Three months after a 13-year-old girl left Gaza for medical treatment, she is in intensive care in a UAE hospital after complications from surgery.

Lamis Abusalim has severe scoliosis that, if left untreated, could compress her lungs and eventually kill her. Before her surgery she spent most of the time on her back, because when she sat up, she struggled for air.

But during an operation to correct her condition on 4 October, her heart stopped three times, her mother said. Doctors told the family the girl had suffered some brain damage.

It is a devastating setback for Lamis and her family, who had spent months trying to escape the war in Gaza to get medical help. Their story was mentioned in BBC coverage of a wider evacuation in July.

Lamis had been due to undergo treatment in Jerusalem last October following three unsuccessful operations in Gaza.

But since the start of Israel’s military offensive following the Hamas attacks on Israel on 7 October, most of Gaza’s residents have been unable to leave the territory.

Eventually, Lamis and her mother were able to get on a list to evacuate with the help of international organisations.

After the complicated surgery, the family is now seeking help to transfer Lamis to the UK or another country for further treatment, although it would be difficult to move her.

“All kids have the right to live in a safe place, in a good place, and seek treatment,” said her mother, Shatha. “The kids are not the ones who make the conflict.”

The months-long, multi-national effort to evacuate Lamis reveals how hard it is for Palestinians in Gaza to access medical care.

Hamas attacked Israel on 7 October 2023, killing about 1,200 people and taking some 251 back to Gaza as hostages.

The Israeli military offensive that followed has killed more than 42,000 people in Gaza, according to the Hamas-run health ministry.

The bombardments have closed hospitals, killed doctors, and overwhelmed remaining facilities with casualties.

The Israeli military says it has attacked some hospitals because, it says, Hamas combatants have been using them as bases. Hamas denies this.

Before the war, Lamis, a “beautiful child” and youngest of five, loved drawing and attending her special education school, her mother said.

At six months old she was diagnosed with a genetic white matter disease.

Dr Joshua Bonkowsky, a professor of paediatric neurology at University of Utah Health said it was a category of brain disease that leaves a third of children dead by the age of eight.

He was not familiar with Lamis’ case.

Barely any of the diseases are curable, but treatment is available for resulting conditions.

In January, the health ministry in Gaza referred Lamis for treatment abroad for her scoliosis. The ministry recorded that she had respiratory compromise and difficulty swallowing food, and recommended surgery.

Her family reached out to charity HEAL Palestine, which arranged treatment with a US hospital, while an Israeli NGO, Gisha, sought security clearance for evacuation.

In June, Lamis received clearance a day before an evacuation via the Israeli-controlled Kerem Shalom crossing, but did not get on the list in time to leave, according to Gisha.

Then, in late July, her mother received a call from the World Health Organization (WHO) that she and her daughter would be evacuating.

After a last-minute delay – which led Shatha to take her daughter on a two-hour journey back home to Deir al-Balah in central Gaza – they received another call the next day saying the evacuation was back on.

Shatha said goodbye to her husband without knowing when they would see each other again.

“It was really difficult for me,” Shatha said. “I did not want to look back.”

Shatha boarded the bus to depart Gaza carrying only a handbag and Lamis on her back, as they had to leave the girl’s wheelchair and bags packed with clothes.

Lamis cried in pain on the bus ride to the border with Israel, where they took another bus before boarding a flight to the UAE.

On a call in August, Shatha told the BBC she had “finally achieved this dream”.

Lamis is one of 229 patients to have left Gaza since May, according to WHO.

Almost 4,900 patients – 35% of those who submitted requests – evacuated through the Rafah crossing into Egypt from November until May, when Israel launched a ground offensive and seized control of the Gazan side of the crossing.

An estimated 12,000 patients still need evacuation.

WHO director Tedros Adhanom Ghebreyesus has said people are “suffering needlessly“ and urged the “establishment of evacuation corridors via all possible routes”.

Cogat, the Israeli military body responsible for humanitarian affairs in Gaza, told the BBC Israel was “actively working on multiple fronts to establish a mechanism for evacuating patients with complex medical conditions, who require further treatment outside the Gaza Strip”.

The agency said Israel was in “constant communication” with aid organisations, health authorities and countries, and reviewed evacuation requests, providing an “appropriate response, subject to security arrangements“.

Since arriving in the UAE, the government has paid for Lamis’ accommodation, pocket money and stay in hospital, where on Friday she remained in a critical condition.

Her mother said that “the most important thing is to get Lamis good treatment.”