NGOs and caregivers operating in the Palestinian territories are warning of the consequences of “collective trauma”, which will even affect future generations.
“Mentally we are destroyed.” In four words, Khitam al-Kurd sums up the psychological consequences of eight months of war on the inhabitants of the Gaza Strip. This 31-year-old Palestinian woman arrived in France in February to seek treatment for her 3-year-old son. “When I sleep, I only have nightmares”says the refugee, who had to leave her two eldest children in the Palestinian enclave.
Like her, hundreds of thousands of Gazans show signs of trauma, after months of humanitarian crisis and military operations which left more than 37,300 dead, according to the report established Monday June 17 by the Ministry of Health of the government of Gaza, territory controlled by Hamas. “What we are seeing is not post-traumatic stress disorder (PTSD), because we are not in the phase ‘according to'”, underlines Jesus Miguel Perez Cazorla, coordinator of the International Committee of the Red Cross (ICRC) on mental health in the Gaza Strip. “The trauma these people are experiencing is ongoing.”
PTSD is, for example, observed in soldiers returning from the front, who react to loud noises reminding them of bomb explosions, while “the threat is imaginary”specifies Samah Jabr, psychiatrist in East Jerusalem and head of mental health services in the occupied West Bank. “In the case of Gazans, symptoms like hypervigilance are not an maladaptive reaction to external stimuli: it is necessary to survive, because the threat is everywhere”she insists.
Since October, all Gazans have been exposed to the violence and stress of forced displacement. The European hospital in Gaza, where ICRC teams work, houses “for months” families “removed multiple times”. “It’s not a healthy environment, surrounded by medical emergencies, sirens, sounds of explosionsdeplores the NGO to franceinfo. We see many patients who are suffering from depression and anxiety, dealing with fear of what the future holds.”
Children, in particular, “have lost all sense of security”, notes Alexandra Saieh, director of advocacy at Save the Children. In 2022, the NGO published a report revealing that four out of five minors in the Palestinian enclave suffered from depression, sleep disorders or stress, after fifteen years of blockade and repeated episodes of violence. Since October, the situation has deteriorated further. “A mother told us about the total psychological destruction of her child”details Alexandra Saieh.
“Young Gazans see things that no child should see: their brothers and sisters mutilated, their parents killed… There are now more than 17,000 who are orphans of at least one parent.”
Alexandra Saieh, manager at Save the Childrenat franceinfo
The NGO mentions children who are “too traumatized” For “talk or eat”or are assailed by nightmares. “Their parents tell us that they can no longer plan for the future: a teenager who wanted to become an engineer, like his father, now just hopes to find a job to feed himself, continues Alexandra Saieh. These young people have gone into ‘survival’ mode.”
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Adults are also affected. “I was told of the case of a Gazan imam, used to speaking in public, who is now mute. What is happening is indescribable, unspeakable”, relates Samah Jabr. Jesus Miguel Perez Cazorla, who works at the European Hospital in Gaza, describes patients in “hypervigilance”a permanent state of alertness which “tires them physically and mentally”. Across the territory, Palestinians are being treated for serious injuries, amputations and burns. “Normally, they would need psychological support to cope with this new reality”explains the ICRC doctor.
Care almost impossible to provide at the moment. “Many centers have suffered damage and are unusableexplains the ICRC. Consultations, assessments and support sessions require a certain amount of privacy, which is currently difficult to find in Gaza.”particularly in the south of the enclave, where several hundred thousand displaced people are massed.
“There is no place in Gaza where it is safe. Under these conditions, it is impossible to provide psychological support.”
Samah Jabr, Palestinian psychiatristat franceinfo
“The caregivers themselves are affected”, recalls Samah Jabr. Before this war, the Palestinian territory had already experienced several conflicts. The psychiatrist then accompanied several emergency doctors working on site. “Some had suicidal thoughts after massive bombings, she remembers. I don’t know what state they are in today.”
