She seemed to represent the collective suffering of Gaza's children: a little girl, eyes cast down, a tear edging beneath her lashes, blood smeared over her forehead, anguish written into her face.
Her picture was taken in the aftermath of the shelling of what was supposed to be a refuge from war, a UN school in Jabaliya. "The world stands disgraced," declared a shocked UN chief after 15 people died and more than 100 were injured.
The girl whose image spread around the world is Najia Warshagha, who at the age of nine is already a veteran of three bloody and devastating conflicts in Gaza. Over four weeks of this war, at least 447 children have been killed and 2,744 injured, according to the UN. Thousands more – Najia among them – are deeply traumatised.
Najia was kept in a hospital for a week being treated for extreme shock. "She is very traumatised since it happened," says Majdolen, her mother. "She can't sleep properly, she's always terrified."
Mulling over the wars – Operation Cast Lead in 2008-09, Operation Pillar of Defence in 2012 and the current Operation Protective Edge – concertinaed into her short life, Najia concludes that this one is the worst.
Doctors and mental health specialists in Gaza can draw on a bitter store of experience of treating traumatised children. After Operation Cast Lead, a study by the Gaza community mental health programme found that 75% of children over the age of six were suffering from one or more symptoms of post-traumatic stress disorder, with almost one in 10 ticking off every criterion. A study conducted by Unicef, the UN agency for children, following Operation Pillar of Defence in 2012 found that 91% of children reported sleeping disturbances during the conflict; 85% reported appetite changes; 82% felt angry; 97% felt insecure; 38% felt guilty; 82% were either continuously or usually in fear of imminent death.
This time it is likely to be worse. "Any child above six years old has now been exposed to three wars. We are talking about a traumatised generation. They will perceive the world as dangerous, and they will have a lot of frustration and anger. And a desire for revenge." said a UN study. “Israel is all the time in the process of creating a new generation of enemies," concluded the report.