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Gazans face psychological toll as fear of death looms
Published Sunday 13/07/2014 (updated) 20/07/2014 19:04
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Palestinian children take shelter at a UN school after evacuating
their home near the border in Gaza City on July 13, 2014
(AFP/Mahmud Hams)

BETHLEHEM (Ma'an) -- Israel's ongoing military assault in the Gaza Strip is exacerbating a mental health crisis in the besieged enclave as Gazans struggle to sustain coping mechanisms under the constant fear of death.

Aside from the huge physical death toll -- over 160 have been killed and at least 1,000 injured since the assault began -- 1.8 million Gazans live in a state of permanent anxiety as families are unable to find refuge from airstrikes, drones, and naval bombings in the densely populated enclave.

Rana Nashashibi, a psychologist with the Palestinian Counseling Center, told Ma'an that not knowing when, or how, you could die amid widespread carnage has a deliberate dis-empowering effect on Gazans, part of the psychological warfare used by Israel to weaken the population.

"It is always parallel to the conventional warfare of military power, using psychological warfare on people. The main aim is to make people feel helpless and debilitated, a way of saying: 'We are powerful and we are doing this to you.'"

The Israeli blockade on Gaza, imposed in 2007, has depleted the resources and energy of Gazans in facing the severe challenges of military attacks, she says.

"Just surviving and being able to cope with every day challenges is fatiguing people."

Adults and children in the Gaza Strip suffer from high levels of psychological trauma which inevitably increase during periods of intense violent conflict, medical professionals say.

Following Israel's war on Gaza in Nov. 2012, the incidence of psychological trauma and post-traumatic stress disorder rose by 100 percent, according to UNRWA.

UNICEF released findings following the conflict which showed a 91 percent increase in sleep disturbances among children, with 85 percent of adults reporting a loss of appetite.

There was also a notable increase in the incidence of miscarriage among pregnant women, UNRWA said.

Sleep disorders, bed-wetting, anxiety, and psychosomatic symptoms such as heart problems, high blood pressure, and even cancer, are a result of living in continuous fear, Nashashibi says.

The ability of people to function in the workplace is also impeded and severe anxiety causes children to have gaps in concentration which obstructs their emotional and intellectual capacities.

"When you fire missiles at someone while they are sleeping it is a way of saying 'you cannot run.' Even if you want to run, where can you go? Gaza is a big prison."

"Israel aims to make people feel helpless, they are hoping that people don't move to a higher level of functioning. In order to feel you can fulfill your dreams you need to feel safe and sheltered, if you don't feel that it makes people feel that they have no future."

Palestinian families seek shelter after evacuating their homes near
the border in Gaza City on July 13, 2014.(AFP/Mahmud Hams)

'Gazans show what it means to be human'

Around 10 percent of Gazans will have clinical symptoms and children usually suffer bed-wetting and severe anxiety for three to six months following Israeli attacks, Norwegian doctor Mads Gilbert told Ma'an from Gaza, with most children witnesses to death and trauma in their young lives.

"There's a very simple way of stopping children from being traumatized; just stop the bombing. There's a very simple way to ease mental health; end the blockade," Gilbert says.

Despite the huge psychological burden of living in a war zone, Dr. Gilbert says the family structure of Palestinian society, a sense of community, and religion, are tools used by Gazans to develop a remarkable sense of resilience in the face of constant hardship.

"I have been here in 2006, 2008, and 2012 and every time I have the same experience. The most impressive sense you get is this coping capacity, that they are not cracking under pressure, they are bowed but not reshaped, they re-find their human shape."

Despite the medical necessities of attending to the physically and psychologically wounded in Gaza, Gilbert is adamant that only a political solution based on equity and an end to Israel's discriminatory system can bring relief to the besieged population.

"The abnormal becomes normal in Gaza after seven years of a siege in which no-one should be forced to live in. The world has to understand that the people of Gaza are like any other, they want to live in peace and have dignity and equity."

The huge military disparities give Israel an automatic advantage in terms of force, but Gilbert says Israel is confronted with a people who will not yield.

"Bomb them as much as you like, people will never surrender. Gazans show what it means to be human in extremely dire conditions. They don't behave like the animals they are treated as by Israel."

Nashashibi agrees that the level of resilience shown by Gazans in the face of such atrocities is remarkable.

The motivation among her colleagues in Gaza is higher than those in the West Bank and East Jerusalem, she says, a testament to how much Gazans "love life and want to do well for themselves."

