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Occupation and the Mind

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    Dr. Samah Jabr exposes the damage done to the emotional health of Palestinians by the Israeli occupation. Occupation and the Mind by Dr Samah Jabr The New
    Message 1 of 1 , Jul 8, 2007
      Dr. Samah Jabr exposes the damage done to the
      emotional health of Palestinians by the Israeli

      Occupation and the Mind
      by Dr Samah Jabr
      The New Internationalist
      May 2007

      Ahmad, a 46-year-old man from Ramallah was doing well, until his last
      detention. But this time he just could not tolerate the long
      incarceration in a tiny cell, with complete visual and auditory
      deprivation. First, he lost his orientation to time. Then he became
      over-attentive to the movement of his gut and started thinking that he
      was 'artificial' inside his body.

      Later, he developed paranoid thinking, started hearing voices and
      seeing people in his isolated cell. Today, Ahmad is out of his
      detention, but still imprisoned by the idea that everyone is spying on

      Fatima spent several years doctor-shopping for a combination of severe
      headaches, stomach-aches, joint pain and various dermatological
      complaints. There was no evidence of any organic cause. Finally,
      Fatima showed up at our psychiatric clinic and spoke of how all her
      symptoms started after she saw the skull of her murdered son, open on
      the stairs of her house, during the Israeli invasion of her village of
      Beit Rima on 24 October 2001.

      Such are the cases I see in my clinic. The traumatic events of war
      have always been a major source of psychological damage. In Palestine
      the kind of war being waged needs to be understood in order to
      appreciate the psychological impact on this long-occupied population.
      The war is chronic and continuous, over the lifetime of at least two
      generations. It pits an ethnically, religiously and culturally foreign
      state against a stateless civilian population. In addition to daily
      oppression and exploitation, it involves periodic military operations
      of usually moderate intensity. These provoke occasional Palestinian
      fractional and individual responses. The vast majority of people are
      never consulted about such actions. While their opinion does not
      matter, it is they who must endure pre-emptive Israeli strikes or
      collective punishment in retaliation.


      Demographic factors complicate the picture. Those living in the
      occupied territories make up just a third of Palestinians; the rest
      are scattered around the region in a Diaspora, many in refugee camps.
      Almost every Palestinian family has experiences of displacement or
      major painful separation. Even inside Palestine, people are refugees,
      expelled in 1948 to live in refugee camps. The massive displacement of
      70 per cent of the people, and the destruction of over 400 of their
      villages, are referred to by Palestinians as the Nakba or Catastrophe.
      This remains a trans-generational psychological trauma, scarring
      Palestinian collective memory. Very often, you will encounter young
      Palestinians who introduce themselves as residents of towns and
      villages from which their grandparents were evacuated. These places
      are frequently no longer on the map, either razed entirely, or now
      inhabited by Israelis.

      Palestinians perceive Israel's war against them as a national
      genocide, and to resist it they give birth to many children. The
      fertility rate among Palestinians is 5.8 - the highest in the region.
      This leads to a very young population (53 per cent under the age of
      17) - a vulnerable majority, at a crucial stage of physical and mental
      development. The geographical enclosure of Palestinians in very small
      neighbourhoods, with the separation wall and a system of checkpoints,
      encourages consanguineous marriages, increasing a genetic
      predisposition to mental illness. Walling off friends and neighbours
      from each other also has a debilitating effect on the cohesion of
      Palestinian society.

      But, it is the violent environment in which they live which most
      undermines the mental health of Palestinians. Population density,
      especially in Gaza - with 3,823 persons per square kilometre - is very
      high. Elevated levels of poverty and unemployment - 67 per cent and 40
      per cent respectively - undermine hope and deform personality. The war
      has left us with a huge community of prisoners and ex-prisoners,
      estimated at 650,000, or some 20 per cent of the population. The
      handicapped and mutilated make up six per cent. Recent screenings
      found a disturbing level of anaemia and malnutrition, especially among
      youngsters and women. The intense emotional hostility provoked by our
      daily friction with the Israeli soldiers at our doorsteps is a
      constant stress factor. Many Palestinian kids have been
      living with daily violence since birth. For them, the noise of
      bombardment is more familiar than the singing of birds.

      Sudden blindness

      During my medical school training in several Palestinian hospitals and
      clinics, I saw men complaining of non-specific chronic pains after
      they lost their jobs as labourers in Israeli areas; school children
      brought in for secondary bed-wetting after a horrifying night of
      bombardment. My memory of a woman, brought to the emergency room
      suffering from sudden blindness that started when she saw her child
      murdered as a bullet entered his eye and went out from the back of his
      head, remains all too vivid.

      In Palestine, such cases are not registered as war injuries and are
      not treated properly. This realization provoked me to specialize in
      psychiatry. It is one of the most underdeveloped medical fields in
      Palestine. For a population of 3.8 million, we have 15 psychiatrists
      and are understaffed with nurses, psychologists and social assistants.
      We have an estimated three per cent of the staff we need. We have two
      psychiatric hospitals, in Bethlehem and Gaza, but it is difficult to
      get to them, due to checkpoints. There are seven outpatient community
      mental-health clinics. In developing countries like occupied
      Palestine, psychiatry is the most stigmatized and the least
      financially rewarding medical profession. Psychiatrists work with
      desperately sick patients and, in the eyes of their communities, are
      far removed from the glory of other medical specialties. As a result,
      competent and talented doctors rarely specialize in psychiatry.

