On Tuesday afternoon, we started hearing about a massive explosion at the largest refugee camp in Gaza. Hamas was quick to blame Israel. And within hours, Israel's military came out and said, yes, it was us. The IDF said it took out a top Hamas leader in the strike whom Hamas denies was there. The IDF also said an underground terror infrastructure was built under the territory.

Eyewitnesses on the ground told CNN the carnage left behind was staggering. One man who was only a couple hundred feet away from the Jabalya camp, told CNN that bodies were hanging on the rubble, bleeding and burnt. He said children were carrying other injured children. Think about that picture for a second. I know it's disturbing, but just really think about it. Children carrying other children.

Now, on Wednesday, we started to see a group of up to 81 injured Palestinians leaving Gaza. They were allowed to cross the Rafah border into Egypt and up to 500 foreign nationals could also be released in the coming days thanks to a deal mediated by Qatar. There are still so many civilians trapped inside Gaza, and human rights groups say kids are paying a huge price in this conflict, that not enough is being done to protect them. Today we hear about one of them. From CNN. This is Tug of War. I'm David Rind.

CNN's Ivana Kottasova is a reporter for CNN Digital and she has been on the ground in Israel talking to the people directly impacted by the military response to the brutal Hamas terror attacks on Israel. She spoke to me on Tuesday night from Tel Aviv.

Ivana, what do we know about how children in Gaza are being impacted by this war?

Well, we know that they are among the groups that are most affected by this war. More than eight and a half thousand people have now died since October seven, since this war started. The number is collated by the Gazan health authorities, which are controlled by Hamas as of the 25th of October, 3000 children or more than 3000 children have been reported killed.

Wow.

So that is a staggering number. And just to put it in context, Save the Children, the charity has said that that number is higher than the number that was annual number of children killed in armed conflict globally in each of the past four years.

Wow so it's just like just a few weeks. We already surpassed a year's total.

Indeed. Yes. So we've seen more children killed in just three weeks than an entire year, which is just tragic. And, you know, the thing about these numbers is these numbers are really, really hard to imagine and comprehend. But we are getting all these stories of these children. Thanks to our colleagues who are in Gaza, who are still on the ground working despite all of what's going on. Hassan Mohammad and Ibrahim, our dear colleagues there, and they're bringing us these stories. And once you start seeing the individual faces and the individual stories, that number just becomes a lot more personal.

Hmm. So tell me a few of them.

I think the one that really stuck with me is, is the story of a three year old girl called Joudi. And she was injured in a strike that hit a car that was next to the car she was in. So her family was fleeing from one neighborhood in the Gaza City to another neighborhood where they thought they'd be safer. And as they were fleeing, they were in a car and the strike hit the car next to them. And Joudi was hit by shrapnel and it got lodged in her head. And the doctors can't remove it. And what they're saying is that she's probably paralyzed and she may never walk again. But, you know, her injuries is absolutely horrifying physically. But when you see her face, when you see her sitting in her bed in hospital, in this little gray dress that she was wearing, it's it had an ice cream cone, picture of ice cream cone on it and said something like sweet and tasty ice cream. And her big curly hair all wrapped in bandages. And she just has this empty stare on her face. She's just looking into space, not reacting to anything that's going on around her.

And her father told us that she hasn't spoken a word in 16 days, and she's refusing to eat and refusing to to drink. All she does is just sit, lie and sleep.

(Arabic).

What did these children do? We have nothing to do with the resistance, he says. They're just targeting Palestinians. They're killing children because they're Palestinian. A lot of them were not humans.

(Arabic).

They don't know if she'll be able to walk again. Judy is one of the lucky ones, if one can call them that. She still has her father by her side.

The thing about Jodi that really, really struck me and that is so heartbreaking is that her parents have shared a video of her from just a few weeks ago. And that video is just a normal happy three year old girl. She's wearing this long princess dress in pink and she's wearing a tiara that is sparkly. And, you know, someone is filming a video and she thinks she's being photographed. So she's sort of posing but looking a bit shy. And she at someone clearly someone behind the camera says, oh, smiles for me, Jodie. And she puts on this big broad smile in her dress and poses for the camera. And and then there's a short clip of her running towards something. We don't know what it is, but it's just that normal way. Three year olds run. And she just looks so beautiful with her big hair and big eyes. And then, you know, you almost cut to the footage from now where she is just sitting motionless on the bed, staring into the distance, not reacting to anyone. And it's just the difference is heartbreaking. It's very, very difficult to watch. And there are so many stories like this. There's so many children who are going through the same thing.

