Aditya Ganapathiraju, The Electronic Intifada, 9 November 2009
More than 40 years of Israeli military occupation have had a devastating impact on Palestinians in Gaza. Air strikes, artillery shelling, ground invasions, jet flybys and other acts of violence have all led to an epidemic of suffering among Gaza's most vulnerable inhabitants. The most recent studies indicate that the vast majority of Gaza's children exhibit symptoms of post-traumatic stress disorder (PTSD).
Soon after the Israeli winter assault, a group of scholars at the University of Washington discussed different aspects of the situation in Gaza and the Occupied Palestinian Territories (OPT). Dr. Evan Kanter, a UW School of Medicine professor and the current president of Physicians for Social Responsibility, delivered a somber talk describing the mental health situation among Gaza's population. The numbers he cited described a staggering level of psychological trauma.
Dr. Kanter described studies that revealed 62 percent of Gaza's inhabitants reported having a family member injured or killed, 67 percent saw injured or dead strangers and 83 percent had witnessed shootings.
According to Dr. Kanter, in a study of high school-aged children from southern refugee camps in Rafah and Khan Younis, 69 percent of the children showed symptoms of PTSD, 40 percent showed signs of moderate or severe depression, and a staggering 95 percent exhibited severe anxiety. Meanwhile, 75 percent showed limited or no ability to cope with their trauma. All of this was before the last Israeli invasion.
Dr. Eyad El-Sarraj, head of the Gaza Community Mental Health Programme, and whom Dr. Kanter described as a "medical hero" working under seemingly impossible conditions, has produced "some of the best research in the world on the impact of war on civilian populations." In a 2002 interview he said that 54 percent of children in Gaza had symptoms of PTSD, along with 30 percent of adults. The hardest hit were young ones who had their homes bulldozed or who lost loved ones like their mothers, he said. Again, these figures were obtained well before conditions dramatically deteriorated.
Gaza's population is overwhelmingly young. About 45 percent of the population are 14 years old or younger and roughly 60 percent are 19 years and younger. The long-term effects of constant violence and PTSD on such a young population are incalculable.
A recent study by international researchers and the Gaza Community Mental Health Programme entitled "War on Gaza survey study" reveals more worrying figures. Of a representative sample of children in Gaza, more than 95 percent experienced artillery shelling in their area or sonic booms of low-flying jets. Moreover, 94 percent recalled seeing mutilated corpses on TV and 93 percent witnessed the effects of aerial bombardments on the ground. More than 70 percent of children in Gaza said they lacked water, food and electricity during the most recent attacks, and a similar percentage said they had to flee to safety during the recent attacks.
In addition, 98.7 percent of the traumatized children reported that they did not feel safe in their homes. More than 95 percent of the children felt that they were unable to protect themselves or their family members, causing a feeling of utter powerlessness that is compounded by a sense of loss over unfulfilled lives.
A whole generation is being lost to the horrors of large-scale military violence and a brutal occupation. In front of many distraught members in the audience, Dr. Kanter described a study that showed that witnessing severe military violence results in more aggression and antisocial behavior among children, along with the "enjoyment of aggression." There are similar studies among Israeli children who witness violent attacks.
PTSD, Dr. Kanter explained, is an "engine that perpetuates violent conflict." It leads to three characteristic symptoms. First, individuals re-experience the traumatic events in the form of the nightmares, debilitating flashbacks and terrifying memories that haunt individuals for years afterwards. Second, other individuals may develop avoidance symptoms in which they become isolated and emotionally numb, deadened to the world around them. Third, individuals have symptoms of hyper arousal, which may lead to excessive anger, insomnia, self-destructive behavior and a hyper-vigilant state of mind. Other maladies like poor social functioning, depression, suicidal thoughts, a lack of trust and family violence are all associated with PTSD.
The most recent study, "Trauma, grief and PTSD in Palestinian children victims for war on Gaza" by the Gaza Community Mental Health Programme, revealed that in the aftermath of the winter assault on Gaza, an unbelievable 91.4 percent of children in Gaza displayed symptoms of moderate to very severe PTSD. Meanwhile, only about one percent of the children showed no signs of PTSD.
The outlook for children in Gaza suffering from these symptoms is not optimistic. Whereas soldiers who experience traumatic events in a war zone can return home to relative calm and seek treatment, the people of Gaza continue to be held in what one Israeli human rights group labeled the "largest prison on Earth"-- a methodically "de-developed" island isolated from the rest of the world.
One of the most distressing prospects for peace are studies of similar war-torn populations like Kosovo and Afghanistan that showed that military violence often leads to widespread feelings of hatred and the simmering urge for revenge. One can easily predict the future consequences of a large number of young people exposed to this level of trauma.
In an op-ed published during Israel's winter invasion Dr. Eyad El-Sarraj warned that "Palestinian children in the first intifada 20 years ago threw stones at Israeli tanks trying to wrest freedom from Israeli military occupation. Some of those children grew up to become suicide bombers in the second intifada 10 years later. It does not take much to imagine the serious changes that will befall today's children."
"The breakdown of an entire society is happening in front of us," Harvard political economist Sara Roy warned in July. Many share Roy's feeling that "what looms is no less than the loss of entire generation of Palestinians," which she fears may have occurred already.
This will be the enduring legacy of the Israeli occupation.
Aditya Ganapathiraju is a student, independent writer and local organizer. He lives in the Seattle area and works on Palestine and other social justice issues.
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