Gaza children running out of time to treat blast-induced hearing loss 

Wateen al-Ajrami was just more than a year old when the blast shook the simple storage room in northern Gaza’s Jabalia that her extended family were sheltering in.

Her mother, Mariam, explains that Wateen was standing next to a door at the moment of the Israeli strike in August last year.

Mariam grabbed Wateen, seeing the fear in her eyes as the child covered her ears and screamed.

But there were no apparent physical injuries. Wateen wasn’t bleeding or had any fractures, and there was no shrapnel embedded in her.

Two or three days later, Mariam and her family started noticing something alarming.

“I would call Wateen and she wouldn’t respond… I would speak to her and there was no reaction,” Mariam says, adding that Wateen would point to her ears.

A hearing test scheduled by a medical specialist soon revealed what Mariam had begun to fear: Wateen had almost completely lost her hearing due to the impact of the explosion.

The young girl had suffered approximately 85 percent hearing loss in her left ear, and 90 percent in her right ear, generally classified as between severe and profound hearing loss.

“It was an extremely shocking moment… Your child is healthy, just beginning to say her first words, and suddenly the doctor tells you she has lost her hearing,” Mariam says, her eyes filling with tears.

According to Mariam, the doctor explained that the cause was the blast wave from the strike. He noted that Wateen’s case was not the first of its kind that he had seen during Israel’s genocidal war on Gaza, which began in October 2023.

Since that day, the family’s life has turned into a series of medical follow-ups and a search for solutions that might restore Wateen’s ability to hear.

The child underwent additional examinations and an MRI scan. Medical reports were prepared and submitted to the World Health Organization in the hope of receiving a medical referral outside Gaza.

But the wait continues.

Unsafe environment

Estimates from United Nations agencies and health organisations show a sharp rise in children in Gaza suffering partial or total hearing loss due to exposure to explosions and heavy bombardment.

Blast waves are a leading cause of inner ear injuries, along with related brain trauma and severe psychological shock, according to medical groups operating in Gaza.

Data from rehabilitation centres and specialised associations in Gaza suggest that before Israel’s war, about 20,000 people were estimated to be living with hearing disabilities.

However, field workers warn the number has risen sharply since the war began, with estimates reaching 30,000 to 40,000 people with hearing loss or impairment, including many children. These groups face severe challenges due to the collapse of the healthcare system brought on by the war, damaged rehabilitation centres, and limited access to cochlear implants and hearing aids.

Organisations helping the deaf and hard of hearing in Gaza also report acute shortages of hearing devices, batteries, and cochlear implant parts due to import restrictions. Many rehabilitation centres providing speech therapy and psychological and educational support have been damaged or shut down, threatening children’s language development during critical growth stages.

International humanitarian law and UN agencies state that children with disabilities in conflict zones – especially those with hearing loss – face heightened risks that directly threaten their lives and increase their vulnerability.

In war, survival often depends on hearing warnings like explosions, aircraft, or evacuation calls. With hearing loss, children lose this “warning system”, making them unable to detect danger or respond in time.

That is a problem facing Usaid al-Shami, a three-year-old who lost most of his hearing at about four months old, during one of the most intense phases of the war in southern Gaza.

His mother, Mariam, says his daily life is filled with constant danger because he cannot hear what is happening around him.

“He was once attacked by dogs because he didn’t hear them barking,” she says. “Children around him ran away, but he didn’t. He couldn’t hear them. Only God’s mercy saved him.”

She adds that he has narrowly escaped multiple road accidents as well, because of cars and motorbikes that he could not hear approaching.

“I live in constant fear and anxiety, as if I am inside another war within the war.”

Growing crisis

Fadel Kuraz, a sign language interpreter and disability rights activist in Gaza with the Atfaluna Society for Deaf Children, says the scale of the crisis has increased dramatically since the war began.

Kuraz explains that the number of people with hearing loss or hearing disabilities was estimated at about 20,000 before the war, but has now risen – according to field estimates – to approximately 35,000.

“As a result of continuous explosions and bombardments, the number has increased significantly,” Kuraz tells Al Jazeera.

“These individuals are unable to integrate into society or communicate with their surroundings.”

One step in the right direction would be access to essential hearing devices, from medical hearing aids to batteries and maintenance tools, as well as cochlear implant equipment.

But as with many of the other issues facing Gaza right now, there was a major impediment: The Israeli blockade on the Palestinian enclave.

The blockade, which Israel has not totally lifted despite the ceasefire that began in October, has led to severe shortages of medical equipment.

“Current policies prevent the entry of assistive devices, cochlear implants, and spare parts, which significantly worsens the situation,” Kuraz said.

According to Kuraz, many of the centres that once provided diagnostic and rehabilitation services have either been destroyed or are no longer operational, reducing the ability to follow up on new cases – especially among children who require early intervention.

“We are facing a real catastrophe,” he says. “Even hearing aid batteries are no longer available. People cannot find the simplest supplies needed to operate their devices.”

He warns that if the situation continues, an entire generation of children risks losing their ability to acquire language and communicate naturally, in the absence of cochlear implantation and early intervention programs.

Struggle to access hearing aids

Wateen is currently undergoing speech and auditory rehabilitation sessions at Hamad Hospital in Gaza, where specialists are trying to train her to respond to sounds and develop communication skills despite her hearing loss.

She eventually received two hearing aids, which have slightly improved her response to certain sounds.

However, doctors continue to stress that hearing aids alone are not a final solution.

Both Wateen and Usaid require cochlear implant surgery, which is only available outside Gaza. Israel continues to restrict permission for Palestinians in Gaza to travel outside the territory, including for medical treatment.

But children suffering from hearing loss don’t have limitless time – doctors recommend cochlear implant surgery before the age of five for it to be effective.

Wateen’s mother, Mariam, explains that time has become a constant source of anxiety, as doctors warn that delays in cochlear implantation may affect a child’s language and speech development, especially in the critical early years.

“I think about her day and night,” the mother says, her voice filled with exhaustion and fear. “It’s not just about today… I keep thinking about the future. How will she hear? How will she learn? How will she speak?”

At home, the family tries to surround Wateen with special care.

“The children around her understand each other, they talk and laugh, and she just sits watching them in silence.”

In those moments, the mother feels that her daughter senses a barrier separating her from the world around her.

At times, Wateen cries or becomes upset without anyone fully understanding what she wants.

“I don’t want anything… Nothing at all,” the mother says, holding back tears. “Just for her to travel and receive a cochlear implant.”