Hours before families in Gaza lined up on Thursday to start the second phase of an emergency polio vaccination campaign, a deadly Israeli airstrike hit near a hospital in an area where a previous round of inoculations had just concluded.

Health officials have heralded the vaccination program, which began on Sunday and is built around a deal by Israel and Hamas for brief pauses in hostilities, as an unexpected success in the early going. The World Health Organization said the first phase, in the central Gaza Strip, finished on Wednesday and the second, in southern Gaza, began Thursday.

But the limited nature of those pauses was highlighted by the strike overnight, which killed four people and wounded a number of others, including women and children, according to Wafa, the Palestinian Authority’s official news agency. Witnesses said it landed in the courtyard of Al-Aqsa Martyrs Hospital in the central Gaza city of Deir al-Balah, where displaced civilians had taken shelter.

Photos and video taken by the Reuters news agency showed flattened tents and makeshift shelters at the site, with tarps, clothes and other belongings strewed on the ground outside the hospital, one of Gaza’s largest.

“We sought refuge in a safe place, in the courtyard of Al-Aqsa Hospital, displaced and sleeping peacefully, we found nothing but the airstrikes hitting us,” one woman, Iqbal Al-Zeidi, told Reuters.

The Israeli military confirmed the strike, which it said was carried out with attack helicopters, but not the death toll or the proximity to the hospital. It said it had struck a Hamas command center to “remove an immediate threat,” which was “embedded” within a humanitarian area in Deir al-Balah.

“Numerous steps were taken to mitigate the risk of harming civilians, including the use of precise munitions” and aerial surveillance, the statement said, echoing words often employed by the military after airstrikes in Gaza.

The charitable group Doctors Without Borders said it was the fifth time since March that the hospital or its surroundings had been hit.

Israel agreed to the brief, staggered pauses in its military offensive in Gaza to allow health officials to carry out the urgent drive to vaccinate hundreds of thousands of children and avert a deadly polio outbreak. The first polio case in Gaza in 25 years was confirmed last month in a boy less than a year old.

Mediators from the Biden administration, Egypt and Qatar have sought for months to reach a deal on a lasting cease-fire, but the talks have been stalled by multiple disagreements between Israel and Hamas.

For weeks, the talks have snagged on the question of an Israeli postwar military presence in Gaza. But American officials say that another issue has also emerged as a key sticking point: the release of hostages held in Gaza and Palestinians held in Israeli prisons.

U.S. officials say that the two sides have not agreed on how many people each side would set free, nor on who they would be, in the first, six-week phase of a truce.

“The negotiations go into the most difficult issues, some of which are not the ones that stand out in the public discussion,” Jack Lew, the American ambassador to Israel, said on Thursday at the Institute for National Security Studies, an independent research center in Tel Aviv.

Prime Minister Benjamin Netanyahu of Israel has said his country’s forces must keep control of a strip of Gaza along the border with Egypt, to prevent Hamas from smuggling weapons into Gaza. The strip, known as the Philadelphi Corridor, would remain under Israeli military control during the six-week first phase of a proposed cease-fire, but Mr. Netanyahu said on Wednesday that its control would probably go on much longer.

Hamas says a full Israeli withdrawal from Gaza is central to any cease-fire deal. Egypt says an Israeli military presence in the corridor would violate the two countries’ security agreement.

But Mr. Netanyahu pushed back on the idea that the Philadelphi Corridor was the chief obstacle, accusing Hamas of intransigence.

“In fact, while we agreed in May and July and in August to a deal, and to an American proposal, Hamas has consistently said no to every one of them,” Mr. Netanyahu said in an interview with “Fox and Friends” that aired on Thursday. “They don’t agree to anything, not to the Philadelphi Corridor, not to the keys of exchanging hostages for jailed terrorists, not to anything, so that’s just a false narrative.”

Complicating the delicate issue further is the killing of six hostages whose bodies Israeli forces retrieved from Gaza over the weekend, an episode that prompted a public furor in Israel and added more pressure on Mr. Netanyahu to make a deal. The Israeli military said the hostages were killed by Hamas.

On Thursday, Hamas released a video of one of those six hostages, Hersh Goldberg-Polin, an American-Israeli, with the footage recorded while he was still alive. It marked the fourth straight day that Hamas has issued footage of one or more of the six hostages.

The parents of Mr. Goldberg-Polin, Jon Polin and Rachel Goldberg-Polin, released a statement saying, “This must serve as an immediate wake-up call to the world to take action today to secure the release of the remaining 101 hostages before it is too late.”

The latest video release ensures that the fate of the dozens of remaining captives, which has inflamed divisions in Israel, remains in the public eye.

President Biden this week signaled that Mr. Netanyahu was not doing enough to bring the hostages home, and American officials have said both sides had thrown up roadblocks to a deal.

But in public, U.S. officials have focused blame primarily on Hamas for holding up the negotiations. At the White House on Wednesday, a senior U.S. official who briefed reporters on condition of anonymity said that the killings of the hostages had not only injected “a sense of urgency” into the talks but also “called into question Hamas’s readiness to do a deal of any kind.”

The negotiations come as Israel is fighting on at least two other fronts, with Hezbollah militants in the border region with Lebanon and in raids into the Israeli-occupied West Bank, which on Thursday stretched into a ninth day.

Israeli airstrikes killed five Palestinians in the area of Tubas, a small city in the northern West Bank. The Israeli raids have left at least 39 people dead and 145 others injured, according to the Palestinian Health Ministry, as well as damaging homes, roads, and power, water and internet lines.

Israel describes the raids as an effort to crack down on Palestinian armed groups and combat rising attacks against Israelis. The Israeli military said Thursday’s strikes near Tubas targeted armed fighters who hurled explosives and shot at security forces.

Violence has flared in the West Bank since Hamas’s surprise Oct. 7 attack on Israel, which killed about 1,200 people, and the devastating Israeli bombing campaign and invasion that followed. More than 600 Palestinians have been killed in that time in the West Bank, according to the United Nations, as Israel has ramped up military raids there and violence by extremist Jewish settlers has increased.

U.S. officials hope that a cease-fire in Gaza could calm tensions across the region, including the West Bank and southern Lebanon.

