Pain, grief, fear, panic, anger: Palestinians in Gaza suffer from psychological disorders

Pain, grief, fear, panic, anger: Palestinians in Gaza suffer from psychological disorders

How are the people of the Gaza Strip, who have been displaced countless times and suffered enormous losses, coping with nine months of Israeli military assault on every aspect of their lives?

The first detailed report on the impact of war on mental health has just been published by the Gaza Community Mental Health Programme (GCMHP).

Nine months of Israel’s war on Gaza: The impact on mental health and the GCMHP response is a new challenge to the international community to end the inhumanity of this devastating military aggression that threatens the well-being of Palestinian generations to come.

The report was written by GCMHP staff, who since October 2023 have seen two of their three centres destroyed and a third damaged, and three of their fellow psychologists killed. It details ongoing work and future initiatives aimed at alleviating the mental suffering of Gaza’s 2.2 million residents and mitigating the traumatic impact on future generations of their wounded society.

In these pages, genocide survivors speak from tents, ruined homes, and temporary shelters to mental health professionals, themselves displaced and grieving like the patients they treat. Photographs show a therapist sitting in a chair, taking notes while leaning intently over a patient, women’s group meetings, children’s group activities, and children’s drawings.

Words of despair, excruciating mental pain, loss, fear, panic, anger, violence, uncontrollable screaming, helplessness, feeling suffocated, suicidal thoughts or denial are the threads of the post.

The report calls for an immediate and lasting ceasefire (as the UN Secretary-General did eight long months ago) and for the entry and distribution of sufficient quantities of fuel, water and food (as all UN agencies have been doing for months). Then, for the first time, it calls for psychological support to become a top priority and an essential element of humanitarian aid in Gaza.

Traumatized

GCMHP is an independent non-profit organization and the largest mental health service in Gaza.

It was established in 1990 by Dr. Eyad el-Sarraj, when Gaza was traumatized by three years of Israeli military response to the unarmed civil society uprising known as the Intifada. Sarraj, who was Gaza’s first psychiatrist, was a pioneer in mental health research and treatment. He built a team of mental health workers, many of whom had experienced Israeli torture, imprisonment and forced collaboration.

Following his death in December 2013, he was succeeded as Executive Director by Dr. Yasser Abu Jamei, a psychiatrist, who had worked in the program since 2002. For 34 years, the GCMHP has enjoyed international support from Sweden, Norway, Germany, Switzerland, Ireland, the United States, the European Commission, OCHA, OHCHR and the United Nations Trust Fund for Victims of Torture.

Most of the 57 professionals and 24 support staff of the GCMHP continued to be active during the war and contributed to the findings of the report. Twelve teams provided psychological first aid to 13,000 people between 7 October 2023 and 15 June 2024.

They heard people describe how this war is “quantitatively and qualitatively different in every aspect of life, with everyone witnessing real battles of soldiers, repeated violent scenes of killings and injuries never seen before, hunger, cold, disease and forced displacement on multiple occasions.”

Teams report “high levels of feelings of helplessness and hopelessness,” as well as complex trauma symptoms including social isolation, adults disconnected from their feelings, who have lost the ability to express themselves and self-confidence. Psychosomatic physical symptoms are common, such as shortness of breath and joint and stomach pain.

Psychological symptoms of the children include night terrors, nightmares, bedwetting, excessive nervousness, intense attachment to the mother, constant trembling, hallucinations, anger and aggressive behavior. These children take on daunting responsibilities related to the daily needs of the families for food and water, replacing adults who have been arrested or who have died.

Torture

AM, a torture survivor, is one of those whose story features in the GCMHP report.

“He is a young man who took refuge with hundreds of other families in al-Aqsa University in western Gaza City. Israeli tanks besieged the campus for ten days before storming it, separating the women from the men and arresting them.”

He tells mental health workers that “Israeli soldiers stormed the premises and started blowing up the buildings one after the other. Then they tied us up and blindfolded us after forcing us to strip down to our underwear.”

“They almost killed me several times. They beat me and kicked me in the groin and head. It was early February and the weather was freezing,” he adds. All this was just a prelude to 80 days of physical abuse and torture. AM was dragged into a pit filled with rotting bodies and thrown on the ground where tanks hit his legs. He was forced to watch other prisoners being executed at point-blank range.

