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On May 20, a ceasefire between the Israeli government and Hamas ended the last round of conflict in the region and caused collective sighs to upset Palestinians on the Gaza Strip.
But the deep wounds of open violence remain fresh.
Eleven days of Israeli-led bombing in the besieged enclave killed 256 Palestinians, including 66 children. Nearly 2,000 were injured. They have destroyed homes, offices and hospitals.
As the ceasefire seems to be maintained, those who survived the conflict are trying to rebuild their lives once again. But the damage caused in those 11 days was not only physical and material. The mental health of Palestinians in Gaza was also bombed in those dark days.
Living in fear of the next air attack, the ghost of death appears. Loss of loved ones and homes. It’s hard to imagine if their reality was utterly traumatic.
Residents of Gaza have been suffering from trauma layer by layer for several decades. Israel’s deadliest attacks are the most damaging – four in the last 14 years – but they occur on the eve of chronic trauma caused by the occupation.
Stupidities such as kidnapping and demolition of houses, oppressive police, unlawful killings, indiscriminate arrests and torture can cause profound psychological damage. This perpetual addiction can destroy self-esteem and leave victims in a state of “learned disability” – renouncing their destiny and being vulnerable to depression.
Israel’s illegal blockade of Gaza is also a psychological suffocation. The resulting economic deprivation has led to widespread unemployment and poverty – risk factors for mental illness that are well known – and poorly funded health services that are underdeveloped and unable to meet demand. Each war in Gaza is further diminished – at least six hospitals, two clinics, a health center and the facilities of the Palestinian Red Moon Association have been damaged this time around.
In most other countries, COVID-19 is now the main public and mental health. In Palestine, it is almost the next thought, replaced by more dangerous attackers – airstrikes and oppression. However, more than 110,000 people in Gaza have been infected with the virus so far, with more than 1,000 dead. Sufficient doses are available to include 60,200 people with a population of over 2 million. So the pandemic anxiety is also widespread in Gaza, adding to the mental burden.
All of this vortex becomes a real mental illness. In Gaza, the rates of post-traumatic stress disorder (PTSD), with sleep deprivation, feeling forever on the edge and easily surprised, the setbacks and nightmares of trauma and emotional love are incredibly high. A study conducted in 2017 found that 37 percent of adults living on the list are eligible for diagnosis.
In my work as a psychiatrist I have cared for refugees with PTSD in the wars in Iraq and Afghanistan. It can be serious, complex and lengthy. It would be almost impossible to begin healing as long as the root cause remains. The head of the Palestinian mental health services once said that his people do not suffer from post-traumatic stress disorder because their trauma is ongoing. The current traumatic stress disorder may be a more appropriate description of their experience.
As is often the case in these situations, children in Palestine suffer the most. According to a study conducted in 2020, before the last conflict, 53.5% of children in Gaza had PTSD. Nearly 90 percent have experienced personal trauma. The Norwegian Refugee Council reported the shocking news that 11 children killed in recent Israeli airstrikes were taking part in its trauma program. It is not surprising that UN Secretary-General António Guterres describes Gaza as a “hell of the earth” for children.
Of course, the Israelis have also suffered. Hamas were killed in May by Hamas rockets, two of them children – a tragic loss of human lives. For Israelis, the Iron Dome defense system and bomb shelters provide a vital safety net and a sense of security for Palestinians. Highly developed health services are much better equipped to deal with both physical injuries and the psychological impact of rocket fires. They also do not experience the mental severity of the occupation. All this is reflected in lower PTSD rates, between 0.5% and 9% of the population.
In 2008, I made a trip to post-conflict Somaliland to teach psychiatry to medical students. The civil war that affected the area ended in 1991, but 17 years later the effects on the mental health and health infrastructure of the population were noticeable. They still continue today. It will take time to rebuild the minds and health services that are divided in Gaza, but there is little hope for them until Israel ends its illegal occupation, expansion of the Gaza and ending the blockade.
Palestinian oppression has led to Human Rights Watch Israel committing the crime of apartheid. Perhaps this situation can lead the international community to put pressure on Israel in view of the serious impact of human rights violations and mental health. Palestinians and Israelis deserve to be protected from security and trauma. The best way to achieve this is to give Palestinians basic human rights.
The opinions expressed in this article are those of the author and do not necessarily reflect the attitude of Al Jazeera’s editorial.
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