Israel is deeply divided between people who want a cease-fire to free the hostages, and those who want the military to continue to pursue and kill Hamas. Even the short pauses in fighting for the vaccination campaign have faced some pushback in Israel.

In the first phase of the vaccination campaign, the W.H.O. inoculated more than 187,000 children in central Gaza over three days. The second phase, which began on Thursday in southern Gaza, is scheduled to last three days. A third and final phase is planned for northern Gaza.

The effort aims to vaccinate a total of about 640,000 children under 10 against the disease. The plan is to give a second dose to each child next month.

Health officials say the war has created the conditions for a resurgence of polio, which spreads by contact with fecal matter. The vast majority of Gaza’s population has been displaced in the war and countless families are living in cramped tents with little access to sewage or clean water.

The World Health Organization says the vaccination program exceeded its target for the first phase by 30,000 children, as more than 2,180 workers fanned out across hospitals, temporary schools and camps for displaced people, visiting tents and areas destroyed by nearly 11 months of fighting.

Raja Abdulrahim and Rawan Sheikh Ahmad contributed reporting.

If the sight of dozens of men accused of raping her, including her husband of many decades, upset Gisèle Pelicot, she did not let it show. She swept into a packed courtroom on Thursday with steely poise, her face composed, her eyes dry beneath sunglasses. Her adult children trailed behind her.

Then, she took the stand and told the court how the life she had built over five decades had quickly unraveled one morning in late 2020, when the police summoned her to a station in southern France. There, they told her that the man she considered the love of her life had been drugging her for almost a decade and inviting strangers to come into their home and join him in raping her while she was comatose.

Under French rules, Ms. Pelicot, 71, could have avoided letting the trial play out in the public eye and chosen to keep it behind closed doors. Instead, she decided it was important for all of France to hear her story and to place the shame on the accused men, rather than on her.

“So when other women, if they wake up with no memory, they might remember the testimony of Ms. Pelicot,” she said in a calm, controlled voice. “No woman should suffer from being drugged and victimized.”

She added, “We must address this scourge.”

The trial in Avignon, which has just started and is scheduled to take four months, has already shaken France. Everything about it seems almost too shocking to absorb — how long Dominique Pelicot is accused of drugging his wife, how ordinary and loving the couple seemed in their retirement, and how many men are accused of raping her.

There are so many men on trial that the court had to build a second glass box in the courtroom for those in custody. They include firemen, soldiers, truck drivers, an IT expert. They range in age from 26 to 74. Many are in stable relationships and have children.

Mr. Pelicot has pleaded guilty to all the charges against him, including aggravated rape and drugging. He is also accused of violating the privacy of his wife, daughter and two daughters-in-law on suspicion of illegally recording, and at times distributing, intimate photos of them. If he is found guilty, he faces up to 20 years in prison.

He hopes to use the trial to explain himself to his now ex-wife and estranged children, according to his lawyer, Béatrice Zavarro.

Standing at a lectern before the row of judges in the courtroom, Ms. Pelicot never showed much emotion. She referred to her former husband formally, as “Monsieur Pelicot.”

As she told it, they fell madly in love at just 19 and were soon married. They’d had three children; seven grandchildren. They’d been together, through some illness, financial problems, and even at least one fleeting affair, but made it through.

Ms. Pelicot told the court that she had trusted him implicitly and said they had what she considered a normal sex life.

“I thought we were a strong couple,” Ms. Pelicot said. “We had everything to be happy.”

After she retired in 2013, they moved from the Paris region to Mazan, a small town in southern France.

There, she said, her husband supported her through a strange, undiagnosed illness. She was losing her hair, losing weight and, most worryingly, losing her memory of some nights and days, she told the courtroom. She would sometimes awake in the morning with no recall of saying goodbye to her children, watching a movie or getting into bed, she said.

These gaps — which she described as “total blackouts” — frightened her so much, she had stopped driving.

“I was persuaded I had the beginnings of Alzheimer’s or a brain tumor,” she said. She had also suffered gynecological problems.

Her husband drove her to appointments with specialists — one of whom did a CT scan of her brain. She was never given a satisfactory explanation.

“I could not have imagined for a single second that I had been drugged,” she said, though later she recalled he once gave her a beer that glowed mint green before he threw it in the sink. She said she now believes he was doing “trials” of ways to drug her.

The reality of what prosecutors say was happening was discovered by chance, after Mr. Pelicot was caught trying to film under women’s skirts in a grocery store. Ms. Pelicot forgave him, thinking it was a rare slip in a 50-year marriage.

Only later would she learn that Mr. Pelicot had been caught doing the same thing earlier, in 2010, and was let off with just a fine, prosecutors said. It was a warning sign she said she never got to see. She said she would have been more vigilant had she known.

“I lost 10 years of my life,” she said. “Those are years I will never get back.”

Mr. Pelicot sat apart from the other accused men in a separate glass box and cast his eyes down throughout his wife’s testimony. He had met most of those men on a notorious, unmoderated French website implicated in more than 23,000 police cases in France that was shut down in June.

He has argued to the police and through his lawyer that all the men knew his wife had been drugged into submission, and followed the rules he established to ensure she didn’t wake up. He filmed the scenes, storing more than 20,000 digital videos and photographs that the police used to track down the accused.

Though one of her lawyers had earlier told The New York Times that the first time she would see those videos would be during the trial, Ms. Pelicot said in court that she had gathered the strength to watch videos in May that would be used as evidence in the trial. It was then, she decided, she needed the trial to be open.

Most of the men on trial have been accused of rape with “many aggravating circumstances,” one being the use of drugs to put her to sleep. Many have pleaded not guilty. Some say they were tricked into having sex with a drugged woman, lured by her husband for a playful three-way encounter and told she was pretending to sleep because she was shy.

Ms. Pelicot responded to those statements in court saying, “They knew exactly what they were doing and what shape I was in.” She noted that one of the accused was diagnosed with H.I.V., though she later tested negative.

She described her bedroom as a “torture chamber.”

“I don’t know how I survived,” she said. “I ask myself how I am standing before you.”

In the days after meeting the police and seeing some of the shocking photos that her husband had kept, Ms. Pelicot said she contemplated suicide. But with the help of her children and friends, she began to slowly gather the shards of her broken life and identity. She sold most things in the home in Mazan and moved elsewhere.

