The besieged Palestinian enclave has the world’s highest number of child amputees per capita.

Some Palestinians who have lost a limb in Israel’s war on Gaza are creating homemade prosthetics to help themselves adjust to their new lives, due to the Israeli destruction of the territory’s medical facilities, their supplies, and the blocking of desperately needed equipment.

Since the conflict began in October 2023, 42,000 Palestinians have suffered life-altering injuries, with roughly 6,000 having an amputation or experiencing severe limb or spinal injuries.

Children account for a quarter of all amputations in Gaza over the past two years, making the besieged enclave the place in the world with the highest number of child amputees per capita, according to the International Rescue Committee.

One of them is Rateb Abu Qaliq, a nine-year-old boy who lost one of his legs after an Israeli attack on his house that killed his mother and brother.

“Before the amputation, I used to take part in many different sports,” he told Al Jazeera.

Speaking in the southern city of Khan Younis, his cousin Ahmed Abu Qalik recalled that Rateb fell over when he tried to kick a football after his operation.

“He walked away and started crying as he couldn’t play due to his amputated leg,” Ahmed said.

However, with an old piece of sewage pipe and a bit of string, Ahmed and his friends fashioned a prosthetic limb to allow him to join in again.

“Once, we went out to play and found a pipe that was longer than his leg,” Ahmed explained. “We cut the pipe to fit him and tied it with a rope so that he could easily join us in playing football and other activities. Now, he is happy and can do so many things.”

Few Palestinian children who have lost limbs have been evacuated for treatment outside Gaza.

In early September, the United Nations Committee on the Rights of Persons with Disabilities (CRPD) reported that at least 21,000 Palestinian children had been disabled in Gaza since October 2023.

In total, more than 64,000 children have been killed or wounded in the enclave, the UN children’s agency UNICEF has estimated.

Like Rateb, father-of-four Ibrahim Abdel Nabi also lost a limb after being shot in the leg as he queued for food at a site run by GHF, a controversial Israeli and United States-backed aid debacle.

It led to the deaths and injuries of thousands of Palestinians, who were fired upon daily by Israeli soldiers and US contractors, as they desperately tried to access food for their families.

A month and a half after he was discharged from the hospital, Abdel Nabi said he and his wife decided to use a sewage pipe, some wire and nails to create a primitive prosthetic leg for him.

“The main purpose of this prosthetic limb is to restore my ability to move so that I can support my family and children,” he told Al Jazeera. “I love life and I am fighting to continue living it.”

Israel’s devastating war on Gaza has killed more than 69,000 Palestinians and wounded more than 170,000.