Gaza war amputees scored far higher on disability than matched controls

A cross-sectional study published in Disability and Rehabilitation measured how war-related limb loss has affected survivors and the people caring for them in Gaza, and found disability and psychiatric symptoms concentrated heavily in the amputees themselves [s1]. On the World Health Organization's disability scale, WHODAS 2.0, amputees scored 51.8, against 18.8 for their caregivers and 11.3 for matched community controls, a difference the authors report as highly significant [s1].

That is the core finding, and it is worth stating what kind of study produced it before reading the numbers as a verdict.

What was done

Researchers recruited 96 adults with war-related amputations across three rehabilitation centres in Gaza, along with 53 of their primary caregivers and 95 community-based controls matched for age, sex and education [s1]. Functional disability was assessed with WHODAS 2.0; psychiatric symptoms with three brief screening instruments — the PHQ-9 for depression, the GAD-7 for anxiety, and the PC-PTSD-5 for post-traumatic stress [s1]. These are screening tools, not diagnostic interviews, so "screened positive" throughout means symptoms above a threshold, not a clinician's diagnosis.

The design is a comparison at one point in time, which sets a hard limit on interpretation: it can show that amputees carry far more disability and distress than similar people who were not injured, but it cannot by itself prove the amputation caused all of the gap, and it cannot describe recovery, which would need follow-up over time.

The psychiatric burden

The mental-health signal was as stark as the functional one. Among amputees, 74% screened positive for two or more disorders, against 52.8% of caregivers and 16.9% of controls [s1]. The caregiver figure is easy to skip past and should not be: more than half of the family members looking after amputees were themselves above threshold on multiple screens, a reminder that the injury's reach extends past the patient [s1].

In models adjusting for other factors, three things were independently linked to greater disability: being in the amputee group (odds ratio 48.1), more severe depressive symptoms (an odds ratio of 1.38 for each additional point on the depression screen), and older age (1.06 per year) [s1]. Income, sex and education were not [s1]. The very large odds ratio for group membership reflects how far apart the amputees and controls were; it is a measure of separation, not a precise effect size to quote on its own.

Why the numbers, and the limits, both matter

A small qualitative study in the Journal of Health Psychology, based on interviews with 30 male amputees in displaced-persons camps in Rafah between January and March 2025, describes the mechanism the screening scores can only imply [s2]. Its participants recounted limited access to medical care, prosthetics and adequate nutrition, worsened by repeated displacement — and the loss of the economic and social roles that had defined them [s2]. That is 30 men in one area at one time, and the authors frame it as an exploration rather than a representative sample; its value is in naming the pathways, not in quantifying them.

Read together, the two studies point the same way: the disabling part of war amputation in Gaza is not only the missing limb but the environment it lands in — no reliable rehabilitation supply chain, recurrent displacement, and mental-health symptoms that both track with and compound the physical disability. The Disability and Rehabilitation authors' conclusion follows directly from their own data: functional rehabilitation and sustained psychological support have to be delivered together, not in sequence [s1].

What to watch

The finding this evidence cannot deliver is trajectory. A cross-sectional score of 51.8 says nothing about whether an amputee fitted with a prosthesis and supported over a year improves, plateaus or declines — and in a setting where prosthetic and rehabilitation services are themselves under strain, that is the open question. It sits alongside the wider injury and health-system toll documented elsewhere in the region, from Lebanon's hospital injury data to conflict trauma surgery in Sudan, and the mental-health strain seen in displaced young people in Lebanon.

Sources

• [s1] Functional and psychiatric consequences of war-related amputation in Gaza and the burden on caregivers: a cross-sectional comparative study — Disability and Rehabilitation. https://doi.org/10.1080/09638288.2026.2704498
• [s2] Shattered wholeness: Trauma, amputation, and the struggle for dignity in Gaza — Journal of Health Psychology. https://doi.org/10.1177/13591053251410903