She has divorced her husband and while she is keeping her married name for the trial, she intends to take up her maiden name as soon as it is over, she said.

Notably, since the day she stepped into the police station, she said she has not had a single blackout.

While she seemed strong, and described herself like a boxer who repeatedly stood back up after being knocked down, she also told the court, “inside, there is a field of ruins.”

“I will try to rebuild my life,” she said. “I don’t know how.”

After Boko Haram fighters threatened them, they could not risk staying. Over a decade, the extremist group had killed tens of thousands of people in the cross-border scrubland around them. So the residents of Mafa, a village in northeast Nigeria’s Yobe State, fled in terror.

About two weeks after that evacuation in late July, according to a village leader, a local official told them it was safe to go back.

“The government assured us that everything is OK and nothing is going to happen,” said Mai-Bano Kanembu, the community head of Mafa.

The official named by Mr. Kanembu denies encouraging villagers to return. But return they did.

It was a catastrophic decision that ended last Sunday in fighters killing dozens of villagers, mostly men and boys, and burning Mafa to the ground. At least 170 people were killed, according to Mr. Kanembu and Ibrahim Hassan, a local farmer who helped recover the bodies, and more are missing. A statement listing purported grievances against the village was left at the scene in the name of Islamic State West Africa Province, known as ISWAP, a Boko Haram splinter group.

The attack was a brutal eruption in a conflict with Islamist extremists that has rumbled on for over a decade. Last year, this same group perpetrated three of the 20 deadliest terrorist attacks worldwide, according to the Institute for Economics and Peace’s Global Terrorism Index. But more people were killed in the assault on Mafa than in all three of those attacks combined.

It came on the heels of another major attack in West Africa — on Barsalogho, a town in Burkina Faso, where members of another terrorist group killed as many as 400 people on Aug. 24, according to victims’ relatives.

Boko Haram, founded in the early 2000s, became infamous internationally in 2014, when the group kidnapped hundreds of schoolgirls, known as the Chibok Girls. In 2016, the group split, with one faction, ISWAP, securing recognition from the Islamic State in Iraq and Syria.

After years of factional conflict, ISWAP has recently regrouped, according to the International Crisis Group.

Mr. Hassan, the farmer, said he was returning to Mafa on Sunday after a long day’s plowing when he saw the fighters arrive on dozens of motorbikes, splitting into three groups to surround the village. He hid when he saw them.

When they had passed, he climbed a tree to see what was happening. It was around 4 p.m., and villagers were gathering in the mosque for prayers.

“The next thing we started hearing was rapid gunshots and smoke billowing from all directions,” Mr. Hassan said in a telephone interview.

Another farmer who watched the fighters arrive told Mr. Kanembu that he saw about 50 motorcycles, each carrying two or three men with rifles.

“The insurgents took their time to wreak havoc,” Mr. Kanembu said, explaining that lack of cellphone connection kept the military from learning of the attack for hours.

On Monday and Tuesday, Mr. Hassan and others who had fled Mafa returned to assess the damage and bury the dead. They found every building burned. Bodies surrounded the mosque. Women and young children were alive but deeply traumatized and hungry — everything they owned had been burned. Seven members of Mr. Hassan’s family, including his 15-year-old son Suleiman, had been killed.

“I’ve lost count of the corpses in the village,” Saleh Musa, a community elder, said in an interview. He said 28 bodies were buried in Mafa and 40 in nearby villages, in addition to 34 taken to Babban Gida, the closest town. Many more were still missing, he added. Speaking to journalists on Tuesday at a mass funeral in Babban Gida, a government military adviser insisted, however, that only the deaths of the 34 people buried there had been confirmed.

The fighters strapped some corpses with explosives, targeting those who would recover them, Mr. Musa said.

Those who recovered the bodies also found a long note, which accused residents of collaborating with the authorities and killing Boko Haram members.

“You have been lulled into a false sense of security, mistakenly believing that the Army of the Caliphate’s restraint — our decision not to trouble you, pillage your property, or disrupt your commercial activities and farming — implies weakness,” the note read. “You have grown bold and boastful.”

For years, ISWAP imposed taxes on Mafa, several residents said in interviews. And for years, its members passed through on their way to other towns and neighboring Niger. They spent freely in local markets.

The situation changed earlier this year. Civilians in northeastern Nigeria have in recent years formed vigilante groups to fight Boko Haram. Mafa’s vigilantes began killing the fighters who passed through.

“The vigilantes were making a fortune, because the Boko Haram members move around with huge amounts of money on them,” said Magaji Musa, a villager staying in a nearby town who lost his father-in-law in Sunday’s attack.

But then ISWAP fighters came to the village and issued a warning, Mr. Kanembu said. Immediately, the villagers fled to Babban Gida, where they were allowed to stay in a school compound.

Two weeks later, Mr. Kanembu said, a powerful local official, Baba Umar Zubairu, sent emissaries to instruct them to go back. In recent years, the Nigerian government has been closing camps, forcing displaced people home, in order to create the impression that the situation is normalizing, aid workers and rights groups say.

Mr. Zubairu denied ordering villagers to return, and said that those who returned did so of their own volition.

“Most of the people were not happy with the decision and were hesitant,” Mr. Kanembu said of the order to go back. But, he added, “Ninety percent of the people returned because the military operatives went to the community and combed the surrounding areas to ensure safety.”

The attack came less than a month later.

Police officers in Munich shot and killed a gunman not far from the Israeli Consulate and a museum about the city’s Nazi-era history on Thursday, the anniversary of the terrorist attack on the 1972 Olympic Games in the city, in which 11 Israelis athletes were killed.

The authorities said they were investigating the gunman’s actions as a possible terrorist attack.

The consulate may have been the target, given the location and timing. “It most probably isn’t a coincidence,” said Joachim Herrmann, the top security official in the state of Bavaria, of which Munich is the capital.

According to the authorities, the gunman, who was identified only as an 18-year-old Austrian, drove up in a car, got out and started shooting at patrolling officers with a rifle fitted with a bayonet. The police returned fire, killing the man. No one else was hurt.

