Until the past week, Samar Hassan had never glimpsed the photograph of her that millions had seen, never knew it had become one of the most famous images of the Iraq war.

"My brother was sick, and we were taking him to the hospital and on the way back, this happened," Samar said. "We just heard bullets.

"My mother and father were killed, just like that."

The image of Samar, then 5 years old, screaming and splattered in blood after American soldiers opened fire on her family's car in the northern town of Tal Afar in January 2005, illuminated the horror of civilian casualties and has been one of the few images from this conflict to rise to the pantheon of classic war photography. The picture has gained renewed attention as part of a large body of work by Chris Hondros, the Getty Images photographer recently killed on the front lines in Misurata, Libya.

The photograph of Samar is frozen in history, but her life moved on, across a trajectory that is emblematic of what so many Iraqis have endured. In a country whose health care system has almost no ability to treat the psychological aspects of trauma, thousands of Iraqis are left alone with their torment.

Now a striking 12-year-old, Samar lives on the outskirts of Mosul in a two-story house with four other families, mostly relatives.

The household is a cramped bustle of activity as women cook and clean and children scramble about. Samar's older sister, Intisar, and her husband, an unemployed former police officer, care for her. Two of his sons are policemen, and their salaries support the extended family.

The pains of war have been visited on thousands of Iraqis, but even here Samar's story stands apart. Three years after her parents were killed, her brother Rakan died when an insurgent attack badly damaged the house where she lives now. Rakan had been seriously wounded in the shooting that killed their parents, and he was sent to Boston for treatment after Mr. Hondros's photos were published. An American aid worker, Marla Ruzicka, who helped arrange for Rakan's treatment, was herself later killed in a car bomb in Baghdad.

Intisar's husband, Nathir Bashir Ali, suspects his house was bombed by insurgents as retribution for sending Rakan to the United States. "When Rakan came back from America, everyone thought I was a spy," he said.

Samar left school last year because she was too shy and not doing well, Mr. Ali said, although Samar said she would like to return and hoped to be a doctor when she grew up. She leaves the house only on infrequent family excursions and has two friends who visit to play with dolls and chat. She spends her days cleaning, listening to music on her purple MP3 player and watching episodes of her favorite television show, the Turkish soap opera "Forbidden Love," about lovers named Mohanad and Samar.

"I am Samar," she said, wearing a long red dress and sitting on the couch next to Mr. Ali. Two of her siblings, also in the car when their parents were killed, sat nearby.

"I've taken them many times to the hospital, where they get pills" for emotional problems, Mr. Ali said. "All of them take pills."

He says Samar's 8-year-old brother, Muhammad, talks to himself when he is alone. "When we go out and see a family, they get sad," he said. Sometimes he finds the children in a room together, crying. "When they remember the accident, it's like they just died."

The photo of Samar had far-reaching impact, for it was visual testimony to a particular scourge of this war: the shooting of innocent civilians as they approached American checkpoints or foot patrols, killings made possible by liberal rules of engagement aiming to protect soldiers from suicide car bombers. The image was a point of discussion at the highest reaches of the Pentagon as it considered ways to reduce civilian casualties.

The Iraq war delivered few singular images for the popular imagination, partly because the country was too dangerous for photographers to move around freely, but also because in an age of saturated media coverage and short attention spans, it may be more difficult for news images to take root in the collective memory.

The military also set strict rules for embedded journalists that kept many graphic images from the public eye; the military asked Mr. Hondros to leave his embed assignment after he shot the pictures of Samar.

Liam Kennedy, a professor at University College Dublin, researches conflict photography and uses Mr. Hondros's image of Samar in his class as one of the few photos from the Iraq war that could stand out in history, comparing it to the famous Vietnam image by the Associated Press photographer Nick Ut of a young girl running from a napalm attack.

"It really seems to say something of what's going on at the time," Professor Kennedy said. "All the arbitrariness of the violence that was going on at that time is summed up by that girl."

Sarah Leah Whitson, director of the Middle East and North Africa division for Human Rights Watch, keeps a copy of the photo on a bulletin board in her office in New York. She remembers crying when she first saw the photo in a newspaper, and having to explain the image to her children.

"At the time, I thought it captured perfectly the horrors of the war that was not really understood by Americans," she said. "Everything in that girl's face symbolized what I felt all Iraqis must feel."

She added, "I kept thinking, ‘I wonder what life will be like for this girl?' "

Mr. Hondros spoke about the photograph in a 2007 interview with the syndicated news program "Democracy Now."

"I think one of the reasons the photo had this sort of resonance that it does is because it has a sort of empty feeling," he said. "You know, the poor girl, all alone in the world now, just standing there in the dark."

This week Samar, hugging a pillow to her chest, recalled: "He was taking pictures of me, I remember. Then he stopped, and they brought me a jacket and put me in the truck and treated the wound on my hand. And they gave me some toys."

She had never seen the picture until this week, but she said she understood that it showed the world "the sad thing that is happening in Iraq."

Near the end of the interview, she pointed to a family photograph on the wall. "I always dream about my father and mother and brother," she said.