Mental health care in Gaza: An accumulation of traumatic events

Through it all they carried on working, with no breaks. As aid workers and Gazans, they’re twice as exposed to the realities of life in the Gaza Strip that’s been under blockade for almost 15 years. They treat people wounded in the conflict. In recent years, most have been Great March of Return protestors, many presenting with bullet wounds in their legs.

So the teams in Gaza are exposed, both professionally and personally. Their work reminds them of how hard life is for people living there, what with the fighting, poverty, unemployment, and lack of protection for their children. They’re attached to their land, to their memories, torn between hope and the reality of their everyday lives.

This is their reality, and it’s how the people we care for describe it. Their access to basic services and the outside world is extremely limited. Young adults in their 20s also lived through the Second Intifada in the early 2000s. Every new war destroys the fabric of Gazan society that bit more. It affects their families—their parents who struggle to survive, find work, get enough money to avoid sinking into poverty, survive the fighting—physically as well as emotionally.

This accumulation of traumatic events has long-term consequences for Gaza’s children and adolescents. A bomb that falls on Gaza City destroys not only a building but also an entire system that used to protect them. They don’t have a safety net anymore. For example, when schools close due to the fighting, children don’t have a safe space where they can interact and play together. There’s a domino effect. A depressed person is more likely to recover from their illness when they’re surrounded by people in good health.

In Gaza, the whole family structure is impacted by these brutal and recurrent events. It’s the same in the West Bank, although the situation is different there. For example, we provide care to children in Nablus in the north of the West Bank. They’re growing up in an occupied city and are aware they might be arrested, harassed, or abused.

Exposure to this violence can have socioeconomic consequences, which means more precarity and mental health issues with a higher number of people experiencing psychosis, depression, and post-traumatic stress disorder (PTSD), but also a higher prevalence of non-communicable diseases like diabetes, asthma, and cancer. We see the same phenomenon among migrants arriving in Europe and African-American and Hispanic communities in the US.

Young Gazans suffer from mood disorders, PTSD, and other stress-related conditions at extremely high rates. The number of suicides and attempted suicides rose steadily in 2020, but they’re clearly under-reported because of the stigma around mental health issues in Palestinian society.