All Sa'ida Idris has known almost since the day she was born just over a year ago is the beeping and buzzing of machines and the touch of a rotating staff of nurses and doctors in the neonatal unit of Al Makassed, a Palestinian hospital in East Jerusalem. 

Sa'ida was born premature at just 27 weeks on July 28, 2023. The 14-month-old is one of five babies who've been living in the hospital for the past year, raised by a team of hospital staff and volunteers while her mother and father are 100 kilometres away in a tent camp in Khan Younis for those displaced by the war in Gaza.

"I was with her a week from her birth," Sa'ida's mother, Heba Idris, 38, told CBC News freelance videographer Mohamed El Saife late last month. She and her husband were preparing to make a video call to the hospital — the only way they can communicate with their baby daughter.

"It feels like something was torn from my heart," she said of being separated from her child. "How do I leave a piece of my soul?"

Idris was in East Jerusalem on a short-term medical permit because of a difficult pregnancy that required care not available to her in Gaza.

Soon after giving birth, she says she fell into a depression after struggling to breastfeed and returned to Gaza to be with her husband. Sa'ida had to stay behind because her organs weren't fully developed and she needed to remain in the incubator for another three months.

"She needed mechanical ventilation for a long time," said Sa'ida's nurse, Imm Amir. 

CBC News has agreed to use only the nurse's patronymic name because she fears speaking publicly could jeopardize her work permit in Israel.

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Fourteen-month-old Sa'ida Idris was born 27 weeks premature in an East Jerusalem hospital. Her mother, Heba Idris, who lives in Gaza, was only able to see her for two months before the Oct. 7, 2023, Hamas-led attack on southern Israel wrenched them apart. Her father has yet to meet her.

An impossible choice

Idris recalled asking a nurse if she could hold her baby before she left. But Sa'ida was too small and weak to be taken out of the incubator, so her mother could only stroke her hair and reach for her little fingers through an opening in the incubator. 

Since then, Idris has had only one other visit with her daughter. She was granted a permit to travel back to East Jerusalem a few weeks after the birth because doctors wanted her to breastfeed, but by then, her milk had run dry. She was able to spend four days with Sa'ida before saying yet another goodbye.

Idris last saw her baby on Sept. 4, a little over a month before Hamas attacked Israel on Oct. 7.

Once the war broke out, Israel stopped allowing Gazans to enter the country, leaving Idris with an impossible choice: bring her baby back to a war zone or leave her in the hospital to be raised by staff and volunteers.

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"It's difficult that I'm not there with her, to touch her hand, to play with her, change her, bathe her," Idris said. 

Sa'ida's father, Saleh Idris, 32, has yet to even meet his daughter.

'I don't want my daughter coming to Gaza'

In a statement to CBC News, the office of Co-ordination for Government Activities in the Territories (COGAT) said the parents of the five premature babies born at the East Jerusalem hospital before the war were offered the chance to bring them back to the Gaza Strip once their care was complete, but chose to have them remain in the hospital "under supervision of caretakers." 

Idris says she felt it was safer for her daughter, who has a compromised immune system, to remain in East Jerusalem.

"I'm hoping that I can go to her," she said. "I don't want my daughter coming to Gaza because of the dirt and tents and sand."  

The couple has been using WhatsApp video calls to interact with their daughter for the past year, although even those are infrequent because they have to go to a makeshift internet café to get a connection strong enough to sustain a video call.  

When they do connect, they spend most of the call trying to get Sa'ida's attention. The baby is distracted by toys and her own image on the phone. But once in a while, she makes eye contact and giggles as they blow her kisses and try to get her to say "mama" and "baba," the Arabic word for dad.  

"I feel that she sees me, but she doesn't see me," said Idris. "I want to see her face to face and hug her." 

Imm Amir, the nurse taking care of Sa'ida, says she is a social baby and greets everyone with a smile because "she thinks everyone is her family."

"She doesn't know her mother," she said as Sa'ida curled up and slept in her arms with her thumb in her mouth. 

Travel out of Gaza limited

Even before Israel's recent war with Hamas, Palestinians' ability to travel between Gaza, the West Bank, Israel and East Jerusalem was highly restricted. Travel across the borders has since become even more difficult. 

"Palestinians need the approval from Israeli authorities, who maintain control over the borders of Gaza," said Aseel Aburass, director of the Occupied Palestinian Territories unit at Physicians for Human Rights.

Ever since the permit system was instituted in the early 2000s, Palestinians who needed to leave Gaza for work, medical appointments or personal reasons, such as attending a funeral, have had to apply for an exit permit.  

Aburass said the process for obtaining a medical permit to exit Gaza can take weeks or months. It begins with a medical assessment in Gaza, followed by an application to the Palestinian Ministry of Health, which is then sent on to COGAT, which manages Israel's borders. 

"The whole permit regime is very complex and a very bureaucratic process," Aburass said. "We call it bureaucratic violence."

The Oct. 7 Hamas-led attack on Israel last year and the ensuing war have made that process and medical transfers more difficult.

The Erez crossing in the north, which Gazans would normally use to enter Israel, was damaged on Oct. 7 and is now closed to all but aid trucks. The Rafah crossing in the south has been severely restricted, with the nearby city of Rafah the site of some of the heaviest fighting.

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Before May, the Rafah crossing was jointly controlled by Egypt and Israel. Aburass says that at that time, about 50 patients with exit permits were leaving daily to seek medical care in Israel, Egypt or abroad. In the five months since Israel seized control of the crossing, she says only 216 patients have been able to cross.

"We don't operate under 'usual circumstances,' " Aburass said. "The old normal is gone; everything is ad hoc."

According to COGAT, since Oct. 7, "for clear security reasons, residents of the Gaza Strip have not been allowed into Israel." But it says it continues to facilitate medical transfers out of Gaza.

"Israel is ready to continue facilitating and co-ordinating the departure of the ailing and wounded to third countries, and even on a larger scale — subject to the agreement of those countries," it said in its statement to CBC News.

Growing up in a hospital room

Back in East Jerusalem, Sa'ida flashes a big smile at the adults fussing over her.

The room she spends her time in at Al Makassed Hospital has toys and mats on the floor for her to play on, but it's still a hospital room. There are cribs for her and the four other babies, but above them there are monitors and wires and machines.

It's a fully functioning neonatal department, but it's also where Sa'ida is living out her childhood. 

As the video call with her parents ends, the little girl goes back to crawling and playing with her toys, a nurse tickles her before moving to the next baby she must tend to. Sai'da is blissfully unaware of the distance between her and her mother and father. 

In Khan Younis, Sa'ida's father is having trouble hanging up on the video call with his daughter. As tears roll down his cheeks, he waves at the screen and tries to get her attention a few more times before the call cuts out. 

For a moment, they were a family again, but now, reality sets in, as they walk back to their tent from the internet café.

All they can do, they say, is wait: Wait for an end to the war, wait for the separation from their daughter to be over, wait for the beginning of their life together as a family.  

"I would love for her to be in my arms," said Sa'ida's mother as she wiped away tears. "But because of the difficult circumstances that we are living in, I know she's OK.

"Over there is better for her."