After the bombs: Gaza's mental health crisis

Although there is relative calm at the moment in the Gaza Strip, residents continue to process the trauma of four Israeli wars since 2009 and the daily suffering caused by a 15-year blockade of the coastal territory.

According to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), more than 5,330 Palestinians, including women and children, have been killed in Gaza since 2008.

In the 2014 war alone, over 100,000 Gazans had their homes destroyed or damaged while 500,000 people were displaced at the height of the conflict.

Compounding this destruction is Israel’s draconian blockade on one of the world’s most densely populated areas, home to 2.3 million people.

"According to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), more than 5,330 Palestinians, including women and children, have been killed in Gaza since 2008"

Tightened in 2007 following Hamas’ takeover of Gaza in fighting with Fatah-led security forces following the Islamist group’s victory in elections, the siege restricts the movement of people and goods in and out of the territory.

As well as physical harm, economic deprivation, and a lack of access to essential services such as healthcare, the blockade and repeated large-scale violence have sparked a mental health crisis for children and young people, who make up most of Gaza’s population. 

Around 80 percent of children suffer from depression, fear, or grief, according to a report by Save the Children.

A third of Gaza’s two million inhabitants, meanwhile, require psychological support, with only one hospital in the coastal enclave able to provide it.

Gazans are alone 

The UN says that at least 60 percent of Gazans have been directly subjected to Israeli military violence over the past 15 years.

Once Israeli military attacks end, Gazans have found themselves alone in facing the unprecedented challenges that they are forced to deal with.

Over 800,000 children have never known a life without the blockade or war. Most have also rarely spent a day of their lives without suffering from a water and electricity crisis, with power available for a maximum of around eight hours per day.

Mohammed Abu Saied, a 14-year-old teenager from al-Bureij refugee camp in central Gaza, still remembers the most terrifying moments in his life over the course of three Israeli wars. He lost both his father and uncle, as well as his home.

“I cannot forget the sound of the huge Israeli missile as it approached our house before I heard the sound of a huge explosion,” he told The New Arab. “For a few seconds, everything around me went black [...] all of my eight-member family became quiet. I heard nothing.” 

Suddenly, there were screams. "Everyone was crying out. I wanted to scream like them to tell them that I was stuck in the darkness too, but my voice was not coming out. I remained silent, surrounded by fear and terror, waiting for death for hours before the rescue teams could find me under the rubble of my house".

At that time, he says, he was five years old, but he still remembers all the fears that to this day mean he is introverted and afraid of people and the sound of planes. 

Abu Saied experienced the same trauma in the 2014 and 2021 Israeli wars, as warplanes attacked his family house and displaced them, killing at least 12 of his relatives, including his father and three of his brothers. 

"At that time, mainly after the war ended, I refused to continue my life and tried many times to commit suicide. I hated everything in my life"

“Israel has turned our lives into hell in the Gaza Strip without us having any blame in this situation,” Hala Abu Saied, Mohammed’s mother, said, her voice breaking. 

Her family’s life has been upended since 2012, with none of her relatives able to live a normal life. “Unfortunately, we are not able to be optimistic about the future,” she says.

As a result of the violence they have experienced, her children are more aggressive and isolate themselves from people. Hala Abu Saied also says that they wish for death, believing that they would die in any new round of Israeli escalation.

Struggle for hope 

In northern Gaza, the situation for families is similar. Heba al-Kafarnah, a 25-year-old hairdresser from Beit Hanoun, lost eight of her family members, including her mother, two sisters, and two brothers, during an Israeli strike on their house in 2014. 

“At that time, mainly after the war ended, I refused to continue my life and tried many times to commit suicide. I hated everything in my life,” the mother of three recalled.

“But I received dozens of psychological treatments carried out by a number of local institutions, including the Women's Affairs Center, to rehabilitate so I could face life again.”

She went on to get married and have children, believing her life could be stable. Yet, it was turned upside down again in 2021 when an Israeli military attack killed her husband during the 11-day war.

“I found myself the only caretaker of my children [...] I realised that I had to be strong to keep them afloat,” she said. “I underwent more psychotherapy sessions so that I could protect my children and take care of them.”

Six months later, she decided to open her own small hairdressing shop that helped to support her family, earning around $35 a day. In August, however, her business was damaged during Israel’s three-day attack against the Islamic Jihad movement.

Now, Heba is doing her best to reopen her shop and hopes to protect her children from both poverty and Israeli airstrikes.

“Because of Israel’s crimes, we [Gazans] struggle for hopes that would be normal abroad [...] I will not give in to the reality imposed on us even if I still suffer from psychological problems. My children need me financially and morally so I have to stay strong,” she said.

"Gaza does not have sufficient specialised centres to treat people suffering from mental health conditions"

Mental health crisis

"For more than 15 years, between 50 to 60 percent of the residents of Gaza were subjected to Israeli violence and they suffer deteriorating living and economic conditions, which impacted their mental health,” Jamil Suleiman Ali, the director general of mental health in the health ministry, told The New Arab.

"There are common symptoms that appear in patients, such as psychological pressure and depression, nervousness, social violence, introversion, and other problems," Ali explained. 

What makes matters worsen, the official noted, is that Gaza does not have sufficient specialised centres to treat people suffering from mental health conditions.

"The injury is not limited to the body, but there are psychological injuries that have a negative impact that could be worse than the physical wound," he stressed. 

For his part, Sami Owaida, an official at the Gaza Mental Health Program, attributed the psychological challenges faced by the residents of the Gaza Strip to the Israeli occupation and blockade, which has lasted for over 15 years.

“Israeli wars and blockade lead to a psychological shock, on top of dealing with electricity and water cuts, high rates of poverty, and unemployment,” he said.  

“All factors that lead to the deterioration of the already worsening health and psychological situation of the residents of Gaza.”

Sally Ibrahim is a Palestinian reporter with The New Arab based in the Gaza Strip