“We have to assume that an attack on the Israeli Consulate possibly was planned early today,” Mr. Herrmann told reporters at the scene, according to news reports. The consulate itself was closed for the anniversary.

“For a moment today, Munich held its breath,” said Markus Söder, Bavaria’s governor, during a hastily called news conference. News agencies in Germany and Austria reported that the man, who is from a Bosnian family, was known to the Austrian authorities because of connections to Islamic radicalization.

Thursday was the 52nd anniversary of the attack at the Munich Games, in which Palestinian militants killed and kidnapped Israeli athletes and coaches. After a botched rescue attempt by the German authorities, 11 Israelis and one West German police officer were dead.

The police said the man drove up to the grounds of the Munich Documentation Center for the History of National Socialism around 9 a.m. He got out of his car and started shooting at officers who were on patrol. Police officers hit him when they returned fire.

By chance, a journalist recorded the exchange of gunfire — an exceedingly rare sound in downtown Munich. The police later said the rifle used by the gunman was an old “repeater” rifle that still had a bayonet attached.

With parts of downtown closed to traffic and a helicopter hovering above, the situation was tense as officers rushed to ensure that the man was not part of a broader attack. Some 500 police officers were part of the response, according to Mr. Herrmann.

Nearly 90 minutes after the shots were fired, the police gave the “all clear.”

The police said the man was a resident of Austria and had entered Germany recently.

Frank-Walter Steinmeier, Germany’s president, described the attack as shocking, according to D.P.A., a German news agency. He vowed to stay in close contact with President Isaac Herzog of Israel with further updates on the investigation.

Two years ago the two presidents commemorated the 50th anniversary of the Munich Games attack and Mr. Steinmeier issued a solemn German apology to the families of the victims.

The group of trans women in South Jakarta were putting on their Sunday best. They wore feathers, silk, glitter and long eyelashes. Each one draped a rosary around her neck.

“Pope Francis deserves our best outfit,” Elvi Gondhoadjmodjo said, as the group got ready to catch a glimpse of the pope on Thursday during his visit to Indonesia.

For many trans women living on the fringes of society here, the Catholic Church is a safe haven, and Pope Francis, with his messages of tolerance and openness toward the L.G.B.T.Q. community, has become a personal hero. They were excited by his four-day visit.

“When we got Francis as the pope, I realized that God was really listening,” said Mami Yuli, the leader of the community and a devout Catholic who has a likeness of a rosary tattooed on her chest. “This is not the pope but God himself visiting us.”

At the shelter where many of them live, the group of 10 trans women squeezed into two rental cars and drove to the Bung Karno Stadium in Jakarta, where the pope was going to hold a Mass later on Thursday. They did not have tickets to enter but hoped they could at least get a glimpse of the pope outside.

Their excitement, and the yearslong closeness between the trans community and the Catholic Church in Jakarta, is a stark contrast with less-favorable attitudes from the church in other countries, and with positions some church officials have expressed. But it also showed how Francis’ message of tolerance has echoed in some corners of the Catholic world thousands of miles from the Vatican.

“Pope Francis has called for us several times not to judge them,” said the Rev. Agustinus Kelik Pribadi, the priest of the St. Stephen Catholic Church in South Jakarta. He was referring to the pope’s famous “who am I to judge?” question about gay priests, which many felt reflected his general attitude toward the L.G.B.T.Q. community. “We must listen.”

Catholics make up a very small minority in Muslim-predominant Indonesia. Still, dozens of trans women who were not born into the church have been baptized in Jakarta in recent years. They came from nearly every corner of the country, said the Rev. Adrianus Suyadi, a Jesuit priest at Jakarta’s cathedral.

The ties between the church and the Jakarta trans women community are a result of the work of the city’s archbishop, Cardinal Ignatius Suharyo Hardjoatmodjo, the priests said. The cardinal instructed priests to welcome transgender people into their parishes as part of a push to respect human dignity. Mami Yuli, the leader of the trans community, also lobbied the church.

The result was a rare and fond bond.

“I often went to the salon and have my hair cut with their group,” Father Pribadi said.

But overall, the transgender community still faces rejection and discrimination in Indonesia. Many are still homeless, and others do sex work to survive, community members said.

Once a month, more than 50 trans women attend a prayer meeting at the cathedral, Father Suyadi said. Many frequent cooking classes organized by the church, and two have become instructors.

“When I go to the church nobody judges me,” said Ms. Gondhoadjmodjo, 40, who got baptized in 2022 and said that she had started volunteering as a teacher thanks to the church. “That makes me more sure I want to be a Catholic.”

Mika Horulean, 26, another trans woman, attends Catholic trans-counseling meetings, in which participants discuss their experiences, on Zoom every Friday. “Romo is amazing,” she said, addressing Father Suyadi with a word that means father in Javanese.

Church teachings oppose gender transition, but Francis has long urged clerics to welcome L.G.B.T.Q. Catholics. He hosted a group of transgender women at the Vatican for lunch. He approved a Vatican document that made clear that transgender people can be baptized and declared laws that criminalize being gay to be “unjust.”

But Francis has also walked a tightrope between his personal urging for more openness by the church and upholding church doctrine.

Recently the Vatican issued a document approved by Francis stating that the church believes that transition surgery is an affront to human dignity. The pope also recently used a slur word to refer to gay people, an episode that highlighted the church’s complicated relationship with gender and sexuality.

Even so, South Jakarta’s transgender community has focused instead on Francis’ positive messaging and openness.

“For us, L.G.B.T. people in Indonesia, there is never someone as high profile who sends a message of inclusiveness,” Mami Yuli said.

“He is much braver than the other popes before him,” she said, as she stood by her small shrine in the shelter, with a statuette of Mary and a picture of Jesus. “His message is a message of love and to pay attention to the little people.”

Some resistance remains among Catholic bishops in Indonesia. Father Suyadi said his proposal to the local bishops conference to let Mami Yuli meet the pope was rebuffed.

Bunda Mayora, 37, a trans woman in Maumere, a city in Flores, in the east of Indonesia, is also involved with the local church. She was watching on live TV as the pope met with Indonesian bishops on Thursday.

She was disappointed because L.G.B.T.Q. Catholics had not been invited to the Mass celebrated by the pope.