Those who were able to flee Gaza are not doing better. “Since I arrived in France, I have been seeing a psychiatrist. He was recommended to me because I am an uprooted mother,” says Raja Abu Mahadi, a 46-year-old widow who took refuge near Paris. She arrived in December with her son Asef, who requires care after an amputation of his right leg. Night after night, the 12 year old boy “Always having the same nightmare.” “I relive the moment I lost my leg” in an Israeli strike, he confides. Raja’s other five children Abu Mahadi are still in Gaza, under bombs. “I live under the stress, the constant pressure of losing my children,” she testifies.
“I’m so stressed that I sometimes feel unwell and lose consciousness. My other children have to be evacuated before I go crazy.”
Raja Abu Mahadi, Palestinian refugeeat franceinfo
In the occupied West Bank too, Palestinians are suffering the consequences of the conflict. Samah Jabr deals with it “many pregnant or postpartum women, who feel deep guilt about bringing children into this world.” But also “young people who stopped eating after seeing images of bread stained with blood” in Gaza.
The suffering of the Palestinians exceeds “the categories usually used in Western psychiatry”, says the psychiatrist. She prefers an Arabic word, often used by her fellow citizens to describe their situation: “qahr”. “It’s difficult to translate, but it expresses the rage, the frustration, the feeling of abandonment caused by extreme injustice and oppression.”
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Beyond individual traumas, decades of conflict “have damaged the Palestinian social fabric”, analyzes the doctor again. War has consequences “about the relationships between people, their belief and value systems, their view of the rest of the worldshe lists. International law doesn’t apply to them, so they don’t believe in it anymore.”
“For months, we have seen children killed every day. At the end of May, we even saw images of a decapitated baby” after an Israeli strike which left around forty dead in a displaced persons camp in Rafah, agrees Alexandra Saieh. “No one can pretend not to know what is happening in Gazashe gets carried away. When officials continue to say no ‘red line’ has been crossed by the army Israeli [comme l’a fait la Maison Blanche lors d’un point-presse fin mai], the message Palestinians are receiving in Gaza and elsewhere is that their lives do not matter.”
“In reality, we have no idea what impact this violence will have on the mental health of Palestinians,” believes Samah Jabr. Even if Israel and Hamas finally reach a ceasefire, “several generations will be affected by what is happening now in Gaza”, judges the psychiatrist. Faced with psychological trauma, “some parents become overprotective, and others very detached from their children”. Behaviors that have consequences on the mental health of young people.
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“We also know that very high levels of stress can change the biochemistry of the body and be transmitted to children through the genes”continues Samah Jabr. This intergenerational trauma has already been observed in descendants of Holocaust survivors, according to an American study cited by the Washington Post.
The NGO Save the Children says it has observed this “transmission of trauma” In “all occupied Palestinian territories”. “All generations of Palestinians have suffered from recurring escalations of violence”recalls Alexandra Saieh. “Today, the trauma of war is ingrained in the DNA of Palestinians, confirms Khitam al-Kurd. We are almost used to war.”
“My grandfather was expelled from his village of Bayt Tima during the Nakba. My father experienced war. My generation is the one that experienced it the most. My children know war. It has become like a heritage. “
Khitam al-Kurd, Palestinian refugeeat franceinfo
If the end of the conflict in the Gaza Strip still seems far from coming, it must be accompanied “a global response”including psychological support and psychosocial activities, estimates Alexandra Saieh. “It will take group activities to deal with this collective trauma: people feel less helpless when they receive help but can also provide it to others”also notes Samah Jabr.
Another pillar of the reconstruction of Gazans will be “Justice”assures the Palestinian psychiatrist. “Israel must be held responsible, just like the international community which has remained silent”she insists. “If we do not rebuild trust [des Palestiniens] towards the rest of the world and international law, if we do not restore a feeling of international solidarity, it will lead to even more despair, warns Samah Jabr. In the event of impunity, the trauma of the Palestinians will be deeper, and more difficult to treat.”