"We as Palestinians, and not only Gazans, have no option but to resist, because for our mental well-being our only option is to resist. Our motivation, our will to resist, is what is keeping us going, and I think this is very important."

'Value of life'

Despite the vast human toll in Gaza, Israel's media and military spokespersons have largely chosen to ignore the impact of its large-scale military action on civilians, referring to them in terms of accessories to Hamas' military tactics, or simply victims of being in the wrong place at the wrong time.

Online images of Israeli civilians in Sderot eating popcorn while cheering bombs landing in Gaza add to the sense that Gazan lives are simply worth less than Israelis.

"For one moment let's sit in the mirror and ask ourselves what would have happen if, God forbid, 18 members of an Israeli family had been killed in a Palestinian attack. Or what would happen if 100 Israelis died," Gilbert asks.

"In that simple question lies the problem Palestinians are so well aware; the value of their lives."

Nashashibi agrees that the level of violence used by Israel, and its support among some sectors of the population, is a trend that their society should be worried about.

"As a psychologist I want to say that Israel has to be very afraid about how these acts affect their community, because they are full of hatred. Those soldiers full of hate will not only hate Palestinians but will cause harm in their own lives.

"If the Israeli community doesn't do anything to help them, they will suffer from all this hatred building up in their society."
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1 ) JoeFattal / USA
13/07/2014 20:01
Psychological toll as fear of death its even in Israel not only Gaza. Gaza is very dense populated city, you expect to have heavy casualties regardless where they go. So far is pure luck not the interception of the Iron-Dome that saved people lives in Israel. Hamas is winning and with a heavy price of human lives, and Israel is losing with a heavy price financially. But freedom is not cheap, there is a price to pay, and right now the Palestinian population in Gaza are paying the price.

2 ) Paul / Kenya
13/07/2014 21:22
On both sides, the innocent suffer, but hamas winning..is that what its all about ? Winning what ?

3 ) Outlier / USA
13/07/2014 21:26
Self inflicted, and thus the stupidest kind of crisis.

4 ) Alison / UK
13/07/2014 21:39
To Joefattal, yes, fear and suffering both psychological and physical are to be found on both sides, as are decent human beings who desire peaceful lives BUT those who live in Gaza have no freedom to go anywhere else. It is not their choice to live in a densely populated city, a prison, where "you expect to have heavy casualties"(sic). I suggest that you need to try living in Gaza under constant surveillance of drones and attack to get a balanced view.

5 ) Hamas is / Winning ?
13/07/2014 23:33
How insane is JoeFattal (#1 above). The physical damage (already over $2 Billion Dollars and climbing), Psychological destruction of Gaza minds and dead bodies everywhere. Hamas is winning? Get real.

6 ) Tibi / Tubas
14/07/2014 00:15
Hamas could end this at any time.

7 ) Mel / USA
14/07/2014 01:56
That is all part of the Zionist package! Kill,destroy,maim,torture,cripple,&inflict as much physical,psychological,emotional short & LONG-TERM damage as possible to last,LONG after they political pretend that they're "accepting" a ceasefire(which killer Israel always breaks anyway).Israel's COLLECTIVE PUNISHMENT is HOLISTIC.Not just to"Break the Bones",but break the heart,mind &soul too,from womb to grave!
It's total criminal sociopathy. Just like Nazism was/is. Welcome to Zionist Israel!

8 ) Tobias / USA
14/07/2014 02:23
Israel's Iron Dome protection system is keeping more civilians alive in Gaza than in Israel, since if Gaza's war crimes were taking lives, then Israel would be responding to the attacks 100 times more vigorously !!

9 ) Bibi / Israel
14/07/2014 02:24
"Who hides in mosques? Hamas. Who puts arsenals under hospitals? Hamas. Who puts command centers near kindergartens? Hamas. The difference between Israel and Hamas is that – Israel uses defensive systems against missiles to protect the residents of Israel, and - Hamas uses the residents of Gaza to protect arsenals of missiles, and In using the residents of Gaza as human shields, Hamas is bringing disaster to the civilians of Gaza (which Israel regrets), and it bears sole responsibility"!!

10 ) Han / Russia
14/07/2014 10:12
Why the need to post comments blaming Palestinians for their suffering? Guilty conscience?

11 ) Nad / UK
14/07/2014 11:00
Those who think that the psychological effect felt in Gaza is also felt in Israel are morally bankcrupt. There has not been a single death in the entity whereas poor innocent babies and civilians have been systemetically massacred in Gaza. In the a civilized world, you feel true sympathy with the real victims and not imagninary ones who have bunkers to escape into.

