"I ask myself, what's the point behind all of this and then I fall asleep."
Such is an excerpt from a short story by 22-year-old Mohanned Younis, a young writer and pharmacy graduate who committed suicide at the end of last month by inhaling poisonous gas. Having tried to leave the Gaza Strip numerous times to advance his writing career, he eventually fell into depression, and finding no apparent use to his life, took the decision to end it.
Younis' case is not an isolated incident. Reports of suicide in Gaza have grown increasingly common; whilst there are no official statistics on the issue, health officials in the Gaza Strip say they are aware of 200 to 300 suicides taking place in the past two years. Other data considers that a conservative estimate, with contributors to grassroots NGO We Are Not Numbers (WANN) noting 80 suicides per month in January and February 2016, an increase of 160 per cent compared to previous years. In some neighbourhoods, suicides have become a weekly occurrence.
Anas Jnena, a writer at WANN, notes how such incidents were unheard of some years ago.
When I was a teen, I never heard about anything like suicide, I never even knew what suicide meant, probably only in books. But it was so far from something to comprehend, until it became more regular and common in Gaza.
The primary cause of the increase is no mystery. Blockaded by Israel since 2007, Gaza is the world's sixth most densely populated area. Scant resources and an inability to escape have chipped at morale, leaving citizens feeling trapped.
As the siege surpasses its tenth year, the Strip has been declared "unliveable" by numerous human rights organisations; three years earlier than the UN had predicted. Today the Strip faces an energy, water and healthcare crisis. Residents are only receiving a maximum of two to four hours of electricity each day, making fresh water and sewage systems inoperable. An estimated 40 per cent of necessary drugs are also unavailable or will be depleted within a month, while patients requiring urgent treatment are prevented from leaving the world's largest open air prison.
Earlier this month the Popular Committee against the Siege on Gaza found that eight out of ten Gazans were living below the poverty line. With no sign of the blockade ending, the economy has been unable to bear the cost and unemployment has exceeded 42 per cent.
The hopelessness is only added to by the continued dispute between Gaza Strip authority Hamas and Fatah which runs the Palestinian Authority in the West Bank. Despite many attempts being made to reconcile the two parties, both remain resolute, although for now Fatah seems to have succeeded following Hamas' dissolution of the administrative committee in the Strip. Meanwhile, the people of Gaza remain trapped in between, struggling against the inevitable.
Youth under siege
More than half of those who live under siege in the Gaza Strip are under 18 years of age. A rise in depression has particularly been noted amongst the youth who, having attained high educational levels despite the Israeli blockade, now find that their skills have no use and they are unable to leave. The Strip has the highest rate of youth unemployment in the world, with 58 per cent of people under 30 out of work in the long term.
"Many of those who tried to commit suicide, in the cases we managed to interview are highly educated; they are all university graduates with no hope of finding jobs," says Ahmed Abu Tawahina, the director general of the Mental Health Promotion and Capacity Building Centre which runs several clinics in the Strip.
Life in Gaza is really difficult, so they are trying to quit it.
Over half of Palestinians in the Gaza Strips who took part in a WANN study were tested as likely to have clinical depression. The reason cited by most young people were an inability to travel outside Gaza, followed by continual power outages, the lack of employment prospects and the threat of Israeli attacks.
The study also noted the sadness young Gazans felt when they observed other people's lives outside of the Strip; one respondent reported suffering from chest pains when scrolling through social media and commented: "All I could think about was my own sorry situation compared with the way other people in the world get to live."
Suicide across the Palestinian territories more generally has been documented in previous years, and whilst not every death has been a result of the socioeconomic situation imposed by the Israeli occupation, it has always compounded other problems present in society. Whilst studies have shown that women who attempt to commit suicide are often victims of domestic abuse or are depressed because of family issues, the occupation has meant that they rarely have access to organisations or equipped hospitals where they can seek help.
Similarly, the pressure for men to financially provide for their families is one that often leads to misery for many as they are perceived as useless by their relatives and wider society. WANN's Jnena seconded this as a cause in Gaza, and also identified the generational rift between many young men and their fathers as a cause of conflict.
"There is really a big gap between how our fathers think and perceive things, and how we do…. It can always create misunderstandings and misunderstandings grow."
A cry for help
It is not simply the rise in suicides that has been noted in Gaza, but the way in which the deaths occur. Public displays of suicide have become a norm, a trend which Jnena considers a cry for help from those suffering from depression.
"Most of them [recent cases] have been in public places, or something like that, and it's more like crying out 'I'm here, I need your attention', unlike someone who is mentally ill who would do it at midnight and would not let anyone see him. People are trying to burn themselves in the street, why in the street and why burning?"
Yet help for those suffering from depression is not easily available. Those caught trying to attempt suicide are sent to trial; one Gazan lawyer reported seeing cases brought before the courts on an almost daily basis at the end of last year. Yet convictions are not coupled with any kind of therapy, pushing victims further into their despondency.
According to Abu Tawahina, there is a huge lack of professionals with the expertise to deal with mental health issues in the Strip; similarly the Ministry of Health and the UN's Relief and Work's Agency (UNRWA) do not offer substantial services to deal with those attempting suicide. There is also a lack of consistency in the way the issues are treated, complicating conditions later on.
"It [treatment] is being provided in an episodic way. If any of the NGOs had a project for ten months, one year or so, they would take care of certain phenomena. But at the end of the project they will leave it, they give up. And this is another risk factor for deepening and creating new psychological problems."
Although a societal stigma does exist in seeking treatment, Abu Tawahina emphasises that for the majority of sufferers, the desire to receive support is there.
"All of those we interviewed so far … are really willing and looking for some help to be able to build up their own internal resiliency, where they can cope better with their daily lives. Generally speaking, and based on our clinical experience, the will to live is there."
But Gaza is a unique case, and Abu Tawahina stresses the need for prospective solutions to address the individual circumstances the people of the Strip is facing.
"When we talk about Gaza, we are talking about a traumatised community; so the approach that should be used to meets such massive needs for mental health services, should not only rely on the one-to-one approach, which is the case among the majority of service providers," he explained.
Some professionals use the 'safe place technique' – of course there is no safe place in Gaza Strip. When you ask any of the clients to think of a safe place in the Gaza Strip, they couldn't think of anywhere … they couldn't feel safe. So these techniques should be re-standardised in a way to respond to the norms.
Life in Gaza is reaching breaking point. Jnena speaks of the pessimism of young Gazans, even those whose financial situation is above average or are employed. The widespread poverty around them, the limitation of prospects and the helplessness that comes with being trapped has hollowed many of the youth of all optimism and determination. Abu Tawahina's services are helping those suffering with mental health issues, but the continuing siege puts all medical services at risk.
Unless the blockade comes to an end soon, Israel can add stripping the happiness and potential of an entire generation of Gazans to its ever growing list of crimes against the Palestinian people.
The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Middle East Monitor.