GAZA — Doctors at Gaza City's Hamad Hospital are reporting an increase in cases of speech loss among children following bombardments. Clinicians described cases in which children with no prior medical cause have stopped speaking after exposure to violence.

Five-year-old Jad Zohud, who had no prior speech difficulties, woke unable to speak after a bombardment near his home. Four-year-old Lucine Tamboura lost her voice after falling from the third floor of her home when a staircase damaged by an Israeli air strike collapsed beneath her. The fall also caused partial paralysis in her arm and leg. Her limbs have since recovered, but she still has trouble with speech and is continuing treatment.

"A child could lose the ability to speak entirely," said Dr Musa al-Khorti, head of the speech department at Hamad Hospital, referring to conditions such as selective mutism or hysterical aphonia. Both conditions are linked to extreme psychological distress and can cause a functional loss of voice.

Al-Khorti said treatment options in Gaza have been diminished by the war. "These conditions require specialised therapeutic intervention and rehabilitation tools. Many have been damaged or lost during the war," he said.

Child psychotherapist Katrin Glatz Brubakk, who has worked in Gaza twice with Doctors Without Borders (MSF), described similar patterns among children she has treated. "These are children who have been exposed to extreme trauma and, without any medical cause, stop talking," she said. "It's always extreme trauma."

Brubakk said prolonged trauma keeps the brain in survival mode, with the amygdala remaining alert while systems responsible for learning and emotional regulation are suppressed. "If children stop playing and interacting, they stop learning and developing," she said. She added that the collapse of healthcare and essential services in Gaza makes it difficult for families to obtain physical or mental help or to escape, compounding the impact of trauma.

"I've been working in the field for 12 years, and there's nothing that can compare to Gaza. Nothing," Brubakk said.

In therapy with withdrawn children, Brubakk uses soap bubbles she calls "hope bubbles" to help shift attention from fear and regulate breathing to calm the nervous system. "They're so beautiful, and so peaceful just falling slowly. And it helps children shift attention from fear," she said. "You have to be patient. Every small step matters."