Children make up nearly half of Gaza's population. Here's what it means for the war

A girl tries to collect usable belongings amid the wreckage of vehicles after the explosion at Al Ahli Arab Hospital in Gaza. Ali Jadallah/Anadolu via Getty Images hide caption

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A girl tries to collect usable belongings amid the wreckage of vehicles after the explosion at Al Ahli Arab Hospital in Gaza.

Ali Jadallah/Anadolu via Getty Images

When Fidaa Al-Araj received the pre-recorded message last week telling her to evacuate her home because the area was about to be bombed, she first thought of her children.

To her surprise, they had actually beaten her to the street.

The day before, an Israeli airstrike had hit her cousin's house, killing his wife, mother and children. Those kids were close to Al-Araj's children in age. They were friends.

"My daughter said to me, 'What are you waiting for?'" Al-Araj recalled. "'Yesterday, we were crying for our cousins. Do you want people to cry over our dead bodies today?' So I had to leave."

The family left their home in Gaza City and started a days-long journey to Rafah, in southern Gaza, where NPR reached her by phone this week. Al-Araj, 39, is a mother of five, aged 13, 12, 10, 8 and 2.

on Wednesday.

Here's why the population skews so young, what it means for this war, and what it means for the future.

Who lives in Gaza?

The population of the Gaza Strip is 2.2 million.

The narrow slice of land covering 140 square miles — roughly the size of Las Vegas — is one of the most densely populated places on earth.

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Two-thirds of the Palestinians living in Gaza are refugees or their descendants from the 1948 war, and most of the population is Muslim. There is also a small native Palestinian Christian population.

Since 2007, Gaza has been under a strict land and sea blockade by Israel that prevents civilians, along with goods like food and medicine, from easily moving across the border, contributing to harsh economic conditions and .

, and most graduate from high school. Additionally, at the Islamic University of Gaza are female.

Schoolgirls pose for a group picture outside their classrooms at a school in Gaza City in January 2018. Mahmud Hams/AFP via Getty Images hide caption

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The drive for attaining education is part cultural, part pride, and it all goes back to the 1948 displacement, says Maha Nassar, an associate professor in the School of Middle Eastern and North African Studies at the University of Arizona.

"So many Palestinians lost their lives and their livelihood," she told NPR. "And so they wanted their children, and then later their grandchildren, to be able to do something that they could take with them even if they were displaced again. And so education came to be seen as the mechanism to do that."

Why do children make up such a large portion of the population?

The reasons are varied.

Many Palestinians simply don't get the chance to grow old — dying in their early adulthood either in conflicts or due to a struggling healthcare system — which drags the averages down.

A member of the Palestinian Civil Defence carries a wounded boy rescued from the rubble of a home that was destroyed in an Israeli airstrike on October 9. Eyad Al-Baba/AFP via Getty Images hide caption

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A member of the Palestinian Civil Defence carries a wounded boy rescued from the rubble of a home that was destroyed in an Israeli airstrike on October 9.

Eyad Al-Baba/AFP via Getty Images

The 16-year blockade has hampered fast access to medical care and caused shortages of essential supplies like gauze and I.V. bags, says Yara Asi — an assistant professor of global health management and informatics at the University of Central Florida, and the author of the upcoming book, .

"Preventive care is basically nonexistent," she said. "They're constantly dealing with short-term health issues, and those that need chronic care either don't get it or have to leave."

And to be able to leave for medical treatment, residents have to .

Another factor for the young population in Gaza is that people tend to marry in their early twenties, according to 2021 data by the . And the fertility rate (births per woman) is 3.38, . This is compared to 1.84 in the U.S.

Children are seen in a destroyed house after Israeli attacks in Gaza City. Mustafa Hassona/Anadolu Agency via Getty Images hide caption

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Children are seen in a destroyed house after Israeli attacks in Gaza City.

Mustafa Hassona/Anadolu Agency via Getty Images

She said she talked with her two oldest daughters, Rita and Ilham, aged 13 and 12, about what they should do if their parents are killed. She told them where they keep the money and the essential documents, and who they should contact.

"They were shocked like, 'What are you saying?' And I was like, ', maybe I'm next. I hope I'm next if we are next, not you,'" she said. "I know this is a huge burden to dump on my kids, but this is the reality of life because, I mean, what are they going to do?"

The number of children also has a practical effect, with some families reporting they simply don't have the means to travel with kids and also have nowhere to go.

"Where can we go as a family of five or six people?" one man .

What does it mean for the future?

Multiple conflicts, the blockade, and harsh living conditions have had a compounding effect.

A 2021 report by the found 91% of Gazan children suffered from conflict-related trauma. A 2022 report by found 80% of children reported emotional distress — up from 55% in 2018.

Children's clothes are seen in the rubble after an Israeli bombing on a house in the city of Khan Yunis in southern Gaza on October 16. Loay Ayyoub for The Washington Post via Getty Images hide caption

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Children's clothes are seen in the rubble after an Israeli bombing on a house in the city of Khan Yunis in southern Gaza on October 16.

Loay Ayyoub for The Washington Post via Getty Images

Still, Nassar, from the University of Arizona, says something can be done. Some of her cousins are in Gaza and have already lived through several wars.

"They know how to laugh. They know how to make jokes. They know how to enjoy life," she said. "We cannot fail them by telling them, 'OK, we're going to go put things back to the status quo until the next war.' That's not an option."

And she believes the children of Gaza deserve the chance to heal.

"They still have dreams, they still have hopes, they still have aspirations," she said. "And I think that with the right support mechanisms in place, we can help them deal and sort through this trauma and help them."