Gaza's autistic children face double trauma of war and medicine shortages

In Khan Younis, 16-year-old Ahmed Hatem al-Mahabeel, who has autism, frequently holds his hand tightly under his chin—a repetitive motion to calm his nervous system amid memories of explosions. His bedroom, school, and the sports academy he attended have all been destroyed during Israel's war in Gaza.

Before the war, Ahmed was making good progress under specialist supervision. He played football, memorized the Quran, and was skilled in English. But the war, which began in October 2023, has killed more than 73,380 Palestinians and devastated a range of services supporting autistic individuals.

Ahmed's mother, Umm Ahmed, said her son is highly sensitive to sudden noises. When he hears an explosion, he panics, covers his ears, and rocks his body. In moments of extreme fear, he engages in self-harming behavior, banging his head on the ground to escape the sound.

Severe malnutrition and lack of protein caused Ahmed's appendix to rupture. The surgical wound became infected due to food shortages, forcing doctors to reopen his abdomen a second time to clean it. Ahmed now rarely leaves home because insecurity in Gaza persists, despite a ceasefire that took effect in October.

Psychological specialist Diaa Abu Aoun, who previously supported Ahmed, explained: "An autistic child relies entirely on routine and quiet to feel safe. When forced to live in a tent amid constant explosions, their brain suffers a sensory shock it cannot process. This fear turns into insomnia, digestive disorders, and violent screaming fits."

At the Nuseirat camp in central Gaza, 19-year-old Muneer al-Haj shows similar symptoms. When he hears an airstrike, he clenches his fists, paces back and forth, and makes sounds to drown out the explosions. Before the war, Muneer was on a promising recovery path, attending school and showing talent in drawing.

Due to medicine shortages caused by Israel's blockade, Muneer's condition has relapsed with screaming fits and seizure-like symptoms. His original treatment regimen has been cut to just half a sedative pill per day.

Muneer's father, who requested anonymity, shared: "He used to communicate and express himself clearly, but war swallowed all that. He asks urgent questions we cannot answer and falls into severe crises. He says: 'I have no shelter or homeland.'"

Experts warn that the disruption of specialized treatments is directly threatening dozens of children. The sudden reduction of sedative or anti-seizure medication causes severe disturbances in brain chemistry, leading to more intense seizures and a loss of ability to absorb behavioral exercises.

According to the World Health Organization (WHO), no rehabilitation equipment has entered Gaza between May 2024 and April this year. The Palestine Special Education Center was also destroyed, and its director, Arij Abu Sultan, was killed, leaving parents to take on therapeutic roles themselves.

Reem Jarour, who oversees the autism program at the Dolphins Association in Gaza, stressed that autistic individuals need a predictable environment to stabilize their emotions. "What we are witnessing in Gaza today is the complete destruction of behavioral foundations built over years. Sudden displacement turns environmental triggers into acute threats, leading to major regression in language and social skills," she said.