The disappointment extended to the stadium on Thursday. A few hours after the group of trans women rallied in front of the stadium, policemen prevented them from standing at the stadium’s entrance with their banner of Francis and colorful clothes. The group headed home even before the pope arrived.

“They cannot receive us here,” said Devine Selviana Siahaan, one of the trans women who was at the stadium. “But I still can talk to Francis in my dreams.”

Muktita Suhartono and Sui-Lee Wee and Ulet Ifansasti contributed reporting.

Swedish public health authorities recommended this week that children under the age of 2 should not use any digital media, as parents, pediatricians and governments struggle to respond to the challenges of today’s tech-soaked world.

“We have to take back control,” said Jakob Forssmed, the minister of social affairs and public health, and give children “the ability to have a different kind of childhood.”

The intention of Sweden’s policy — and others like it — is to cut down on distractions, promote healthy development and help preserve the innocence of childhood. But some experts wonder if the guidance — however well-intentioned — may be too unrealistic and too judgmental to stick.

Here’s an overview of the debate.

What are Sweden’s recommendations?

There are four main categories to Sweden’s new screen-time recommendations:

Duration. No screens for children under 2, an hour maximum for children aged 2 to 5, two hours for children aged 6 to 12 and three hours for teens.

Control. Sweden recommends following the age limits provided by social media and game companies, and that parents keep tabs on what their children use.

Sleep. No screens before bedtime, or in the bedroom. (That’s probably also a good move for adults, sleep scientists say.)

Self-reflection. Parents should think about their own screen time, which can cut into their interactions with their children — and set the tone for a child.

In a phone call, Mr. Forssmed described the recommendations as an effort to help families balance physical activity, relationships, schoolwork and sleep, and set healthy habits. He also wants to address what he called a “sleep crisis” for older children, which he said could lead to mental health challenges.

What do other countries suggest for toddlers?

Sweden’s guidance for toddlers and screens builds off similar recommendations elsewhere. Other countries suggest that the youngest children use screens only to video chat with adults they know.

Pediatric health experts in the United States and Ireland recommend no screens before 18 months, save for video chats with adults they know. That jumps to 2 years old for experts in Canada and Australia, which, like Sweden, does not make exceptions for chats.

France may go further. President Emmanuel Macron commissioned a report, which was published in April, that recommended children under 3 have no exposure to screens — including television. (The report is titled “Children and Screens: In Search of Lost Time,” a nod to Marcel Proust.)

What is the rationale behind a no-screens-at-all approach for the youngest children?

Many experts doubt that there is any educational benefit to screen use for children who are still learning to walk, talk, feel, socialize and navigate the world. Some also worry that too much passive screen time could make children less active during critical years.

“From a neurobiological point of view, there’s a massive amount going on in the first years of life,” said Sebastian Suggate, a professor of education at the University of Regensburg in Germany. “There’s just no substitute for the three-dimensional world for that.”

A study of about 7,100 mother-child pairs that was published last year in JAMA Pediatrics found that more screen time at age 1 was associated with developmental delays in communication and problem-solving when the children were between 2 and 4.

“The most educational thing is another human being — who is not looking at a phone,” said Kathy Hirsh-Pasek, a senior fellow at the Brookings Institution and a professor of psychology at Temple University.

What are criticisms of the no-screens policy?

Some researchers think the policy is simply unrealistic. What parent has not handed a fussy child a screen to keep them quiet in public, or to buy some much-needed alone time?

Dr. Suggate said that longer working hours for parents, smaller family sizes, urbanization and a general fear of letting children play alone outside mean that kids are often less able to amuse themselves.

Andrew K. Przybylski, the professor of human behavior and technology at the University of Oxford in Britain, said the bans could be “shaming” parents who have few other options to make a different choice. He also said that the amount of time is less important than the type of activities on a phone.

“It has a flawed part, which is about raw hours, which probably don’t matter,” he said of Sweden’s recommendations. “But it has really good common sense parts to it, which, again, is about the balance of the online world, the screen world and the offline world.”

How about for school-age children?

Sweden’s guidance comes as children begin the new academic year and efforts to restrict their access to screens take effect. In the United States, at least eight states this year have moved to cut down on students’ phone use during school.

Many such efforts were influenced by a report published by UNESCO in 2023 that found that smartphone usage can disrupt classroom learning. The report said that about one in four countries had a phone ban. A year later, it is now 30 percent, Manos Antoninis, the director of the report, said in a phone interview.

“Even just having a mobile phone nearby with notifications coming through is enough to result in students losing their attention from the task at hand,” UNESCO said in a summary.

Sweden does not yet have a policy on phones in schools, Mr. Forssmed said. But it plans to soon, he said.

As Kyiv raced reinforcements to eastern Ukraine to try to stabilize its buckling defensive lines there, President Vladimir V. Putin of Russia amplified his threats against the region on Thursday, calling Moscow’s offensive in the area his military’s “first-priority goal.”

Mr. Putin, speaking at an international conference in Vladivostok, sought to portray his army’s grueling advance in the eastern Donbas region as evidence of a failed Ukrainian military strategy. He largely dismissed Ukraine’s capture of hundreds of square miles of Russian territory in the Kursk region as little more than a distraction that would be dealt with over time.

Kyiv made a mistake, he said, in deploying “fairly large and well-trained units” to the Kursk offensive.

“The enemy’s goal was to make us nervous and worry and to transfer troops from one sector to another and stop our offensive in key areas, primarily in the Donbas,” Mr. Putin said at the conference. “Did it work or no? No.”

Analysts have said that diverting troops was not the only goal of Ukraine’s incursion into Russia, noting that it provided a morale boost and created a buffer zone that Ukraine might leverage in future cease-fire negotiations. It also punctured the notion that Russia was immune from troops invading and capturing its territory.

Mr. Putin, though, declared that “the enemy weakened itself in key areas, and our troops accelerated offensive operations.”

“Most importantly, no actions are taking place to contain our offensive,” he added.

The situation in the Donbas has become increasingly difficult for Ukraine over the last month, particularly in the besieged city of Pokrovsk. The last evacuation train packed with families fleeing the fighting left the city this week and authorities announced on Thursday that service would be suspended indefinitely amid ferocious Russian shelling.

