Her left leg was almost entirely ripped off when her home in Jabalia, Gaza was hit by an explosion in October.

"I used to run and play, I was so happy with my life, but now when I lost my leg my life became ugly and I got sad, I hope I can get an artificial limb."

A generation of child amputees is emerging in the enclave amid Israel's retaliatory blitz after Hamas' deadly Oct. 7 attacks.

It's led to blast and crush injuries as densely packed high-rise housing blocks are bombed.

But doctors and aid workers say Gaza's collapsed medical system is ill-placed to give children the follow up care needed.

Poor hygiene and medicine shortages spell more complications and amputations on existing injuries.

At the European Hospital, Nurse Wafa Hamdan provides as much care as she can.

"I try as much as I can to make things easier for them as a nurse, but no matter what you do, they have a severe psychological problems, they feel incomplete with lots of pain, with that we have shortages in pain killers and they need it permanently."

Experts say children with war-related amputations will need dozens of surgeries by the time they reach adulthood because the bone keeps growing.

The strip's main prosthetic limb center, the Qatari-funded Hamad hospital in Gaza City, was shuttered weeks ago after being hit by Israel, Gaza health authorities say.

British emergency medicine doctor Chris Hook has just returned from working in Gaza.

"Many limbs that have apparently had been saved, will go on to require amputation. And many (people with) amputations and limbs that we think have been saved may still go on to die of the longer term consequences of all of this."

Israeli authorities have previously said they work to minimize harm to civilians.

Israel's military spokesperson's unit pointed to what it called Hamas' strategy of the "exploitation of civilian structures for terror purposes" but provided no specific comment on child amputees.

Gaza's health ministry says the total recorded Palestinian death toll had reached over 22,000 by Thursday.

That's almost 1% of its 2.3 million population,.