on me.

RAGHDA ABU AL-ATTA: [translated] To make her feel better, I tell her, “It isn’t just you. It’s this kid, that kid, that kid. And that’s just who we know.”

AYOUB ABU AL-ATTA: [translated] I took her cellphone to see what she used to film. I wanted to see how she used to be, because I was so sad for her. What touched me when I saw her videos was that she was so ambitious. She was excited about the future and loved to document everything. This made me feel I wanted to see her like she was before, not confined to a bed.

LEYAN ABU AL-ATTA: [translated] I was awake, but I felt like I was in a dream. It didn’t feel real.

My name is Leyan Ali Musa Abu al-Atta. I’m in Egypt, and we’re getting ready to go to America tomorrow.

AMY GOODMAN: That’s 13-year-old Leyan al-Atta. In this next clip from the Fault Lines documentary All That Remains, Leyan’s parents and her older brother describe what happened after she was injured in this Israeli strike on Deir al-Balah.

ALI ABU AL-ATTA: [translated] It was like Leyan was fading away before our eyes, and we were watching our hopes and dreams being destroyed.

ICU! ICU!

AYOUB ABU AL-ATTA: [translated] Her leg looked almost amputated. The doctor told us that the majority of her leg’s tendons were cut. Ten to 15 centimeters of her bones were missing.

RAGHDA ABU AL-ATTA: [translated] There wasn’t any equipment for the doctors to perform proper surgery. The doctor came out and said that the girl was in very bad condition. It was clear on his face.

LEYAN ABU AL-ATTA: [translated] I had a high fever that never went away. And my leg suddenly turned black and blue.

I can’t breathe! Enough already!

RAGHDA ABU AL-ATTA: [translated] We didn’t know what to do. The girl was dying.

AMY GOODMAN: That’s a clip from All That Remains, a new Al Jazeera Fault Lines documentary. Leyan is now in Philadelphia. She’s being treated at Shriners Hospital.

For more, we’re joined from Washington, D.C., by Rhana Natour. She’s the director and producer of All That Remains.

Rhana, this is a devastating film. Yes, it’s the story of one little girl and her unbelievable courage, but take us on that journey from the day last December when she was injured in this airstrike and then how she and her mom got out of Gaza to Egypt and ended up in Philly.

RHANA NATOUR: You know, Leyan was injured in an airstrike, in an artillery strike on a mosque that happened to be by the school where she was sheltering. And it changed the trajectory of her life forever, and her loved ones’ and her family’s life, but it didn’t even register on international media’s reporting because of all the massacres that were going on.

And after that strike, her family saw that her leg was at risk of being amputated. And they couldn’t get the care they needed, to get the medical care to prevent that amputation from happening. So, her brother, her older brother Ayoub, launched a social media campaign. He reached out to every journalist in Gaza in an effort to make a public plea to get his sister out of Gaza. And they were successful. But it was too late. Her leg was amputated because gangrene had reached up to her leg and was going to kill her if she didn’t amputate that leg.

And Leyan — for every Leyan that is able to leave Gaza, there are hundreds, if not thousands, who are not able to leave. A medical evacuation out of Gaza and her eventual medical evacuation to the U.S. for medical treatment, it’s what I call a lucky ticket for the profoundly unlucky. But it was the best shot that Leyan had at a future. It was the best shot that Leyan had for the chance, even just the chance to be able to walk again on prosthetics.

AMY GOODMAN: So, her leg was amputated in Cairo because —

RHANA NATOUR: Yes.

AMY GOODMAN: — gangrene threatened her life, when she got out —

RHANA NATOUR: Yes.

AMY GOODMAN: — of Gaza, her mother making this devastating decision to leave her other children and her husband, who remain under, to say the least, enormous danger in Gaza, but to be with Leyan?

RHANA NATOUR: Yes, exactly. These evacuations are essential, because the medical system in Gaza is collapsing. But what this does is it means that these families are ripped away from their support system at the exact moment they need it most, when they have a very sick child that needs medical treatment.

At the beginning of this journey of making the film, we thought we were following a medical journey. We wanted to know all about her treatments. And we realized soon after that this was about more than that, that this was not just about a girl who wanted to walk again, but that this was about a girl who wanted to make sure that her life didn’t go unlived, that she didn’t just languish in a hospital bed, and that this was a journey and something that changed the entire trajectory of this family.

Every single member of this family’s life changed as a result of this injury. Her mother had to make the decision. She did not want to leave Gaza, but she had to, to give — to try to save her daughter’s life, essentially. She left behind an 8-year-old boy, who suddenly didn’t have a mom. She left behind her husband, who remains in Gaza today. And we were able to document, with the help of Media Town Productions, who documented the family that Leyan left behind, this 360-degree perspective of what this injury did, because it’s not just an injury that’s physical to one girl, but it’s a traumatic injury of separation for an entire family.