More than 26,000 civilians, including more than 1,000 children, will now be forced to evacuate by car, bus and foot, military administrators said.

Russian forces have sought to seize the whole of the Donbas since 2014, when it led a previous incursion. Thirty months after launching its full-scale invasion of Ukraine and deploying nearly every conventional weapon in its arsenal to seize the territory, the Kremlin has yet to take control of some of the most important cities in the region.

Since last fall, Russia has been waging relentless assaults up and down the eastern front, making only marginal gains while sometimes losing as many as 1,000 soldiers a day, according to Ukrainian and Western estimates.

Long before Ukraine launched its Kursk operation last month, the Russians were making significant progress in the direction of Pokrovsk, a vital logistics hub for Kyiv’s forces.

After more than six months of brutal battles, Russian forces have been able to create a large bulge that extends about 20 miles deep through the center of Ukraine’s defenses in the region, ending about five miles from Pokrovsk.

This push has created new dangers that Kyiv is struggling to address.

Ukraine’s military commander, Gen. Oleksandr Syrsky, told CNN on Thursday that the defense of Pokrovsk is being bolstered and claimed that Ukraine had halted the Russians’ direct assault toward the city, for the moment. Though Russia has not moved any of its best soldiers from the fight in the area, he said, Ukraine’s push into Kursk has prevented Moscow from reinforcing them.

To the north of the bulge, the Ukrainians are still managing to thwart Russia’s push into Chasiv Yar, another Ukrainian stronghold. Bloody urban fighting in another nearby stronghold — Toretsk — has slowed Russian advances in that direction. But the situation remains unpredictable.

To the south, the Russians are stepping up assaults in the direction of Kurakhove and Vuhledar — two towns that play a critical role in the overall defense of the Donbas. If these strongholds were to fall, it could lead to a wider breakdown of the overall defenses in the region.

Analysts say that Ukraine’s bold military gambit in Kursk created a battlefield that is more dynamic than perhaps any time in the past 18 months.

“By redirecting resources away from defensive efforts in the eastern Donetsk region, Ukraine is betting that other parts of the 750-mile front won’t collapse, that it will not lose a large number of soldiers and equipment in Kursk, and that the benefits from its operations in Kursk will outweigh the costs sustained elsewhere,” Michael Kofman and Rob Lee, two military analysts, wrote in an assessment in Foreign Affairs.

President Volodymyr Zelensky of Ukraine has said that he hoped the Kursk offensive would ease pressure on the eastern front. But the success of that strategy is unclear. Instead of redirecting Russian units away from the east to thwart Ukraine’s Kursk offensive, the Kremlin appears to be relying on conscripts and other units instead.

The Kursk operation still holds potential diplomatic benefits, even if not all military goals are achieved, said Mick Ryan, a retired Australian general and fellow at the Lowy Institute, a Sydney-based research group.

“Notwithstanding the failure to draw Russian troops from the Donbas, the Kursk campaign has forced the West to at least rethink some of its strategic assumptions about Ukrainian capacity,” Mr. Ryan said. “It has not, unfortunately, resulted in a shift in strategy from the ‘defend Ukraine for as long as it takes,’ which is a strategy for defeat.”

Mr. Ryan said the Ukrainian plan seems designed to telegraph to Mr. Putin “that Ukraine will retain Russian territory and destroy Russian forces and strategic targets for as long as it takes to achieve the aims.”

Mr. Putin’s theory of victory is predicated on the idea that he can outlast the West’s willingness to provide robust military support to Kyiv while breaking Ukraine’s ability to function by pounding critical infrastructure, throttling the economy and terrorizing the population through punishing missile and drone strikes.

Those tactics were evident in a series of devastating assaults on Ukrainian cities in the last 10 days, including a missile strike in Poltava on Tuesday that killed 53 and wounded almost 300.

Mr. Zelensky has his own vision for how Ukraine could achieve victory and has said that he will present his plan to President Biden — as well as former President Donald J. Trump and Vice President Kamala Harris — when he travels to the United States later this month.

“For our part, we definitely want the war to end,” Mr. Zelensky said this week in an interview with NBC News. The victory plan, he said, “is aimed purely at forcing Russia to end the war.”

That, he has said, can only be done by making Russia feel the cost of the war directly, articulating a rationale for the invasion into Kursk.

While Kyiv hoped that the Kursk campaign would show Western fears of escalation were overwrought and demonstrate that the Kremlin’s “red lines” were illusory, it has not led to a change in U.S. policy prohibiting the use of long-range weapons to hit deep inside Russia. Mr. Zelensky and members of his inner circle have lobbied relentlessly for permission to do so.

Mr. Zelensky said that a sweeping overhaul of his wartime cabinet this week — including the replacement of the country’s foreign minister, Dmytro Kuleba — was part of an effort to bring new energy to the fight, both at home and abroad.

However, the overhaul has largely resulted in filling senior positions with officials who have largely been beholden to Mr. Zelensky for their political rise, making major changes in how Kyiv pursues its strategic objectives unlikely.

After approving the dismissal of Mr. Kuleba, Ukrainian lawmakers voted to appoint Andrii Sybiha as the new foreign minister.

A career diplomat who served as Ukraine’s ambassador to Turkey in 2016, he joined Mr. Zelensky’s administration as deputy chief of staff in 2021 before moving over to the foreign ministry.

It is expected that key foreign policy decisions will remain tightly controlled by the president’s office, a system that is likely to increase criticism against the administration, which has been accused of consolidating too much power within a small circle.

Andrew E. Kramer and Maria Varenikova contributed reporting.

There were young girls, sitting nervous and excited in new clothes under the afternoon sun. There were musicians, dancing and plates of food. There were old handmade knives and bright new razor blades.

For the 30 traditional practitioners of female genital cutting, who swayed to somnolent melodies in their matching print dresses, the event was a little like the mass cutting parties that they and their ancestors had held for centuries, in the forests of the tiny West African nation of Gambia.

These women were prominent practitioners in their communities, and cutting girls provided them with an income and respect.

