Handcuffed and dazed, she struggles to get out of the trunk of the Jeep. She is barefoot and limps. She is bleeding near her temple. Your ankle is injured.
Her gray sweatpants are bloody. She is dragged into the vehicle by her long brown hair at gunpoint. A crowd is watching. The car speeds off.
This is the last time 19-year-old Naama Levy was seen alive, as captured in a video dated Oct. 7. She is among 17 female hostages aged 18 to 26 still being held by Hamas somewhere in Gaza.
Their families fear the worst.
“Time is running out for Naama,” said Levy’s mother, Ayelet Levy Shachar. “Time is running out for the vulnerable young women who are being held hostage by those who torture and abuse them.”
Shachar was referring to mounting evidence of rape, sexual violence and mutilation of women and men during the Hamas attacks in southern Israel on October 7.
But sexual assault does not appear to have been limited to October 7th. Two Israeli doctors who treated released hostages and an Israeli military official familiar with the matter confirmed to USA TODAY that some released hostages revealed that they had suffered violent sexual assaults while in captivity.
All three spoke on condition of anonymity.
One of the doctors noted that “many” of the released Israeli female hostages aged 12 to 48 – there are about 30 – were sexually abused while in detention by Hamas in Gaza.
The doctor did not want to go into more detail about the specific nature of the attacks out of concern for the survivors. The doctor said people who have been sexually abused typically have a mortality rate four times higher than someone who has not been sexually abused.
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The second doctor said that many of the freed hostages showed signs of post-traumatic stress disorder and “came to us as patients with the trauma of those who had witnessed very serious sexual assaults.”
The first doctor said that all freed hostages of childbearing age had been given pregnancy tests and screened for sexually transmitted infections.
The Hostages and Missing Persons Families Forum, a group representing the families of those held by Hamas, recently published a selection of anonymous quotes purportedly from a meeting of some of the released hostages and their families with the Israeli war cabinet.
“First of all, they touch our girls,” a released hostage said at the meeting.
“My mother almost fainted here (during the Cabinet meeting) because she knows what is going on there. She saw what was done to the men,” said the daughter of another freed hostage.
The Israeli military official said that while authorities knew that many women were sexually abused during the Supernova music festival and in their homes on Oct. 7, “they also know that they were raped while in Hamas captivity.”
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The official said that “we know” that the remaining female hostages are being held in “very poor mental and physical condition.” The official said the hostages were being beaten, lacked access to sufficient food, water and medicine and were being held in southern Gaza, where they were moved from house to house, sometimes above ground and sometimes through tunnels, to avoid detection .
The official said some of that information came from statements from the released hostages and other parts of it came from the Israeli intelligence network, which the official declined to comment on.
President Joe Biden, who has sought to balance support for Israel's retaliation against Hamas with concern for Palestinian civilians, has strongly condemned Hamas's reported use of sexual violence against Israeli women and girls. He called it “appalling and unforgivable.”
“We must all, without exception, condemn such brutality,” Biden said at a Hanukkah holiday reception at the White House this month.
Thirty-three American senators wrote a letter to UN Secretary-General António Guterres in mid-December calling on the international body to launch an immediate independent investigation on October 7 into Hamas's use of sexual assault. Volker Turk, the UN High Commissioner for Human Rights He has claimed that Israel blocked his team's investigators.
Five volunteers and first responders who collected the bodies of those killed in the Oct. 7 attacks and helped identify them said they observed several signs of obvious and undeniable sexual assault. These included women who were naked from the waist down, with their legs spread or their underwear ripped. USA TODAY was shown photos and videos that appeared to confirm these claims, which were backed up by forensic pathologists.
“We went from house to house and never knew what we would find,” said Nachman Dickstein, a volunteer with ZAKA, a search and rescue group that works closely with Israel’s military and government.
Israeli medics and morgue workers said many women who died on October 7 were found with broken legs and pelvic bones. They said the severity of the mutilations they investigated was such that it was not always possible to distinguish female from male victims. At least one survivor of the attack, who was at the Supernova music festival near Gaza on October 7, has told Israeli police that she witnessed a gang rape.
Despite this evidence, Hamas has consistently denied allegations that it committed sexual violence on October 7. She claimed the allegations were part of an attempt by Israel to distract from its mass killings of civilians in Gaza. International human rights groups waited two months before finally condemning the sexual violence.
The evidence of sexual violence on Oct. 7 was “overwhelming and irrefutable,” said Carly Pildis, director of community engagement at the Anti-Defamation League, an advocacy group that works to combat anti-Semitism and extremism.
“The voices of so many of these women and girls were stolen by Hamas, but their bodies tell the story,” Pildis said. “Broken pelvis. Mutilated genitals. Brutalized bodies. Then come eyewitnesses who report stories of gang rape, torture and murder.”
Anti-Jewish bias makes it easier for some people not to believe these reports of sexual assault, Pildis said.
“We live in an era where it’s all women, and somehow that philosophy has disappeared very quickly when we talk about Israeli women,” she said. “It's really hard not to see this as deep-rooted anti-Semitism, a deep-rooted bias that makes people not want to believe these voices.”
Still, one of the doctors who treated the freed hostages said determining whether a sexual assault had occurred was no easy task. First, physical evidence in the form of bodily fluids, cuts, and bruises can disappear quickly, while oral statements from victims can take months, years, and even decades to emerge.
“In the first few days after the hostages were released, the main thing they talked about was the lack of sufficient food. Then they started talking about how children were separated and left alone in isolated rooms. Then they talked about Hamas' aggressiveness and how some sick and elderly people were denied medicine. After all, it was physical violence. It happened step by step, as testimonies about sexual violence usually do.”
The doctor said it took decades in Israel for soldiers who were kidnapped and sexually abused during the 1973 Yom Kippur War between Israel and a coalition of Arab countries led by Egypt and Syria to begin speaking about their experiences.
“It is not uncommon for victims of sexual assault to not remember what happened to them for a long time, only to recall details later,” said Jim Hopper, a US-based clinical psychologist and nationally recognized expert on psychological trauma .
Sexual assault is so heinous that some victims simply watch while it happens, he said. Some may feel like they are floating on the ceiling, dreaming or in a movie and therefore may be unaware of what is actually happening to them, Hopper said.
Later, they might encounter something — for example, a specific place, person or event — that acts as a trigger, allowing them to remember specific information stored in their brain about the attack, said Hoppers.
Defense attorneys often point to a victim's delayed memory or inconsistencies in those memories to cast doubt on the victim's credibility. However, research suggests that only 5% of sexual assault reports are false, Hopper said.
Chen Goldstein-Almog, a released hostage held by Hamas in Gaza, told Israeli broadcaster Kan that three women held hostage with her had told her stories of sexual abuse by their captors.
However, Goldstein-Almog, 48, did not say whether she was sexually abused herself.
One of the doctors treating released hostages said one of the clearest evidence of how Hamas might be treating the hostages remaining in captivity was Levy, the bloodied 19-year-old woman who was caught on video walking into the The back of the jeep is crushed at gunpoint.
Shachar, her mother, said she finds it difficult to watch the video of her daughter, who she describes as a “joyful,” good-natured personality who enjoys dancing with her friends, enjoys athletics and dreams of a career in diplomacy .
Every moment was the most indescribable pain Shachar had ever felt, she said. Her heart is broken. Your nights are haunted by absence.
Contributors: Michael Collins and Maureen Groppe. Illustrations by Veronica Bravo/USA TODAY.
If you are a victim of sexual assault, RAINN offers support through the National Sexual Assault Hotline (800.656.HOPE & online.rainn.org).