More pain

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More pain

Samah Jabr, a psychiatrist, has seen the effects of Israel’s war on Gaza. She writes that Palestinians need a lot more than a ceasefire (stopping the fighting).


We cannot see many of the effects of Israel’s attacks on Gaza. © Belal Khaled/AA/TT/TT News Agency/Press Association Images

In Israel’s war against the Gaza Strip between 7 July and 25 August, there were 2,133 deaths (including 577 children) and more than 11,000 injuries. Thousands of people now have disabilities, tens of thousands of homes were destroyed, and hundreds of thousands of people are homeless.

But these reports are only the beginning of the bigger effects on the mental health of the people and the wellbeing of society. There are a lot of psychological and social problems that people cannot see or measure.

One story is of a Palestinian-American mother. She who had a choice: run away from Gaza with two of her children (who had US citizenship) and leaving behind the two who did not; or stay in Gaza with the bombs with all four of her children. The questions the children ask their parents show the psychological damage: ‘Why do children in Gaza die?’ ‘What happens to them after they die?’ ‘Will you be sad if I die, too?’ Many families had to leave their homes. Many people suffer so much when their loved ones died in horrific ways.

Mariam lost her little sister years ago. Soldiers shot at her family’s car on the way to school. Even now, every time Mariam sees a soldier, she has a strong memory of the shooting and the death of her sister. This traumatic memory is taking over her life.

The effect of war on the mental health of civilians is great. All scientific studies have shown an increase in mental health problems after war. Women, children, the elderly and people with disabilities suffer most.

In war, people often have extra energy to fight against danger or run away from it. But they can also feel frozen and helpless. Often they have very bad memories, dreams and flashbacks of traumatic events for many years.

When people die in accidents or natural disasters, this is also tragic, but impersonal; war is very personal. War is not an accident – people want to injure and kill others. The anger and helplessness are more painful. There is no winner with an earthquake, but in war, one side wants to win and the other side loses. The loser feels shame. In Gaza, the other side is so near, so they always remember the past and they are a threat for the future.

The destruction of physical, material life is also the destruction of a way of life and ideas: physical war is also psychological war.

Gaza is one of the most densely populated areas in the world. The people have lived under occupation for decades. There is very high unemployment and poverty. The civilians do not have airspace, land, waterways, sanitation, roads and boundaries; they are separated from Palestinians in the West Bank and East Jerusalem. Families have been separated and there is no economic, social and political growth.

This is because a very strong military force has controlled Gaza, and all of Palestine, for generations. They control everything in their lives, so life cannot become normal simply by a ceasefire. The war in the world news is after terrible suffering for many years that is no longer news. Palestinians need the bombing to end, but they also need their rights and they need the problems to end. If not, there will be more trauma from violence and revenge.

So how do Palestinians live with this? A young boy from Gaza, in a Jerusalem hospital with a bomb injury to his foot, said: ‘If Allah saves my leg, when I get older, I’ll rebuild our house that was destroyed. My situation is better than others: two of my classmates are dead. When I go back to Gaza, I will visit their families.’

Cultural and spiritual life help. There are not as many mental-health problems as there could be.

I have listened to hundreds of people talking when they begin to understand the terrible destruction of war and its effect on their lives. I have helped injured Gazans in hospitals in Jerusalem and the West Bank. Very often, they say ‘Allah is enough for us and He looks after us’. The ‘international community’ have not helped. These people trust a power that they believe is higher than the power of Israel, the UN, and the US government. Their faith is stronger than the missiles of Israel and the psychological treatment from professionals. In Palestine today, there is a lot of sadness, but people do not give up; people are disappointed but not bitter at the cruel world.

Gaza has suffered so much destruction and loss, but many ordinary people have taken risks to help other people survive: medical and civil defence people; journalists; families who look after people who lose their homes. These people will continue to help.

To help with the traumas, people often need help to remember and talk about their experience in a safe place. But in Palestinian, there is ‘post’-traumatic stress and also more traumatic stress now. You cannot forget about traumatic events when they are still real. This is a social process, bigger than psychotherapy for individuals. Treatment that does not include the political reality can do more harm than good. Victims of crime need individual sympathy and also justice; so the Palestinian community needs people to see it and listen to the suffering. The wrongs have to become right. Finding out the truth, memorials and ceremonies may also help the healing.

Other ways of healing could be national unity, social cohesion and international solidarity. These could all help the psychological pain and alienation caused by Israel. They have dehumanized the Palestinians and the result is that not many people in the world are interested or care. Solidarity can bring healing, could stop them wanting revenge and prepare for a better future; it will allow the rebuilding of society. This will help the Palestinians and the Israelis.

Safety brings trust; understanding helps; compassion allows people to forgive; and justice brings peace.

Samah Jabr is a psychiatrist and psychotherapist in Jerusalem. She cares about her community, and often writes about mental health in occupied Palestine.

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