Over the past month, the expansion of the Israeli offensive in Gaza has compounded the healthcare crisis in the blockade-cursed narrow strip of land. But as thousands fled their homes to rush to refugee centers, the average Palestinian is faced with a new challenge—staying sane.
"There are scars you can see and scars you can’t," Christopher Gunness, spokesman for United Nations Refugee and Works Agency for Palestinian refugees told Firstpost. "The dearth is of a sense of security. Not just medication."
According to a daily report released by the United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA), as of 10 August, at least 456 children have been killed in the conflict and at least 3,73,000 will require "direct and specialized psychosocial support." This is not including adults who have been reeling from similar problems—Post-Traumatic Stress Disorder to depression and increased anxiety.
A recent report in New York Magazine quotes Dr Akihiro Seita, the director of health for UNRWA, as saying:
Children with untreated PTSD suffer from a variety of ailments: “higher risks of developing attention deficit disorder (e.g., anxious state, hyperactivity, attention problems, phobias and impulsivity), violence, adopting extreme ideas, low school performance, addiction, criminal conduct, and other antisocial behavior and ideas.”
Dr Seita told Firstpost over email that he had encountered several children who showed signs of psychological trauma. "Women and children are usually the most vulnerable populations in the community, including those in Gaza. So they have been seriously affected by the war. I visited three health centers in Gaza last week, and mothers I met in the health centers indicated night wetting, anxiety in their children, and other symptoms of psychological trauma," he said.
A 2009 joint Israeli-Palestinian study which looked at the psychological well being after the second intifada, showed that 37.2 percent of the Palestinian students suffered from PTSD by the time the violence had ended. This was further exacerbated by the repeated outbreak of violence in the region, including the week-long Israeli airstrikes in 2012.
"Whatever is happening in Gaza is a fallout of what happened in West Bank. In the first week, after the three Israeli boys were kidnapped, authorities were searching for them and the kidnappers. There were about 750 incursions into houses where people were checked, beaten and intimidated. Children often witness their fathers and other elders and family members getting beaten up and taken away—it destroys the image of the protector, sense of security," Srijeeta Verma, field coordinator for Medecins Sans Frontieres’ (MSF) Mental Health Programme in Occupied Palestinian Territories told Firstpost.
MSF launched an intervention in mid-June and has done 1146 consults since. The symptoms, says Verma, among majority of their patients are the same: hopelessness, anxiety and psychosomatic manifestation of trauma. "We administered what is called ‘Psychological First Aid’ but any form of long term therapy, which many patients need, is not possible due to the nature of the conflict," Verma said.
The conflict, in some ways is setting itself up to continue, constantly producing generation after generation whose psychological well being is permanently affected. This is particularly damaging to those still recovering from PTSD or other mentally traumatic conditions.
"When something happens for the first time its terrifying. But when it happens again, it comes with a reminder of how bad it was the first time. It adds another layer to the trauma," says Gunness. "If you’re a five or six-year old in Gaza you’ve probably witnessed such an outbreak of violence at least twice times since you were born. For a child, that isn't easy."
MSF terms the conflict as "low intensity and chronic," making long term mental well-being essential to breaking the cycle of violence. Even families in West Bank, who have not been the focus of the Israeli strikes, have been severely affected by the steady stream of violence. "Families in West Bank see whats happening in Gaza. They have relatives in there. They are their people--so it’s all connected for them. For some others in the West Bank, its the realisation that its not so bad, not as bad Gaza anyway," says Verma.
Gaza, a densely populated strip of land has a population of 1.8 million people crammed in a total area of just 360 square kilometers with a largely young population. According to the New York Magazine report, "63.8 percent of Gazans are age 24 years or younger" reeling from the destruction of war amid no future or opportunities.
"I was overwhelmed with the psychological burden of the war to the people. I attended a group session for young children (around 10 years old). There were 16 children: all of them have their houses destroyed: and 12 of them have seen bodies during the war, and eight of them have ongoing episodes of night crying. This is a clear example of impact of the war," Dr Seita told Firstpost.
"Majority of the people who approach us seeking counseling or help are children. Nearly 50 percent of the children who come to us suffer from anxiety related problems," says Verma.
The long term effects on children due to the atmosphere of insecurity and loss also takes away any semblance of normalcy a child needs growing up. "When you lose your home, you lose your past and present. Photographs, memoriblia, inheritances, things that are special to you, that populate the world in which a child feels safe, are all taken away."
The lack of counselors, centers, medication and lack of means to monitor patients on a long term basis has created a cycle of trauma and violence, each feeding the other, manifesting in daily life from very early ages.
"One of the games that Palestinian children play is called ‘checkpoints and searches’. They pretend to reach checkpoints, and then they frisk and search each other the way they are often searched. This is how things work here. You have to cross military checkpoints where documentation and searches are often humiliating. So much so that it’s trickled into the way they approach their childhood," says Verma.
The game, Verma says, represents the larger reality of living in a conflict zone like Gaza and West Bank, where circumstances make no allowances for any Gazan to have a normal life or support when dealing with severe trauma.
But amid the games that the international community has been playing, an entire generation of children in Gaza have been handed adult lives that are unlikely to ever be normal.
Updated Date: Dec 04, 2014 08:54 AM