But this party, in 2013 in the town of Wassu, signified the renunciation of their calling. The women carried signs that read: “I have stopped female genital mutilation,” below a drawing of a girl’s tear-stained face. One by one, they stepped forward and swore never to cut a girl again. One by one, they dropped their knives and razor blades down on a red cloth embroidered with cowrie shells.

For these women, it was the end of an ancient, socially important, and to many, horrific practice.

Or was it?

One of the 30 cutters present that day, a grandmother named Yassin Fatty, would over a decade later become the first Gambian cutter ever to be convicted of female genital mutilation.

Gambia passed a law banning the practice in 2015, but for years, the law was not enforced, and many Gambians continued to support it. When Mrs. Fatty was arrested for cutting girls and convicted last year, there was a nationwide backlash against the law.

Then Mrs. Fatty got caught between two men: a celebrity imam who wanted to make cutting legal again, and an anti-cutting activist with perhaps mixed motives.

A veteran cutter

We traveled to rural Gambia in July to meet Mrs. Fatty. We found her napping, at noon, on a mat in the shade in her family homestead in Bakadaji, the village she was born in. At 96 years old, she had earned the right to nap. For decades, she was her family’s mainstay, growing all the rice they ate and keeping her sons, their wives and their brood of children in line. But now she was tired, and her legs hurt.

We moved to a room to talk, her son and grandsons sitting around us.

“Now, my only job is to eat,” she said, her eyes twinkling. Then she turned to Mariama Souso, her adopted daughter, and inquired when her next meal would be.

Girls have always been cut in Bakadaji, a tight-knit village in Gambia’s Central Rivers Region where teens sit under trees trying to load their WhatsApp messages, men zoom off on their motorbikes to go fishing, and the muezzin calling the faithful for afternoon prayers, despite his valiant efforts, often manages to attract only a knot of old women.

And for decades, Mrs. Fatty — whose age is apparent not in her barely wrinkled skin but in her earlobes, split and scarred from long-departed earrings — was the one who cut them. Thousands of them.

“We found the practice here,” she said. “Our parents did it.”

She always cut the girls in an outdoor bathroom, she said, and immediately after, brought them to the rough-walled, unpainted room we were sitting in. We looked around. Worn fabric hung from the entrance in place of a door. The only furniture was a simple wooden bed and a bench covered in a piece of cloth, embroidered with the words “I love you.”

In Gambia, female genital cutting usually means removing the clitoris and part of the labia minora, and sometimes sealing the vagina shut except for a tiny hole. To outsiders, it seems unspeakably cruel.

But many Gambian villagers see girls who are not cut as unclean, and unreligious. These girls often become social outcasts. No man will marry them. Nobody will eat their cooking.

But Mrs. Fatty believed that the consequences of not being cut went much further than that. She asserted, against all medical evidence, that by cutting girls, she was also protecting their health. Uncut women are more likely to suffer and die in childbirth, she said, and are more likely to get sexually transmitted infections. (The opposite is true.) And then there was the sexual desire of women who still had clitorises, which many people in Bakadaji thought was a huge problem.

“If a woman is not cut, she’s always ready for sex,” Mrs. Fatty said, with a hint of a smile. “She can do it from morning to night.”

From his spot on the packed dirt floor, one of her grandsons, 24-year-old Abdoulaye Cham, piped up. Cutting girls prevented them from cheating on their husbands, he said. “A lot of young men travel and leave their wives here,” he added.

Another grandson, 23-year-old Masanneh Cham, dressed in skinny jeans, put forward a different argument, one espoused by several influential imams and their flocks, and spread on Facebook and WhatsApp.

“Whoever fights female circumcision is fighting God,” he said.

The lion man of Gambia

When Mrs. Fatty’s grandson cast opponents as godless, he had someone in mind. This was Momodou Keita. Mr. Keita was a heavyset, often affable man in his 50s with a liking for Coca-Cola, known for his decades fighting female genital cutting. He zoomed around the Central Rivers Region on his motorbike, persuading cutters like Mrs. Fatty to stop, and take part in the dropping-the-knife events held by the organization he worked for, the Gambia Committee on Traditional Practices Affecting the Health of Women and Children, known as GAMCOTRAP. In a series of evening interviews at our guesthouse, he told us how he worked.

He had signed up hundreds of cutters over the years, he said, pulling posters featuring their faces, like mug shots, from a leather folder he always carried. Each woman was given money to start a business, as an alternative income source. Mrs. Fatty got cash to start a bakery, operated by her youngest son, which made the family good money, especially during the holy — and carb-heavy — month of Ramadan.

Before she attended the dropping-the-knife ceremony, Mrs. Fatty was shown a video about the consequences of cutting for women’s health. She attended a few days of an awareness-raising program on cutting organized by GAMCOTRAP, with the blessing of Bakadaji’s village chief. But beyond that, there was little attempt to change her mind.

After he recruited and educated the women, Mr. Keita had informants keeping tabs on each of them. He was proud that none of the women, according to him, had ever gone back to cutting — and took much of the credit.

“I am the lion man of The Gambia!” he said in one of our interviews, after detailing his credentials in the fight against cutting. “I am the gorilla of The Gambia!”

He and Mrs. Fatty had, in the years since her renunciation ceremony, struck up an unlikely friendship. Mr. Keita often stopped by her house. He shot the breeze with her and her sons. He drank glass after glass of attaya — sweet, frothy green tea.

“It was just casual chat, he never asked about circumcision,” Mrs. Fatty said. “I even gave him chickens, sometimes.”

But then, in late 2022, Mr. Keita said, his informants told him something was brewing in Bakadaji. Mrs. Fatty was going to cut eight girls, they said. He immediately drove to her home, he said, to warn her not to proceed.

“Proper monitoring is on you,” he remembered telling her. “You will be arrested.”

“She said, ‘Me? I will never ever do it,’” he recounted.

But on Jan. 16, 2023, an informant called again. The cutting was going ahead that morning, the informant said. Mr. Keita jumped on his motorbike.

When he arrived at Mrs. Fatty’s home, babies were screaming inside.

He had come too late. Mrs. Fatty had already cut two baby girls. He saw a woman running across the field away from the house, a third baby in her arms, but he couldn’t catch her.

He turned to Mrs. Fatty.

“I told her, for these girls, this thing will not end between us,” Mr. Keita said.

