Samah Jabr is one of the first female psychiatrists in Palestine, and one of only 22 psychiatrists serving the occupied West Bank's 2.5 million strong population.
Born in Jerusalem, Jabr grew up as a resident with no citizenship rights. Throughout her life, she was exposed to life under military occupation, witnessing the impact of traumatic events such as imprisonment and home demolitions on the psychological wellbeing of Palestinians.
"Growing up in Palestine as a Jerusalemite made me aware of the vulnerability of my situation, and made me understand that injustice is a very important pathogen that harms the wellbeing of the Palestinian people under occupation," Jabr told MEMO.
After graduating from the School of Medicine at Al-Quds University, Jabr pursued advanced training in psychiatry and child psychotherapy in France, England and Palestine. Aside from her clinical work, she has also been documenting her experiences since 1998, writing for media outlets and producing scholarly publications for specialised journals.
"My work in medicine brought me close to the experiences of people," she said, "and I feel an ethical responsibility to provide a testimony about the cases and the experiences of Palestinians."
Jabr tells me that she has encountered many victims of physical and psychological torture throughout her career, but it is always the less visible, less pronounced scars that strike her the most.
She relates the case of a young man who now sleeps with a bag of underwear next to his bed because he is in constant fear of re-arrest. Another case that left its mark on Jabr was that of a few sisters whose mother was arrested by Israeli soldiers in a raid on their home. Fearing another raid, the girls slept in the middle room of the house for months instead of their bedrooms, fully dressed and wearing their headscarves.
"People are more interested in concrete injuries; the amputation of a leg or a head trauma," she explains, "and we often don't pay attention when it is not bloody."
We talk about how many people were killed and how many were injured, but there is a lot of invisible, unseen suffering.
"I perceive my ethical responsibility not only to do the palliative work necessary for managing the consequences of abuse, but also to inform and to do what can be done to stop the abuse and the injustice."
She goes on to relate another story of a Palestinian boy who told her that the guards in prison were better than his father because they would give him a cigarette to smoke whilst his father wouldn't. "Later, I learned from that boy how his father couldn't protect him from being arrested," she continues.
"This is a very small example of the kind of unseen damage vulnerable people suffer and the kind of abusive intimacy that people can have, which can disturb their feelings and value system," she says, "and these examples were very common."
Documenting trauma on film
Jabr's encounters and insights into the psychological impact of life in Palestine were the subject of a documentary released in theatres in France last month. In the film, "Beyond the Frontlines: Tales of Resistance and Resilience in Palestine", she narrates excerpts from her writings addressing what resistance means in the context of the Israeli occupation.
French film director Alexandra Dols contacted Jabr towards the end of 2012 wanting to feature her writings as the foundation of the documentary after she came across an article Jabr wrote in 2007 for the Washington Report on Middle East affairs entitled "Dancing to Different Drummers – But Dancing, Nevertheless", which explored what one act meant to different individuals. The article starts off with an encounter with a patient of hers telling her how she was "dancing like a slaughtered chicken" when her son was killed, and then follows her other encounters that day with Israeli soldiers dancing at a checkpoint and later herself dancing at a family wedding.
Hesitant at first, Jabr wrote back to Alexandra in 2013 agreeing to the documentary. The crew arrived in Palestine towards the end of the year.
"Dols came with two volunteers," Jabr says, pointing out the difficulties the team had encountered in securing funding for the montage. "But the fact that they were not supported by a big institution was reassuring for me," Jabr says, indicating her concerns about mainstream censorship of her discourse. She explains:
I view resistance as a healthy response to the violent reality and the occupation, where people have to submit to injustice.
This idea was echoed by the various Palestinian voices interviewed in the film, who come from a variety of backgrounds from across the political and ideological spectrum.
"The interviews and the recording of my articles took a lot of time," Jabr adds, "but I am satisfied with the film."
I liked how Dols visualised my articles. She made me read them and provided images and pictures that make the articles, the themes and the ideas that I'm writing about, more visible and more pronounced.
Having attended the first week of screenings in France, Jabr says she found the film to be a great tool for discussion, adding that the reaction was encouraging. "It's a two-hour film but people would stay another two hours to discuss and ask questions," she says.
"Some mental health professionals who attended were challenging me about the question of neutrality and impartiality," she continues. "Some of them came with the assumption that being politically opinionated lacks professionalism and that allowed me to elaborate on the ethical responsibility that I find necessary, and on the importance of understanding the context…without ignoring the intrapersonal conflicts in individuals."
Find out about Jabr's latest film: Beyond the Frontlines: Tales of Resistance and Resilience in Palestine
Following the screening, Jabr received a letter in which a member of the audience wrote that Israel must be suicidal to allow the film director to enter Jerusalem or to allow Jabr to travel abroad to criticise it. Her encounter with him was addressed in an article she wrote following the screening.
The film was also screened in Palestine and was accepted for the "Days of Cinema" film festival. It later won the Sunbird Award for best documentary.
The Israeli group of mental health professionals for human rights, PsychoActive, also hosted a screening of the film. "There was a spectrum of different reactions," Jabr said, "and the first reaction was silence and sadness."
While some Israelis were encouraged not just to have an opinion about the occupation but to act against it, others accused the film of being one-sided and lacking an Israeli perspective.
"The director makes it clear from the first scene, where there is a conversation between an Israeli and a Palestinian, that she has decided to follow the story of the Palestinian," Jabr explains.
Mental health in Palestine
Fifty years of occupation have left Palestinians with one of the highest rates of mental health disorders in the Middle East, yet mental health services continue to be among the most under-resourced areas of health provision, with insufficient budgets and personnel.
"These deficiencies are not only influenced by the reality on the ground, but also by attitudes of policy makers in health," Jabr says, "but in spite of these limitations, there is growth in this profession and we are doing a lot to improve it."
In her capacity as the head of mental health services in the West Bank, Jabr is trying to develop a model of services that corresponds with the resources available. "I am trying to promote a hierarchy of services, by which general doctors, nurses and teachers can provide low intensity interventions to support the resilience and the wellbeing of people," she adds, "to identify those who need help and refer the ones who need more specialised intervention to specialised professionals."