Shukran, gracias: 6-year-old twins from Gaza give thanks for lifesaving treatment in Spain
Iman Almajayda, 33 years old, and her 6-year-old twins Samar (left) and Eleen (right) are from Khan Yunis, in the Gaza Strip. Today they live in Spain, where Eleen is receiving treatment for leukaemia, a form of blood cancer.
Eleen was just 4 years old when she was diagnosed with leukaemia. She was receiving treatment in Gaza, but the hospital was destroyed by shelling when war broke out in 2023.
Iman, her mother, made the heartbreaking decision to leave her husband and family behind to seek asylum and treatment for Eleen in Spain, where they are now trying to integrate into Spanish society – a formidable challenge.
“After the hospital was bombed, there was no treatment available for Eleen,” Iman recalls. “Her doctor said he could do nothing more for her. We made it to Cairo [in Egypt], but Eleen spent 25 days in a hospital there getting sicker because they didn’t have the specialized care she needed.”
We meet Eleen and her sister, Samar, in Spain. The 6-year-old Palestinian twins, wearing matching outfits, are bundles of energy, filling the room with joy and hugging the team that supports their family.
Eleen was one of 15 sick and injured children who were medically evacuated with family members from Gaza in July 2024, via Egypt, to receive urgent medical care in Spain.
“I left for Spain with only my documents, some clothes and my phone,” explains Iman. “It was such a difficult decision to leave. On the one hand, I was happy that Eleen could receive the treatment she urgently needed, but, on the other hand, it was so difficult to leave my family behind in Gaza. It was especially difficult for my husband because he had to say goodbye to his little girls and to his wife.”
All of the 15 children evacuated to Spain, ranging in age from 3 to 17 years, had been in Egyptian hospitals for several months, receiving care for life-threatening illnesses after fleeing Gaza.
They make up a small portion of the thousands of other children and adults who need access to specialized medical care outside of Gaza. Thirteen of the evacuated children have complex injuries. All are being treated at various hospitals across Spain.
The evacuation was supported through the European Union Civil Protection Mechanism in partnership with WHO. The Palestine Children’s Relief Fund facilitated the patients’ documentation and evacuation approvals. The Government of Egypt supported their care while they were there, and 6 Spanish government ministries provided additional support.
Eleen, aged 6, is living with leukaemia. She is now receiving treatment for her cancer in Spain.
Now in Spain, Iman continues to grapple with the challenges of rebuilding a life far from home while ensuring Eleen’s treatment and well-being.
Her daughter’s health has improved significantly, she says, thanks to the medical care she is receiving in Spain. Eleen undergoes chemotherapy and takes oral medication for her condition. Every 2 weeks, she goes for comprehensive tests to monitor her progress. Her current treatment will continue until January 2025, when doctors will determine the next steps.
“The most important thing is that Eleen is now receiving the treatment she needs,” says Iman. “The current situation in Gaza now means it is not possible for a child to have any sense of security or a normal childhood. We live in peace now. Because there are no missiles falling around us, my girls feel secure.”
Iman, Samar and Eleen at a playground in Spain.
Mental health is often a hidden casualty of war. Iman has been seeing a psychologist to help her process the trauma she endured in Gaza and the challenges of adjusting to life in a foreign country without her family and friends. The safety of her husband, who remains in Gaza, weighs heavily on her mind.
“Every day I worry about my husband, how he is doing in Gaza,” Iman shares. “At the beginning of my sessions with the therapist, the focus was on the children, how they are adapting. Then I started talking about my feelings, how it felt to leave my family behind in Gaza while I’m here. The sessions vary; sometimes she just lets me talk about my preoccupations.”
Maria Tejada is Head of Campaigns and Communication at Accem, a Spanish non-profit organization.
Accem, a nationwide non-profit organization in Spain, provides Iman and her children with essential support, including housing, food, access to medical care, education, the services of a translator and a social worker, and psychosocial support. Accem is also helping them integrate into Spanish society. Samar and Eleen are now enrolled in primary school, while Iman attends Spanish language courses.
Maria Tejada, Head of Campaigns and Communication at Accem, explains, “Mental health support in these situations is very important. People coming from Gaza have experienced very dramatic circumstances. In addition to leaving their country, they’ve had to leave family members behind and constantly worry about them. If you add to this the stress of having a sick child, it’s a very tough situation. As a parent, you will do anything to make sure your child lives. We’re dealing with 2 situations that deeply affect their psychological well-being.”
Maria adds, “You can’t help feeling for them – their struggle for survival, their pain, sadness, feelings of insecurity, anxiety.”
Veronica Canel Álvarez, a social worker, plays with Samar and Eleen. Accem provides Iman and her children with this support; Veronica helps them to access services in Spain and shares methods to help them cope.
“Some of the things we deal with are anxiety, depression and changes in emotional behaviours,” Maria says. “We work with children to normalize their reactions. For example, the children from Gaza, when they first come to our office, are terrified of being in a closed space and try to escape. They instinctively look for a door or a window, automatically reacting without thinking. They come from a situation where, if there was an attack, a ceiling could collapse on them. That’s why they are always looking for a way out.”
Maria explains, “The first thing we did was to reduce their constant state of alertness, lower their anxiety levels and help them feel safe. By normalizing these behaviours, they’re now able to sit in a classroom and meet with us in our offices.”
Accem’s Tamara Vega Sierra is a reassuring presence in the lives of Eleen and Samar, bringing a sense of normalcy to their lives.
When asked if Accem’s work is making a difference for Samar and Eleen, Maria says, “We have seen a change in their behaviour, and one of the most significant changes is that the girls are just acting like children again. This might sound simple, but it’s actually very difficult. If you’re a sick child without access to help, you can’t act like a child. And all children have the right to live a childhood and to feel safe. This is a small triumph for us.”
Maria smiles as she recalls the children’s first word in Spanish: the translation of shukran, the Arabic word for thank you. “Gracias – that’s probably the first Spanish word they learn. Because when you feel safe in a place, the first thing you want to say is, thank you.”
WHO has appealed for the establishment of multiple medical evacuation corridors to ensure sustained, organized, safe and timely passage of patients via all possible routes, including Rafah and Kerem Shalom.
Israel has committed to facilitating the urgent medical evacuation of sick and injured women and children from Gaza to receiving countries in Europe via the Kerem Shalom border crossing and Eilat Airport (Ramon Airport).
Dr Hans Henri P. Kluge, WHO Regional Director for Europe, is intensifying his personal outreach to WHO European Member States to expedite evacuations and to appeal for more hospital slots to receive patients.
WHO once again calls for the end of the war, as peace is ultimately the best path to health.