AMY GOODMAN: I wanted to go to another clip from your documentary, Rhana, All That Remains, where we hear from the renowned surgeon Dr. Ghassan Abu-Sittah, who spent more than a month in Gaza working with Doctors Without Borders in the early days of Israel’s assault there.

DR. GHASSAN ABU–SITTAH: So, this is a photo that I took of our operating room after I finished. And the anesthetist is waking the child up, and one of the nurses is writing the child’s name on the box that has their amputated limb. And you can see the box where the limb is in it. This is a limb that’s unsalvageable and needed amputation. This is a surgery that I did on the hand to try to salvage the limb. This is a 14-year-old boy called Amadan [phon.]. So, there are lots of reasons why I take these photographs. Sometimes the memories are so horrendous that you need to see it to believe that it did happen.

It was really the scale, so the scale of children’s amputations. Half of my cases were always children. The delay that was happening in taking patients to the operating room meant that these wounds became infected and gangrenous, and you had to do amputations to save the children’s lives. And as the war progressed and children knew of other children who had lost their limbs, they would come to the operating room screaming, “Don’t take my leg away! Don’t take my leg away!”

Children are not small adults. There’s a difference in the way you treat them. The child’s body is programmed to grow. Even the injured child’s body is programmed to grow. A child that has a war-related amputation needs between nine and 12 surgeries by the time they reach adult age. This growing child needs a new prosthetic every six months, as their body outgrows the length of the prosthesis.

This problem is so complex. So you need to create a system that ensures that these children have the most productive life possible. It is of paramount importance that we continue to plan for tomorrow, because genocide is about there not being a tomorrow. There is a tomorrow for these children. And our job is to make sure that they do not spend the rest of their lives in pain and misery as a result of this injury.

AMY GOODMAN: That’s renowned surgeon Dr. Ghassan Abu-Sittah, who spent more than a month in Gaza working with Doctors Without Borders. You can see our interviews with him at democracynow.org. But that’s from the film All That Remains, that’s produced and directed by Rhana Natour.

So, let’s talk about the number of Palestinian children who have lost their limbs. In fact, you document in a piece that you write, Rhana — you tell the story of another teenager, little young girl, named Layan also, who lost both her limbs. The Leyan who is in this documentary is at Shriners in Philadelphia right now, and Layan Albaz is at Shriners in Chicago, Rana.

RHANA NATOUR: That’s correct. And I think what — when I first started reporting on this issue, I thought that the mountain that these kids were climbing medically was getting them access to a prosthetic limb and making sure that they had specialized care from specialized doctors who would be able to make that all happen.

What I soon learned, with the story of Layan Albaz, which I document in the Atavist magazine, is that these injuries are incredibly complicated and difficult to treat in the best of circumstances, even before these specialists that are renowned throughout the entire world. And why? The reason is because, A, children, historically, didn’t typically survive these injuries, and they are surviving multiple very severe and complicated injuries.

To give you an idea of Layan Albaz, she has an above-the-knee amputation on one knee and a below-the-knee amputation in another knee. She had limbs that — she’s a victim of a blast injury. So, these limbs have been eviscerated. The limbs, the bones, the muscles, the tissue, the tendons, the skin, there’s a specialist for each of those things, because they all have to work together in order to accommodate a prosthetic.

And when she finally was able to walk on a prosthetic, I was able to witness what that therapy looks like. She’s operating basically two different instruments at the same time. She has to learn how to master two different instruments, because she has a mechanical knee on one side and she has a prosthetic that looks completely different on the other side, because the injuries look completely different. It is very, very, very difficult.

AMY GOODMAN: So, we have to wrap up right now. We have 30 seconds. The documentary All That Remains, just utterly heartbroken with the divided family. And the most — the strongest figure in this film is this little girl, is Leyan, who is comforting her mother, who came with her, her dad who’s still in Gaza, her brothers. Her spirit is astounding.

RHANA NATOUR: It absolutely is. I mean, these kids survived bombs being dropped on them, buildings falling on them, shrapnel ripping through their body. And they survived all of this, and they still have the fight to fight for their future and demand they have one. It sounds like it’s a depressing story, but I promise you it’s a hopeful one.

AMY GOODMAN: Rhana Natour, I want to thank you for being with us, director and producer —

RHANA NATOUR: Thank you.

AMY GOODMAN: — of the Fault Lines documentary film All That Remains. And all should see it. We’ll also link to your article in Atavist called “Coming to America.”

Coming up in 20 seconds, we go to France, where President Macron is refusing to resign, even though lawmakers across the political spectrum have united and ousted his prime minister. Back in 20 seconds.