Right. And do we know why we're seeing such, you know, large numbers of children being hurt or killed? Is there something specific to that group that is putting them at such risk?

Well, one reason for that is that there are just very, very many children in Gaza. So Gaza has a population of just over 2 million, and about half of those 2 million people are children. But also children are generally more vulnerable to to these injuries. So if you think about it, if an adult person gets hit by shrapnel, the same size, shrapnel hitting a child's body that's much smaller will cause a lot more relative damage. Right. And Tilden also have a lot less blood to lose. Hmm. So that's another reason they have bones that bend more easily than adult bones. So their injuries tend to be worse and they tend to be more permanent. And then it's also the the mental health like the the trauma that these children are going through is is something that perhaps, you know, I'm not saying that it's easy for adults to process, but it is much harder for children to process.

We'll be right back.

Welcome back to Tug of War and my conversation with CNN's Ivana Kottasova.

We've heard from a 13 year old in Gaza on one of our past episodes. Her name is Nadin. And you know what really struck me, listening to the voice notes that she's been sending back to us is that even though she's a young teenager, she kind of sounds like an adult, like not her voice necessarily, but just the way she comports herself and the way she thinks about the world and kind of constructs her thoughts. Is that something that you've experienced in the course of your reporting, the idea that kids living in Gaza just kind of have to grow up faster, I guess?

Absolutely. Yes. I think every single child that we speak to, they are older or they appear and speak as if they were older. And I think that is just a direct consequence of of their lives so far, if you think about it in advance. She's 13 years old, which means that all she knows is life in Gaza under a blockade under Hamas regime. She never experienced anything else. You have to remember that majority of people in Gaza are not just children, but but adults have never stepped foot outside of Gaza. All they know is this tiny strip of land that is a violent place. If you think about kids who were who are now 17 were born after Hamas took over. And there's been numerous wars with Israel. So these children just it's a never ending cycle of violence and death. And, you know, on on the other hand, that kind of atmosphere, that kind of experience, that just leads to radicalization. And so it's a cycle that is very, very difficult to break. And I think this is something that the Israeli leadership is currently thinking about and possibly struggling with, because if there is no plan for Gaza for afterwards, you will have another generation that has grown up associating Israel with war and death and and pain.

It's like you're saying the war that currently surrounds the children that live there now may have impacts on their mental health, their physical health in the short term, but in the long term could lead to a different way that they live their lives as opposed to if they'd grown up somewhere else.

Absolutely. Absolutely. I don't think any of us can imagine what it's like. I mean, I've covered the war in Ukraine, which, of course, is is very different. But but it's also a war. There's violence. There is bombing, but there are escape routes. You know, we've seen children being sent to safety, to eastern Ukraine. We've seen lots of people seeking refuge in surrounding countries. These children in Gaza, they don't have that option. The families are stuck in Gaza. There is no way to go. So I think it's that hopelessness of there is nowhere safe and there is no end in sight.

Well Ivana thank you very much for bringing us some of these stories. Really appreciate it.

Thank you so much for having me.

Just want to note that the death tolls we talked about here are all according to the Palestinian Ministry of Health in Ramallah, which draws its statistics from sources inside Gaza, which, of course, is controlled by Hamas. The calculations by Save the Children that Ivana mentioned also worked off that data.

Tug of war is a production of CNN Audio. This episode was produced by Anna Staurla and me, David Rind. Our senior producer is Haley Thomas. Dan Dzula is our technical director. And Steve Lickteig is the executive producer of CNN Audio. Special thanks to Matt Wells, Nick Thompson, Anissa Gray and Nathan Hodge. We'll be back on Friday with another update. In the meantime, head over to CNN dot com or the CNN app for the very latest. I'll talk to you later.