Generations Traumatized Under Occupation
- Generations Traumatized Under Occupation
By Isabelle Humphries
Oct. 10, 2005
On October 10, 2005, international campaigners launch a campaign to
try to shake the stigma over seeking help in mental health related
issues. In the following article, Isabelle Humphries highlights the
extent of suffering causing mental health difficulties over
generations in Palestine, and considers community initiatives working
to address this overwhelming issue.
The elderly woman visibly folded into herself as she described the
behavior of her nephew's children in Jenin. "You should see what the
noise of the planes has done to them. They are too frightened to sleep
separately, so they all sleep in the same bed, huddled up close
together. The poor little things."
Dispossession has tailed the lives of Umm Khalil and her family over
generations, a typical tale of how trauma is rooted in the lives of
uprooted Palestinians. In 1922 her tenant farming family was kicked
from their land as an Ottoman landlord (not Palestinian) sold it to
Zionist Jews meticulously preparing for the takeover of the land. By
1948, Umm Khalil was married with three young daughters when all were
forced to flee the village of Al-Mujaydil to nearby Nazareth.
Without enough food to feed her daughters, Umm Khalil didn't know what
had happened to her husband for months until he returned from the
prison labor camp to which he had been taken. "In the first days we
just kept worrying about what had happened to the bodies of those
killed in Al-Mujaydil. We believed we could smell them even though we
were six kilometers away in Nazareth. But they wouldn't give us
permission to go back to bury them. We were frightened more men would
be killed, so in the end the women went. They were unable to dig
graves, so they just sprinkled earth on top. Some of the women were
literally driven "out of their minds" by seeing body parts strewn
across the ground."
This is no trauma long gone, but fresh in Umm Khalil's mind; an
inseparable story from what is happening to her relatives in Jenin
today. Many of her family became West Bank refugees, and as her own
children and grandchildren stand around her today, they know what is
happening to their cousins, one of whom is being kept as a political
prisoner in a jail not so far away. The Nazareth neighborhood that
they live in is 90 percent refugees from Al-Mujaydil. "I used to speak
with the grandchildren about what happened," says Umm Khalil, "but
now I don't do it so much. They get so angry about what they have lost."
Gaza: Where to Begin?
Tackling mental health issues is a challenge in any community, but
where do we start in an overcrowded strip of land where military
assault is a daily reality for every person?
While the Gaza Community Mental Health Programme (GCMHP) deals with
1,500 individual clients a year, the project addresses the problem of
trauma with a wider approach. "Psychological trauma and distress in
Gaza cannot be divided into isolated cases. We cannot begin to reduce
people's suffering if we don't make the link between mental health and
human rights," says GCMHP director Dr. Salah Abdel Shafi. "There can
be no well-being when people are oppressed; thus, we must look to
expose the root causes of stress in the community."
One of the projects that GCMHP runs is community clinics, with sites
selected to be accessible to large numbers in the highly populated
residential areas around, without dangers of travel and impossibility
of closure. In addition to providing a suitable environment for
individual therapy, centers provide facilities for community sessions,
meetings, and training. The building is designed with the needs of
specific therapy in mind, e.g., green areas have been created for
children's play sessions.
GCMHP focuses its work on trying to raise awareness of the suffering
caused by mental distress, and to spread an understanding of coping
mechanisms. Effectively tackling a problem requires a professional
needs assessment, and GCMHP has an extensive network of professionals
working both in Gaza and in foreign universities researching
Post-Traumatic Stress Disorder. The results of this work are used for
international advocacy, raising awareness of the depth of community
suffering and stress caused by the ongoing occupation, but the
research is also central to help the development of situation specific
coping mechanisms. From specialized research focusing on vulnerable
groups such as children or former detainees, the GCMHP team is able to
design the most suitable ways to work with the community to ease
collective pain and stress.
So how does this work in practice? âWe are under no illusions that
we can somehow "solve" the mental health crisis in Gaza, but we
believe that by increasing awareness of coping mechanisms within the
community, we can start to make a real difference in many people's
lives," says GCMHP director Dr. Salah Abdel Shafi. Research has shown
that only 30 percent of mental health problems are detected by GPs,
showing a clear need for training amongst primary health care workers.
Psychological distress often surfaces in physical illnesses, meaning
that people seek help from their GP not a psychiatrist. GCMHP is
working with primary health care workers to provide training in
identifying the symptoms of mental suffering.
Another example of community work is GCHMP's meetings with religious
leaders. People listen to and seek advice from religious authorities
as respected elders, and thus it is essential that leaders are able to
assist their communities.
Children are a central focus for GCMHP, so training and working
alongside teachers and school counselors is a large part of the work.
âChildren may not verbalize their fear and distress, and it comes
out in symptoms such as bedwetting, insomnia, and loss of
concentration. For example, if teachers are not aware that lack of
concentration demonstrates that the child is traumatized, the child
may be punished and then the situation becomes even worse,â stresses
Dr. Salah Abdel Shafi. The project conducts collective therapy such as
art classes in schools, and encourages parents and teachers to find
positive ways to ease children's distress.
Women and Mental Health
It is impossible to deal with the problem of domestic violence for
women in Gaza in isolation from their experience of political
violence. The organization has a specific department addressing
women's psychological needs and dedicated to empowering them to
overcome the effects of trauma. The project offers therapy and
counseling on a psychological level, but also legal counseling and
practical vocational training to allow women to have new interests and
develop possibilities of economic independence. GCMHP runs Women's
Empowerment Centers in Beach Camp, Gaza City, Deir El Balah, and
Rafah, where women can seek the ongoing support and help that they
Ex-prisoners are another group to which GCMHP pays particular
attention. Many thousands of Gazans have at one time or another been
held as political detainees in Israeli jails, and such tortuous
experiences can have a lasting and terrifying impact. The stigma
attached to discussing mental health makes it particularly difficult
for men to seek help, for they often mistakenly believe that to
express fear is a sign of weakness. GCMHP works to challenge taboos in
order to reach out to this group who are often suffering from severe
Post-Traumatic Stress Disorder.
Breaking Through the Barriers
There are other associations that deal with mental health issues, from
large medical services such as the Red Crescent, to other specific
centers like the Palestinian Counseling Center based from East
Jerusalem. "As a direct result of the psychological trauma from
military occupation, our work is focused on the problems created for
the average person in an abnormal situation," explains director Rana
Nashashibi. "The effects of suffering direct military assault or
living with the everyday frustration of not knowing if you can reach
school or work are psychologically debilitating in the extreme." The
PCC provides counseling and mental health services for the kinds of
problems that occur within any society, but the focus is on proactive
support for collective trauma and distress within the whole of society.
The PCC is conducting extensive research into the damaging effects of
a life ruled by checkpoints, humiliation, and frustrations of closure.
"We want to be one step ahead in helping people, rather than always
being reactive and merely dealing with the resulting effects. We want
to use our research to develop specific coping mechanisms and
strategies to spread a deeper understanding among the grassroots and
professionals within the community," said Nashashibi.
Imagine life behind walls, both walls that physically exist, and
imaginary walls that symbolize the limits of opportunities living
inside a land under occupation. This is the daily life of a
Palestinian; "disengagement" is irrelevant. Without an economy and
opportunities, there is no hope and no future. In such a situation,
services provided by community support networks are essential.
To find out more, or to send much needed support, please check Web
** Isabelle Humphries is a freelance journalist working on a PhD on
internal refugees in the Galilee. For more details regarding the
project contact her at isabellebh2004 @ yahoo.co.uk
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