Gaza’s traumatised young minds

Habiba bounced from corner to corner in a small room as her mother tried to dress her for the school day. Always ready with a smile, the six-year-old’s happy demeanour belies a fraught temper and a troubled mind, however.

The cause? A massive 51-day Israeli assault on Gaza earlier this year that cost over 2,000 lives has left its marks not only in the destruction it wrought on the tiny, overcrowded strip of land, but in the minds of all those who survived.

There is a rocket over the front door of my uncle’s house near our home. - Marah Abu Shaqfa, 9

The vulnerable, children between 5 and 14 in particular, were exposed to deeply stressful situations for an extended period of time that, even in battle-hardened Gaza, were exceptional in their intensity.

“The last war on Gaza was the harshest, in terms of intensity and duration, compared to previous Israeli attacks,” said Mohammad al-Zeer, head of the Deir al-Balah branch of the Gaza Community Mental Health Programme, GCMHP, Gaza’s main mental health service provider.

Zeer is the doctor Habiba comes to see for counselling now. At the centre, they’ve started her off in the play room, where she and other young trauma victims can become familiar with the place and feel at home.

And like those other victims, Habiba displays the classic symptoms of post-traumatic stress disorder (PTSD). Her behaviour can be erratic. She has temper tantrums. She is anxious. And she is deeply attached to her mother, Nawal al-Taabeen, 38.

“She gets frightened when she hears an Israeli drone,” Nawal, for whom Habiba is her only child, said. “During the recent thunder storm she threw herself into my arms screaming that ‘they are striking’.”

Neither mother nor counsellor are in any doubt as to the source of her trauma. During the 51-day assault, the Taabeen family fled their home when a tank shell landed nearby their home in the Central Gaza village of Zawayda. But on their way to seek shelter at Nawal’s parents’ house, another tank shell landed nearby, knocking mother and daughter to the ground.

	Habiba, 6, and her mother Nawal al-Taabeen (Shadi Alqara)

When relatives noticed bloody spots on Habiba’s body, they called an ambulance to take her to the closest hospital, the Shuhada al-Aqsa. But the shelling around the hospital was too intense, and ambulances in the end were re-routed to Gaza’s main hospital, Shifa, in Gaza City in the north.

Most at risk

It was, said Nawal, a scary drive. “Shells landed to the left and right. Only God’s care made us survive.”

The spots turned out to be shrapnel wounds some of which had pierced to her kidney. Habiba was advised to stay still until she could receive treatment outside Gaza. She is still waiting for permission to leave Gaza, even though she has been accepted for treatment at a French hospital. And though she moves better, even if sometimes randomly, the scars lie deeper, and random aggressive behaviour sometimes scares even her mother.

“I was doing dishes once. She suddenly lunged at me and pushed me into the tap,” said Nawal.

It is children between 5 and 14 that are most at risk, according to GCMHP psychologist Jasser Salah. And the intensity of this year’s assault has brought hundreds new cases of PTSD to the centre, over 100 in the main branch in Gaza City alone.

The centre does its best to cope. It releases information about symptoms to look out for – bedwetting, anxiousness, unusual aggression, carelessness – and now conducts a five-month intervention programme that includes home visits for the less traumatised.

But overstretched and underfunded, the centre can only reach so many. Though Salah said home visits had allowed professionals to reach more children, trauma victims are not always identified. Unhelpfully, he said, among the “most important mechanisms employed by children to cope with their fears is denial”.

Afraid of the rocket

	Marah, 9, with her father Mahmoud Abu Shaqfa (Shadi Alqarra)

Marah is a bright 9-year-old, whose school copy books are filled with comments from teachers like, “Excellent” and “Bravo”. She is also one of Dr Salah’s latest patients. Among other symptoms of PTSD, she is afraid of leaving her house. “It’s the rocket,” she explained to al-Araby al-Jadeed. “There is a rocket over the front door of my uncle’s house near our home.”

There is no rocket. But there was. The spot Marah is afraid of is where her brother, Mohammad, 11, was killed on the first day of the Eid, 27 July, when a temporary truce was announced but a missile the family says came from an Israeli drone, nevertheless struck, also seriously wounding Marah’s father, Mahmoud Abu Shaqfa, 29.

“We were all sitting near my cousin’s shop,” recalled Mahmoud, counting Mohammad, Marah and their five-year-old brother Khaled. “People were beginning to go out. It was the eid. A truce had been announced. We thought it was safe.”

Mahmoud was knocked out and only found out what had happened to his children when he returned from treatment in Egypt eight days later. With fractures in his right arm and right leg, Mahmoud will not recover fully for a year, according to his doctors. Unable to even use a wheelchair, he remains confined to the family’s home in the Shati Refugee Camp in western Gaza.

Like Habiba, Marah is irritable and jumpy. When there is electricity, said her mother, Heba, she will stay up all night to watch cartoons. Earlier that day, she had lost her temper with a teacher, throwing her books to the floor, Heba said.

“Marah is no longer tolerant or calm; she is nervous all the time, even for trivial reasons. Sometimes, she remains quiet and inattentive to things around her.”

Salah and his colleagues work hard to help children like Marah. But it is a battle against the odds. Gaza remains blockaded, huge pledges of financial aid to rebuild to battered region remain just words on paper and occasional Israeli strikes continue. Before any healing can really begin, said Salah, Gaza must see an end to its isolation.

“What is needed is that this siege be lifted once and for all,” he said, “and those attacks to stop. It is abnormal that the whole population of Gaza remains hostage to constant fear and chronic economic uncertainty."