Then Mr. Keita called the police.

Cutting in secret

As the moon rose one evening, we walked through Bakadaji’s alleyways, stopping at two family homesteads full of children and young teens playing raucously, eating dinner, cuddling with their fathers and disappearing into clouds of soapsuds as their mothers washed them before bed.

Even after the dropping-the-knife ceremony, Mrs. Fatty had secretly cut girls, she and family members told us. Over the years she had cut every girl in these two homesteads, their parents explained, except one — a 2-year-old girl named Nyara Kebbe, who played quietly in a pink bathing suit. This was the girl who Mr. Keita had seen in the arms of her fleeing mother but was unable to catch.

Mrs. Fatty had been given a bakery to lure her away from cutting, which, it was assumed, she practiced for the income. But Mrs. Fatty said that for her, cutting was a belief, and the threat of prosecution meant little to her.

“Even if you bring a bag of money, I won’t stop what I found my grandparents doing,” she said. “I don’t do anything just because I’m told to by outsiders. I listen to myself.”

And she claimed that although she’d attended the 2013 dropping-the-knife ceremony, she didn’t drop her knife or make any vow — a claim contradicted by GAMCOTRAP staff who were there.

Experts say that many practitioners are now cutting in secret, and cutting younger girls, who are less likely to remember. In 1991, Gambian girls were cut on average at age 4; now, they are usually under 2, U.N. estimates show.

Despite the millions of dollars spent by U.N. agencies and American and European donors on programs to curb cutting in Gambia over the past three decades, and even though it has been illegal to cut girls since 2015, there has been almost no change in the rate of cutting, which stands at 73 percent of girls ages 15 to 19.

Dramatic change takes decades, said Claudia Cappa, UNICEF’s lead expert on global trends in cutting. “It’s a social norm. It links to identity, it links to sexuality,” she said. “These things don’t change overnight.”

Gambia’s first convicted cutter

When the police arrived, they arrested Mrs. Fatty along with the mothers of the two babies Mr. Keita found, screaming and bleeding, in her house. The babies were treated in the hospital and slowly healed, though the permanent damage was done.

The whole family was worried about Mrs. Fatty, who was released on bail but was bewildered, and could barely manage the arduous motorcycle trips to report at the police station.

And they could not believe how, in their view, Mr. Keita had turned on them.

To the outside world, Mr. Keita looked heroic — the man who had dedicated his life to fighting cutting, who dramatically caught Mrs. Fatty in the act, and thus, according to him, saved several girls from being cut.

But Mrs. Fatty and her son Abdou Cham now say that Mr. Keita was a fraud. He never cared about cutting or protecting girls, they said, and told them to take the money from the Westerners who funded GAMCOTRAP while doing as they pleased — something Mr. Keita denied.

“Circumcision cannot be eradicated in this area,” Mr. Cham remembered Mr. Keita telling his mother. “You can do this in secret. Nobody will find out.”

The way they saw it, Mr. Keita was interested in nothing but money — and that was why he had latched onto a Western-funded organization campaigning against cutting.

At the police station, as Mrs. Fatty waited to be booked, Mr. Keita confirmed their suspicions, Mr. Cham and two male relatives said. He approached them, they said, telling them he could “kill the case” in exchange for a bribe. They complied, and gave him money then and more two weeks later — a total of 5,500 dalasi, about $80, they said. Mrs. Fatty’s adopted daughter and devoted caretaker, Ms. Souso, said she saw the money change hands.

In an interview, Mr. Keita vehemently denied soliciting or taking any bribes.

But an official familiar with the case, who spoke on the condition of anonymity to avoid reprisals, confirmed the family’s account.

Mr. Keita was charged with obtaining money under false pretenses, but the charges were later dropped. Mrs. Fatty’s family was advised to bring a civil suit instead, as the police did not consider the matter to be a criminal one, according to the official familiar with the case.

And Mr. Keita did not kill the case. That August, Mrs. Fatty and the two mothers stood trial. All three pleaded guilty. All three were convicted and fined 15,000 dalasi each (about $215).

The celebrity imam

The costs of the whole affair — the fines, the alleged bribes, and the gas costs of traveling to and from the police station and court — almost bankrupted Mrs. Fatty’s family members, who mostly work as subsistence farmers.

But the trial also attracted the attention of a powerful distant relative.

Abdoulie Fatty, one of Gambia’s best-known imams, was outraged when he heard what his 96-year-old cousin had been subjected to.

The right of Gambians to cut girls was a cause Imam Fatty had long and loudly espoused. He falsely claimed that female genital cutting carries no health risks. He called those trying to stop it enemies of Islam. And he accused the West of imposing its culture on Gambia.

With several Gambian lawmakers, he started campaigning in earnest for the country’s Parliament — or its Supreme Court — to decriminalize cutting, using Mrs. Fatty’s travails as a rallying cry.

The resulting national debate sometimes verged on culture war, and had some surprising effects in conservative Gambia, which is 96 percent Muslim. In urban areas, people were suddenly speaking openly — in person and online — about clitorises and women’s sexual desire.

Imam Fatty himself went on a talk show on Kerr Fatou, one of Gambia’s best-known websites, to suggest that men rub their wives’ nipples as an alternative to clitoral stimulation.

In villages like Bakadaji, and families like Mrs. Fatty’s, steeped in tradition, Imam Fatty’s message added to the impression that cutting was sanctioned by Islam — something many Muslim clerics and scholars say is not true.

The imam changed the financial fortunes of Mrs. Fatty’s family.

He visited her in Bakadaji, paid all three women’s fines, and relayed donations from some of his followers in the United Kingdom, which they used to build a cinder block wall around the back of the homestead, where Mrs. Fatty usually cut girls.

The support of such a prominent figure emboldened Mrs. Fatty. But her arrest and trial had weakened her, and though she talked a good game, her family doubted she would ever have the strength to cut again.

It would be the end of a long era. Mrs. Fatty inherited her vocation from cutting practitioners on both her mother’s and her father’s side.

Now, she said, “I’m the only one left.”

But she confided something before we left Bakadaji, as evening deepened, as men came back from fishing.

She pointed to Mariama Souso, her adopted daughter. She has chosen her as her successor.

Susan Beachy contributed research.