Independent Appeal: Victims of a terrible war receive pioneering help in Gaza - and across the Israeli border

The moment that changed three-year-old Mohammed Kulab's life for ever came when he was buried in the rubble of his home after an Israeli shell exploded during an incursion into Gaza's southernmost town of Rafah in March 2004.

It wasn't only that both his parents were killed; it was also that trapped and starved of air, Mohammed, until then a normal, healthy one-year-old, suffered brain damage. By the time he was pulled out of the wreckage of his house he was in a coma.

Mohammed only came out of the coma after being transferred for three months to the Israeli Ichilov hospital in Tel Aviv.

Mohammed suffers from cerebral palsy as a result of the oxygen shortage that terrible day, and requires constant attention from his grandmother, Etas, 47, a woman who lives in one of the poorest areas of the Khan Yunis refugee camp.

"It's no more than my duty," she explains without fuss. She talks to Mohammed, who has a slightly crooked, winning smile, without ceasing. "What's four?" she asks. Mohammed holds out four fingers. "What does Arafat do?" In cheerful imitation of the late Palestinian president, he puts his outstretched hand to his forehead in a military salute. "What happened to you?" Here Mohammed points his index finger at the side of his head and makes a mock-angry face.

The exact nature of the disaster which crippled and orphaned Mohammed isn't clear even today. Local health workers and his extended family say his father, Awni Kulab, was a Palestinian policeman and the house was hit by Israeli shells. Reports at the time said that Mr Kulab was a leader of the armed militant Palestinian Representatives Committees faction and the Israeli military said an accidentally exploded Palestinian bomb was to blame.

Across town, 23-year-old Fawzia Abu Ims'ad lies in Nasser hospital with her right leg bandaged below the knee. She says that four years ago she was walking home when two Israeli soldiers started shouting at her. "They said dirty words," she says. "I don't look at them or say anything. I just kept walking." Then, she says, the soldiers shot at her twice.

The first bullet missed her, but the other hit her leg, smashing into the bone. Ms Ims'ad was also transferred to Israel, and spent 22 days in Tel Hashomer hospital where she says she had 15 separate operations. With the prognosis looking grim, doctors there secured her written permission to amputate the right leg. Then when she was under the anaesthetic and they could see more clearly the nature of the injury, they changed their mind.

When Ms Ims'ad came round they had the greatest difficulty in persuading her the leg had not, after all, been amputated. "I was very happy," she says. "I couldn't believe it."

Not that it has been easy since. Ms Ims'ad, a lively and attractive young woman, whose marriage prospects in a deeply conservative society have nevertheless almost certainly been impaired by her injury, is back in hospital because her leg had developed an ulcer. She badly wants to be transferred back to Israel - or possibly Egypt - because she has little confidence that the doctors here can treat her leg as well as those in Tel Hashomer.

But she complains that Nasser medical team aren't even bothering to fill in the forms for a transfer because they say the Hamas-led Palestinian Authority wont be able to refer her out of Gaza because of the international boycott. This may mean, she fears, that her leg could still, after all, be amputated.

But if Mohammed's life, and Ms Ims'ad's leg, were saved in Israeli hospitals, it is a project for rehabilitating the war disabled which has helped to give them hope of living anything like a normal life.

Using the skills of paramedics at the Al-Wafa Medical Rehabilitation hospital in Gaza City, the Gaza Community-Based Rehabilitation Programme (which is funded by the Welfare Association, one of the three charities in the current Independent Christmas appeal) started up soon after the second intifada in September 2000. It serves those disabled by the conflict. At the same time, it provides Al Wafa physiotherapists and occupational therapists with something valuable to do.

They had previously been prevented from getting to work by the Israeli-operated Abu-Houli checkpoint in central Gaza.

Now the project provides support for between 375 and 500 war disabled people a year in southern Gaza and hopes to extend to the north of the Strip. It gave Mohammed a walker; and provided vital training for his grandmother and her family to look after him. Its therapists helped Ms Ims'ad to walk despite the "dropped foot" problem resulting from her injury.

The project's occupational and physical therapists also worked hard with brain-damaged Sari al-Bardaweel, badly injured, and initially paralysed, by shrapnel from a tank shell. His unemployed father, Khaled, says the shell struck Sari's head and neck as they were both sitting one evening three years ago with friends in the yard of a house a few doors down from their own.

Sari, who is now 13, has no memory of the attack. He was one of the brightest and sportiest members of his class until his injury. After brain surgery at Gaza City's hospital he was gradually coaxed back to being able to walk and talk by the paramedical team. Now, although Mr Bardaweel says his son still has learning difficulties and easily gets irritable, he goes regularly to school and can think about the future. "I want to be a policeman in the national security force," the boy says without hesitation.

Al Wafa's Akram al Satari, who co-ordinates the programme, says it adopts a "holistic approach" to its clients. It provides aids in the form of wheelchairs, and training in basic needs such as dressing and going to the lavatory. It also offers health education for the patients and the carers.

But above all, he says, both its therapy and its campaigning in the wider Gaza community is aimed at ensuring that the disabled victims of the conflict are being rehabilitated "not as an act of charity but because it is their human right".

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