Khan Younis, Gaza – Five-year-old Ahmed Abu Zariaan lay on a bed at the European Hospital in southern Gaza, hidden behind bandages covering his disfigured face, and remained unknown for more than a week.

The injured boy was among a growing number of children in the war-torn enclave who were registered as “unknown,” or under the acronym WCNSF — wounded child, no surviving family.

Ahmed’s family was wiped out in an Israeli airstrike as they traveled south along the Salah al-Din Road, a route through Israel intended for safe passage from the northern Gaza Strip, early November.

They are following the Israeli army’s orders for residents in the northern part of the enclave evacuate southThe family of five left Beit Hanoon on a donkey cart and made their way to Rafah on the border with Egypt.

An attack on a nearby house along the way killed the entire family but spared the five-year-old. Nour Lafi, a 28-year-old nurse at the European Hospital, said the boy was in intensive care for two weeks after suffering serious injuries and burns.

“His face couldn’t be seen at all and no one recognized him. He was nameless,” she said. “None of his family was there. I could hear him groaning in pain. We tried to talk to him but he wouldn’t say a word.”

The boy was recognized by his grandmother 10 days later.

At least that’s what UNICEF, the UN organization for the protection of children, estimates 17,000 children in the Gaza Strip have been unaccompanied or separated from their immediate relatives since the conflict began on October 7 – about 1 percent of the total displaced population of 1.7 million people.

In Gaza, where Israel’s brutal war has passed the four-month mark, parents have long resorted to it write the names of their children on their bodies so they can be identified if they are killed or injured. If no clues to their identity are immediately available, hospitals send out alerts on social media in the hope that relatives will come forward.

But sometimes a child’s injuries are so severe that their own families have a hard time recognizing them.

The NGO Save the Children found that more than ten children are losing one or both legs every day during the course of the conflict.

“Rockets destroy people outside and inside”

Samira Abu Zariaan, 60, is still shocked that her daughter was killed, but she has made it her mission to care for her grandson, whose physical and psychological wounds are life-changing.

“His emotional state is still very difficult,” Samira told Al Jazeera. “He didn’t talk much. His voice trembles with fear. He’s afraid of all the noises around him.”

Ahmed asked about his mother, but Samira couldn’t bring herself to tell him the truth. “He doesn’t know she was killed. I told him she was injured and needed to rest.”

“I don’t know how Ahmed will overcome his shock. These missiles destroy people outside and inside,” she said. “He went from being a happy, mischievous, babbling child to a quiet, quiet child.”

The UN estimates that about 40 percent of people in Gaza have lost their identity cards and other documents, making it more difficult to identify unaccompanied children and reunite them with their families.

“Forced separation exposes children to various dangers and increased risk of exploitation, neglect and abuse,” UNICEF spokesperson Ammar Ammar told Al Jazeera.

A 2022 assessment by Save the Children found that the psychosocial well-being of children in Gaza has reached alarming levels due to protracted conflict, a global pandemic and a crippling blockade.

The needs are now “unimaginable,” Soraya Ali, a regional spokesperson for Save the Children, told Al Jazeera. “After a conflict, children experience increased feelings of anxiety and depression, which leads to long-term consequences.”

UNICEF estimates that around 500,000 children in Gaza were already in need of mental health and psychosocial support before the attack began.

Today, the number is estimated to have doubled to more than a million children, as a result of what they call the “war on children” that has made Gaza the most dangerous place in the world for children.

During Israel’s war on Gaza, more than 28,000 people were killed, including more than 12,000 children.

Life-threatening bottlenecks

As children face a mental health crisis, essential medical supplies and food remain available largely unable to enter Gaza. Have aid convoys with life-saving supplies came under fire by Israeli forces, although they are clearly marked.

According to the latest UN assessments, 13 of Gaza’s 36 hospitals remain partially functional and are operating at many times their capacity while facing critical shortages of basic supplies and fuel.

Humanitarian organizations have called for an end to hostilities to allow an increase in incoming humanitarian aid.

“UNICEF can expand its support, but we urgently need full access to communities and families to properly identify, register, make temporary care arrangements and conduct family tracing and family reunification services for children,” Ammar said.

“An immediate and lasting ceasefire is the only way to end the killing, injury and separation of children and their families.”

Save the Children also called for a permanent ceasefire, Ali said, “so that we can go to Gaza and begin providing the mental health and psychosocial support that is urgently needed.”

(Federica Marsi reported from Italy for this article.)