“The next day, they transferred us in a truck to the Gaza border. I was still tied up, blindfolded and naked. They threw us out of the truck and a soldier kicked me in the scrotum. I couldn’t walk for 16 days because of the impact of that blow on my private parts,” he explained.

“In the concentration camp, I was made to take off my underwear and expose myself to the nakedness, my arms were tied behind my back and pulled up in a very painful position. I spent the whole night in this position, which prevented me from sleeping. A whole night in this position, to the point that I felt as if my arms no longer existed. I was then transferred to al-Eizariya prison in Jerusalem. I was in a very bad state of health.”

Excruciating mental pain

AM goes on to describe the mistreatment he suffered before being “transported in a truck, 34 men and one woman. On the way, we were insulted and beaten. We were threatened with arrest again if we spoke about what had happened to us, even though we were in the middle of Gaza.”

“When we arrived, UNRWA met us at the Karem Abu Salem crossing and gave us water to drink. They asked me if I knew where my family was. I shook my head. They then gave me a phone so I could call my family, who told me they were still in Gaza. I felt a strange feeling of fear and joy. Thank God, they are okay.”

“I felt so overwhelmed by emotions that I fainted. However, my father was not in Gaza City with the rest of the family; the Israeli soldiers had forced him to leave south. So he came to get me and took me to the shelter where he lives in al-Maghazi. There, I was not treated as I should have been. I was not provided with a mattress to sleep on for several days – I did not receive the help and attention I needed.”

A GCMHP team visited AM, diagnosed him with post-traumatic stress disorder and provided him with medication and therapy sessions to relieve his symptoms. The team also visited the shelter management, explained his special needs and ensured he had a mattress, food and water. He continues to receive therapy and is being closely monitored.

Another survivor, AD, a father working in Israel, is one of many Gazan workers arrested after October 7. He was interrogated for 24 days, starved, deprived of sleep, cruelly beaten and mentally tortured.

He later asked the GCMHP for help and described his return to the Karem Abu Salem crossing, where Israeli soldiers told the prisoners to run to the nearest point in Gaza.

“The soldiers started shooting at us as we ran. Bullets came from all directions,” he said. “Some prisoners were injured, others were shot. I ran as fast as I could, then one of the men running next to me was injured and fell to the ground. I carried him on my shoulders and kept running until I reached an UNRWA medical point. We received first aid and were sent to al-Najjar hospital in Rafah.”

But AD’s return home plunged him into even deeper grief. He soon learned that on October 17, while he was in prison, his house had been bombed and his wife, children, mother, siblings, uncles and aunts had all died. Only his father remained alive, but he is far away in Gaza City, cut off from the south where AD is located.

AD came to GCMHP for professional help “in terrible mental pain. He found himself alone overnight. He had lost his loved ones who were his strength and gave meaning to his life. The team visited him in his tent (a very difficult environment, something hundreds of thousands of displaced people suffer from). AD was diagnosed with post-traumatic stress disorder. As part of our intervention, AD was placed on medication and will receive psychological sessions as per protocol.”

Hope

In a sea of ​​need, these men found hope. Among the hundreds of children’s drawings on the GCMHP website, there is hope – smiling suns, trees and flowers among the dark images of falling bombs, helicopters and fires.

In the years leading up to this war, several international reports highlighted that in Gaza, which has been under siege for 17 years, 500,000 children were already in need of mental health care. Today, the number is much higher.

A ceasefire is in the hands of Western governments that arm Israel and tolerate Prime Minister Benjamin Netanyahu’s evasion of a ceasefire against the will of so many Israelis. It cannot be delayed any longer.

In this report, security and hope are the keys to the future. For mental health professionals to work effectively, they need security, which implies, beyond a lasting ceasefire, “an end to all human rights violations and the removal of visible signs that trigger trauma, including the clearing of all rubble from the streets.”

These are the practical demands of hope and ambition. There is also the visionary challenge that the 3,000 psychologists now living in Gaza could, with additional funding and training, alleviate the mental suffering of its 2.2 million inhabitants and future generations, as the staff of the GCMHP did during those nightmarish months of war.

Translation: JB for

Source: Middle East Eye