The day his mother and brother died is permanently one that eight-year-old Iraqi Ziad Irhaima will never forget, as the cauterised stump of one of his arms serves as a permanent reminder.
Irhaima's lost family members are only two of the countless and largely anonymous victims of the more than four years of bloodshed that has convulsed Iraq and inflicted deep and lasting wounds on its children.
The UN children's fund UNICEF has called for an additional 42 million dollars to fund child health initiatives and warned of the dire state of children's health in the war-torn country.
The spectre of disease is all the more frightening because of the gutting of the country's public health system, which has suffered from a mass exodus of doctors and other trained professionals. The violence and displacement has also cut off thousands of families from health care, preventing children from receiving treatment for the physical and psychological wounds inflicted by the appalling violence.
"I will never forget the image of my mother and brother lying on the ground covered with blood," Ziad says, referring to the aftermath of a car bomb intended for the local courthouse in his hometown of Kirkuk, north of Baghdad.
His physical injuries will not prevent him from one day leading a relatively normal life, but the psychological impact of the attack will last a lifetime, as it will for thousands of Iraqi children.
Nawzad Mahmud, nine, escaped a similar car bomb with only a wound to his right leg, but when the dust cleared he was surrounded by the smouldering corpses of four other children.
"Nawzad is bitter. It was so frustrating for him to see the other kids at school that he quit," said his father, Mahmud Shakir. The relentless violence in Iraq will leave behind not only an entire generation of traumatised children like Nawzad, but hundreds of permanently disabled children without proper medical care.
Abdullah Mahmud, seven, is disfigured from mortar shrapnel that tore through him flesh during a firefight in the northern town of Samarra. His posture is twisted because of a fractured pelvis and he can not move his hand.
"My son cannot study or play with his peers because of his handicap," his father Mahmud Ahmed said. "Our children have paid a high price for the struggle here."
"Thirty percent of registered handicapped children were the victims of car bombs and roadside bombs," said Qamar Abdul Rahman, who heads the Red Crescent in Baghdad. "There are desperate cases, some that cannot be treated in Iraq."
While the trauma wards of the country's hospitals are regularly flooded with patients, the Iraqi health care system is declining as doctors join the mass exodus of qualified professionals.
"We do not have enough staff or equipment in our hospital that meet the needs of the patients and victims we receive," said Abdul Hamid Rashid, a doctor in Samarra's hospital. The lasting wounds inflicted on children in Iraq cut across the country's bitter sectarian divide. In Ramadi, capital of the restive Sunni province of Anbar to the west, Yas Khidhir, nine, was paralysed from the waist down after he was caught in the crossfire between US forces and insurgents.
"I had just left school and was surprised to find myself on a battlefield. I got hit in my back and now I am paralysed," said Yas from his wheelchair. In the southern city of Basra, Hassan Nasir, six, was paralysed on his right side when shrapnel struck him during a clash between Shiite militiamen and British forces.
"I put Hassan in Al-Sadr hospital, but his situation did not improve after two months there. Then British forces treated him at their own hospital, but his handicap is permanent," said the boy's father, Nassir Hassan. In the Shiite holy city of Karbala, Ali Murtadha, 10, had shrapnel tear through his leg when mortars slammed into his primary school.
"His injury is critical, and it may force us to amputate his leg," said Dr Abdul Razeq Khalaf. "Locally, we do not have adequate capabilities or the medical equipment to save this child." Orphaned by a conflict that grows more tangled every day, some of the children of Iraq's war are resorting to embracing the violence around them.
In restive Diyala province, northeast of Baghdad, some children have joined insurgent groups, according to the UN's International Organisation of Migration. "It was reported that some children and adolescents have joined the local insurgents or militia either for money, protection or revenge for incidents against family members," it said in a 2006 report. "There were also reports of an increase in drug use among children who lost their parents," it added.
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