For the 68 orphans saved from Rafah, the road to recovery is likely to be a long one

TEL AVIV, Israel — It took months of negotiations for the charity group SOS Children's Villages International to get 68 children without parental care out of Rafah, in southern Gaza, to the relative safety of the Israeli-occupied West Bank last week.

Efforts began as soon as November — one month after the outbreak of the war between Israel and Hamas — to safely remove the children to Bethlehem, where they are now based, according to Angela Rosales, the chief program officer of SOS Children's Villages. The group also relocated 11 employees and their families in the move.

"When the conflict started, we had to start to think: What is the best situation that we can give them? Because their lives were being threatened. And we needed to think of options," Rosales said in an interview with NPR.

The United Nations said the transfer was carried out with the approval of Israeli authorities, a fact that angered elements of Israel's right wing.

The children, between ages 2 and 14, were moved with the consent of their legal guardians — extended family members who are still based in Gaza. SOS Children's Villages had been caring for some of the kids for years prior to the outbreak of the war, Rosales said.

The children, now safely ensconced in Bethlehem, are getting a reprieve from war and trauma, Rosales said. But the charity is still supporting more than 1,200 families in Rafah and more than a dozen unaccompanied children — though that number fluctuates as the war continues.

"We remain very concerned about all the children who are still in danger in Gaza," Rosales said. "And because the situation has not improved, we of course would like for peace to be reestablished so that our children can grow up in a peaceful [environment]."

The care children are getting in Bethlehem

SOS Children's Villages has been running programs in the Palestinian territories since 1968, and it has been present in Israel since 1977. The group has seen numerous outbreaks of violence in that time, but none quite as deadly as the current war.

"The work that is done there is specifically targeted at children that are at risk of losing their families," Rosales said. "So this is working with families at high risk, supporting them to avoid the loss of parental care for the children and also providing support for those children that for several reasons cannot grow up with their families."

For the children who were relocated from Gaza to Bethlehem, the staff members, who include social workers, psychologists and other caregivers, are working to ensure they receive the support they need, Rosales said.

"Our main concern is that they get a glimpse of reality, a normal life a child would have," Rosales said.

The past five months have been anything but normal for children in Gaza. When Hamas-led militants stormed southern Israel on Oct. 7, they killed 1,200 people and took roughly 240 others hostage, according to Israeli officials. Israel's assault on Gaza in response to those attacks has killed more than 31,700 Palestinians, according to Gaza's Ministry of Health. That number includes about 13,450 children, according to the ministry.

The war has also displaced roughly half of the Gaza Strip's prewar population of 2.3 million people into Rafah governorate — including an estimated 600,000 children — and caused a spiraling humanitarian crisis in Gaza. Acute malnutrition has doubled in the last month in the north of Gaza, according to UNICEF, which says that a third of children under 2 years old are now suffering from a lack of food.

At least 23 children in northern Gaza have died from malnutrition and dehydration in recent weeks, according to Gaza's Ministry of Health.

Bethlehem is a safer place, where the newly relocated children can play and have access to dependable meals each day. Ultimately, though, SOS wants to bring the children back to their original homes.

"Our intention is that they return as soon as possible, as conflict allows it, so that they can go back to the communities and under the care of their extended families," Rosales said.

War can cause lifelong trauma for children

Before the war, the organization was running family strengthening and other preventive programs that supported more than 400 families in the West Bank and Gaza, the group said. Since the war, it has increased support to families in Gaza with emergency humanitarian aid.

Now, more than 100 internally displaced families with children are living on the premises of SOS Children's in Rafah.

The children whom the group still cares for in Gaza are facing devastating impacts on their physical and mental development, Rosales said.

The children who have come into the Rafah center are unaccompanied or separated, Rosales explained. Some of them may have had parents or other family members who died in the war, or they may have otherwise been separated from family members in the chaos.

They come to SOS' care when other aid organizations find the children and bring them in, she said.

Rosales says she is fearful about the long-term impact on the young people growing up during this conflict.

"They are suffering from an important loss in their development," she said.

Research has shown that the cumulative trauma of ethnic-political violence has a long-lasting impact on children's mental health and development.

Many children deal with the physical scars of the trauma they endured on top of mental, emotional and behavioral impacts even years after surviving conflict. That can include post-traumatic stress, flashbacks and depression.

"When they are growing up in a zone that is in conflict, the children lose, in many cases, the hope for a future. They cannot dream of what they want to be when they are grown-ups," Rosales said.

Beyond that, basic needs like food, clean water and sanitation are not being met.

"They are losing precious years of development. So every day, every month that they live under conflict, it does have a consequence for them," she said. "Conflict does strike very hard for the life of children, not only in the present, but for their future lives."