      I find psychiatry a humanizing and dignifying profession - not least
      because it helps me personally to cope with all the violence and
      disappointments surrounding me. I move from Ramallah to Jericho to see
      psychiatric patients. In one working day I see between 40 and 60
      patients; 10 times the number I used to see during my training in
      Parisian clinics. I observe my patients' disorganized behaviour,
      listen to their overwhelming stories and answer them with the few
      means I have: a bit of talking, to pull together their fragmented
      ideas; some pills that might help them to organize their thinking,
      stop their delusions and hallucinations, or allow them to sleep or
      calm down. But talks and pills can never return a killed child to his
      parents, an imprisoned father to his kids, or reconstruct a demolished

      The ultimate solution for mental health in Palestine is in the hands
      of politicians, not psychiatrists. So, until they do their job, we in
      the health professions continue to offer symptomatic treatment and
      palliative therapy - and sensitize the world to what is taking place
      in Palestine.


      Nowadays, Palestinians are pressured to surrender once and for all,
      when they are asked to 'recognize' Israel. We are asked to accept,
      reconcile ourselves with and bless the Israeli violation of our life.
      The fact that our homeland is occupied does not, by itself, mean that
      we are not free. We reject the occupation in our minds, as far as we
      can cope with it; and learn how to live in spite of it, rather being
      adjusted to it. But, if we recognize Israel, we are mentally occupied
      - and that, I claim, is incompatible with our wellbeing as individuals
      and a nation. Resistance to the occupation and national solidarity are
      very important for our psychological health. Their practice can be a
      protective exercise against depression and despair.

      Israel has created awful facts on the ground. What remains for us of
      Palestine is a thought, an idea that becomes a conviction of our right
      to a free life and a homeland. When Palestinians are asked to
      'recognize' Israel, we are asked to give up that thought, and to
      renounce everything we have and are. This will only sink us deeper
      into an eternal collective depression.

      After several years in Paris, I returned to a tired, starved
      Palestinian people, torn apart by fractional conflicts as well as by
      the separation wall. Palestinians are especially demoralized by the
      infighting taking place on the streets of Gaza, but orchestrated
      elsewhere in order to abort the results of last year's democratic
      elections. Those who have stopped all money from going to Palestine
      are, in effect, sending us guns instead of bread. They encourage the
      psychologically and spiritually impoverished to kill their neighbours,
      cousins and ex-classmates. Even if the factions settle up, Palestinian
      society will be left with a serious problem of intra-family revenge.

      We shall overcome

      It is hard not to wonder whether Israel's targeting of Palestinians is
      deliberately designed to create a traumatized generation, passive,
      confused and incapable of resistance. I know enough about oppression
      to diagnose the non-bleeding wounds and recognize the warning signs of
      psychological deformity. I worry about a community forced to extract
      life from death and peace through war. I worry about youth who live
      all their lives in inhumane conditions; and about babies who open
      their eyes to a world of blood and guns. I am concerned about the
      inevitable numbness chronic exposure to violence brings. I fear also
      the revenge mentality - the instinctive desire to perpetuate on your
      oppressors the wrongs committed against yourself.

      There has yet to be a comprehensive epidemiological study of the
      psychological disorders in Palestine. And, despite all that is
      published on Palestinian war-related psychopathology, my impression is
      that mental illness is still the exception in Palestine. Resilience
      and coping are still the norm among our people. In spite of all the
      home demolitions and extreme poverty, it is not in Palestine that you
      find people sleeping in the streets or eating from trash cans. This
      resilience is based on family foundations, social steadfastness and
      spiritual and ideological conviction.

      Still, we do have a mental-health emergency. Services are urgently
      needed for people who have suffered and endured crises so that they
      can restore their recuperative powers and coping capacities. This is
      crucial if they are not to crack when peace finally comes, as so often
      occurs in a post-war period. It is not just at a small number of sick
      individuals but an entire wounded society that needs care. Our trauma
      has been chronic and severe, but by recognizing our suffering and
      treating it with faith and compassion, we shall overcome.

      Dr. Samah Jabr works as a psychiatrist in occupied Palestine.


      Ophthalmic team treats refugees in Lebanon

      On May 19, Dr. Francis Nathan, an ophthalmic surgeon from Australia,
      and Baillie Brown, a nurse from the USA, arrived in Lebanon to begin
      a week of treating refugees in the camps suffering from cataracts.
      This is their third mission to the Middle East through the PCRF this
      year, as they did missions in Nablus, the West Bank earlier in the
      year. They are working at the Haifa Hospital in the Bourj Al
      Barajnah refugee camp in Beirut. Despite the fighting around the
      Nahd El Barad refugee camp in the north of Lebanon, the team
      continues to provide humanitarian services for the refugee population
      in Lebanon, who are suffering in Lebanon due to poverty and
      discrimination as refugees.



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