Trauma and despair on the increase in besieged Gaza

Cases of trauma and acute despair are being seen more often by medical professionals across the besieged Gaza Strip. Almost every family, it is claimed, is affected, and the problems are leading to a marked increase in suicide attempts.

According to Dr Ayman Sahbani of Gaza City’s Al-Shifa Hospital, most of those trying to kill themselves are under 30 years of age. Local officials say that there are between 30 and 40 suicide attempts every month, and the figure is expected to increase. “We see young people who have swallowed rat poison and pesticides, overdosed on medication, cut themselves or jumped off high buildings,” said Dr Sahbani. “There are also shootings, self-immolation and hangings to deal with.”

Survivors are often helped by staff at the Community Mental Health Programme in Gaza. Psychologists there speak of a “sense of hopelessness”, particularly among the young, which is exacerbated by the effects of the Israeli-led siege, which prevents students from travelling abroad for study and work and has destroyed the local economy. Gaza has a very high population of young graduates who are out of work; the siege and military invasions have targeted factories, farms and other means of production. “There is a tremendous need for psychological support in Gaza,” said CMHP officials.

In fact, UNICEF reported in September that 430,000 children are in need of such support immediately. The cost of failing to treat children suffering from Post-Traumatic Stress Disorder and Complex PTSD is far too high. Doctors point out that they can set broken bones, but when it comes to rebuilding someone’s psychological integrity, this is something else. “Israel and its supporters in the West don’t understand this,” they claim. “They’re creating psychological damage for these kids that will be with them for the rest of their lives and will be carried through the generations.”

Dr Lena Geha is a trauma expert at the Palestine Trauma Centre; she points out that there are nowhere near enough mental health facilities in Gaza to meet the growing demand for their services. “We can’t even help those with long-standing issues, let alone those who have been traumatised recently,” she insists. “That is even when they have the courage to overcome the stigma of mental health and seek psychological support.” Adding that Palestinian children are constantly traumatised as a direct result of Israel’s brutal policies, she points out that those in the Gaza Strip are exposed to more violence in their lifetime than any other people, any other children, anywhere in the world.

A Palestinian child born in the year 2000, for example, has lived through the Second Intifada, the internecine war in 2006, and the Israeli bombardments of Gaza in 2008/9, 2012 and 2014, as well as almost daily incursions, bombings and deliberate low flying by Israeli jets and helicopters intended to strike fear into the civilian population. “That’s fourteen years of Israeli air strikes, fourteen years of family and friends being killed, one by one, or sometimes 25 at a time,” Geha points out. “Fourteen years of constant trauma-inducing horrors, ranging from daily realities of the blockade and occupation, to seemingly bi-annual outbursts of carnage.”

Although a 2009 study by Dr Abdul Aziz Thabet and his colleagues at the Community Mental Health Programme estimated that 98.3 per cent of children were suffering from trauma, that figure is now said to be 100 per cent. “It’s a logical conclusion to make,” he says. “There isn’t a single Palestinian in Gaza who wasn’t traumatised by the Israeli war crimes this summer.”

Extreme poverty persist in Gaza, and people are ashamed of relying on food aid. Even before this summer’s invasion, the UN Relief and Works Agency (UNRWA) said that 80 per cent of the Palestinians in the coastal territory were dependent on aid. Despite the alleged “easing” of the siege by Israel, that figure is now 100 per cent; nothing gets in without Israeli permission, even via the Rafah border crossing with Egypt. The government in Cairo has destroyed the smuggling tunnels which Palestinians were using to break the siege and get essential food and medical supplies; the tunnels were described by journalists as “Gaza’s lifeline”.

“In all studies of disaster and war crisis,” says Dr Jenifer Leaning of Harvard University, “the fundamental feature that protects the children from serious psychological stress is their confidence that their parents or grandparents will be able to protect them and hold them. If they can get the sense that the parent is OK, then they will be OK in the long-term.” In Gaza, though, that certainty is not there. “There is a deliberate and total destruction of the structures for psychological stability of the parents,” adds Dr Leaning, “and grandparents are also suffering greatly. The ongoing Israeli violence and lingering occupation keeps uncertainty for any normal future for Gaza. With Gaza, there is an extraordinary series of acute stress on top of chronic stress.”

This means, says journalist Mohammed Mattar, that people say goodbye instead of goodnight when they go to sleep. His sister used to sneak into his room during the Israeli attack on Gaza in July-August because she was too scared to be alone. “I remember where I was when I heard the news about the death of my cousin,” he explains, “and then the death of another cousin; and then the death of yet another cousin; and then the death of my neighbour; and then the death of my best friend; and then the death of my first ever girl-friend; and then the death of another friend and yet another neighbour; it was a never-ending cycle of violence and with every loss I cried, my family cried, my friends cried and Gaza cried.”

The Palestinians are waiting for international promises about peace and rebuilding the shattered Gaza Strip to be fulfilled. As the media spotlight has shifted elsewhere, however, they could have a long wait before that happens. In the meantime, to the great shame of us all, the cycle of violence despair and trauma looks set to get worse.

The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Middle East Monitor.