Drawing Gaza: When childhood is shaped by fear and violence

During group psychosocial sessions organized by Doctors Without Borders/Médecins Sans Frontières (MSF) teams in Gaza, children quietly explain the meaning of their drawings — drawings of a childhood defined by fear and violence.

Three years of Israeli forces’ bloody offensive on Gaza have taken a devastating toll on the mental health of young Palestinians in the Strip. Many have lost their family members, homes, schools, and friends, while repeated displacement and catastrophic living conditions have stamped out spaces where children should be able to play and live without fear.

Soaring mental health needs with little support available

Despite the enormous mental health needs in Gaza, services and spaces available for children’s recovery remain severely limited due to the systematic decimation of the health system by Israeli forces. According to the World Health Organization, the number of people in Gaza requiring urgent mental health and psychosocial support has more than doubled since before the conflict, from around 485,000 to more than 1 million people. 

“Across Gaza, we are seeing overwhelming levels of grief, anxiety, sleep disorders, and psychological distress among both adults and children,” says Franz Luef, MSF head of mission for Palestine. “These symptoms are being exacerbated by a crisis that has evolved into a less visible phase, characterized by Israel’s systematic dismantling of conditions necessary for Palestinians' survival.”

Mental health care has become a crucial part of MSF’s work; our teams provide individual consultations, psychosocial and psychoeducational group activities for adults, and recreational activities for children and adolescents, who are particularly vulnerable.

Childhoods stolen by genocide

For children who were old enough to remember life before Israel’s genocide, almost nothing remains of the world they knew. The places where they grew up have been destroyed. The basic things that should define childhood — feeling safe, playing with friends, going to school, and spending time with family — have been stolen from them, replaced by memories of violence, the constant threat of attacks, and scenes of destruction. Fetching water, lining up for food, and helping their families survive are now part of their daily responsibilities. Some are so young they have never known anything other than displacement and the sound of airstrikes.

“Children who grew up during the war, who are today 3 or 4 years old, have lost their understanding of so many fundamental concepts,” explains Mahmoud Al-Balbisi, an MSF mental health counselor. “Many don't know what ‘home’ means. The tent has become their home because they have never experienced living in a house.”

Children have also begun to recreate what they see around them through play and drawings. Instead of games reflecting an ordinary childhood, counselors see children imitating aid distributions, describing attacks, and playing among the rubble of destroyed buildings.

Dina, a 9-year-old girl, remembers being forced to leave her home with her family and pushing her injured father in a wheelchair after his foot was run over by a truck while collecting aid. Dina longs for something simple: “That we go back to how things were before. My grandma and grandpa.”

Rahaf, an 11-year-old girl, says: “Sometimes I stand at the window and see the tanks firing. I tell my mom, ‘Come inside, because the tanks are firing and shooting shells.’ I’m scared for my family, so I tell her to come inside. My girl cousin was killed. I can’t forget her. I used to play with her all the time.”

Effects of prolonged violence on everyday behavior

The effects of prolonged violence are visible in children’s everyday behavior. Counselors report increasing anxiety, fear, screaming, aggressive behavior, nail-biting, and involuntary urination among children.

At MSF’s Zaytoun Clinic in Gaza City, counselors provide psychosocial support to children through music, games, stories, and drawing, giving them a space to express themselves. Counselors hold follow-up sessions to help children reconnect with who they were before the war and understand their emotions. “We try to remind the children of their humanity and that they are children,” says Al-Balbisi.

Activities help the children recognize their right to safety and bodily protection in an environment where children are increasingly exposed to danger.

“After three years of violence, inhumane living conditions, and loss, children are not simply carrying memories of war; their experiences have reshaped how they understand safety and childhood itself,” says Luef. “There is still no safety for children in Gaza. Bombing can happen at any moment, and they continue to live in constant fear, with no opportunity to recover or escape from what they have already endured.”

Between late 2023 and September 2026, MSF teams provided more than 132,000 individual mental health consultations and supported more than 246,000 patients through group activities.