12 ) Upset / Ramallah / Palestine
14/07/2014 13:30
Downscaling Palestine, be it the West Bank or Gaza has been the zionist dream since the beginning of the occupation. The constant attacks on Gaza are an example of how that vision is carried out, yet Israel uses pretexts so that their attacks look defensive and necessary, such as the kidnappings. Use of collective punishment against civilians is illegal and inhumane, moreover it is a cover up for the eliminating of Hamas. Don't ever compare Israeli's to Gazan's, there is no comparison.

13 ) Mutassim / Palestine
14/07/2014 14:31
For those talking about winning, its not a came of cards. Hamas fights to preserve the dignity of its people, it fights back against the occupier of their land. It tries to protect what little is left of Palestine and keep it in Palestinian control. Hamas doesn't beg, or collaborate with the enemy, whilst stabbing its own people in the back. Hamas abides to the principles of Islam and struggles for the sake of Allah. Most of Hamas work is social, schools, hospitals, charity. Hamas really cares.

14 ) JoeFattal / USA
14/07/2014 15:38
@4 and 5 Yes hamas Hamas will emerge the winner. A month or so ago a unity was signed, Hamas lost their control of Gaza. They are not the government anymore. That war with Israel and their rockets that have reach as far as Tel-Aviv even with no casualties as the Israeli media is claiming still put Hamas in a very strong political position. Yes gaza has their casualties, but they have them everytime they have a war with Israel. This time Israel is in a different ball game,

15 ) JoeFattal / USA
14/07/2014 15:46
Cont...would they go in, or not. If they go in the airtrikes going to halt, for fear of hitting their own men. The rockets will still be flying over their heads into Israel and they will suffer casualties. So what do we have, Israel airstrikes mostly on civilians, and rockets deep into Israel. While rockets are still flying how Hamas can lose. For now they winning.

16 ) Tom / USA
14/07/2014 19:09
There has been a consensus in Israel that the status quo - a murderous occupation, maintaining concentration camp Gaza - is "kol biseder," that everything's alright. The Palestinian resistance is providing a convincing "roof knock" that complaisance, in the face of their government's crimes, is not good for Israelis.

17 ) Khalid / Qatar
14/07/2014 19:38
@9 - So not true, last UN fact finding mission found no evidence of Hamas using people of Gaza as human shields. Gaza is a built up area of 1.8 million people. Hamas fires from fields on the edge of Gaza, not from populated areas. Gazans testify to this. You have the 4th most powerful military in the world, paid for by US complicity, plus nukes. You use illegal weapons like DIME's to kill our children. You have to bear responsibilty for your occupation, oppresssion & war crimes. We only resist!!

18 ) ben Zalman / USA
14/07/2014 19:56
Hamas shot several hundred rockets before Israels operation began. Enough said. Im sure Hamas knew the consequences. You who think its okay to attack Israel and the mighty Israelis will not respond are plain stupid and must be from another planet. What would any of you do if an intruder came into your house to kill your family? Would you sit and talk to him or would you kill him before he can kill you. Ill give you all one guess what Id do. Those of you who claim youd do different are liars.

19 ) Mel / USA
14/07/2014 22:17
O mighty SHAME ON YOU Israel! CRIMINAL SHAME ON U,Israel! You are controlled by EXTREMISTS.Israel's version of maniacla NAZISM!You have no conscience.
State-sponsored PSYCHOPATHY.
http://www.democracynow.org/2014/7/14/israel_targets_civilians_the_casualties_speak?autostart=true
http://www.democracynow.org/2014/7/14/we_are_human_beings_gaza_doctor

20 ) spb / us
14/07/2014 22:26
i don't understand it. I can understand that the losing party israel and its citizens are facing psychological problems. but why should gazens and hamas which are clearly wining should have ones?

21 ) Mel / USA
15/07/2014 00:24
The good Palestinian people of Gaza should SEND their OWN propaganda/terror leaflets to Israeli's. If USG allows Israel to do it by routine policy,then I'm sure D.C. won't mind Hamas/Gaza doing same.Tit for Tat.At least that's fair! The Israeli military occupation,&it's increasingly obnoxious band of trolls has never been fair! Send your own leaflets Gaza. 'WE WILL NEVER SURRENDER TO OPPRESSION'.'Zionist Israel isn't tall enough to kiss my shoe'.'After 67yrs we're STILL here'.'WE LUV U ISRAEL'!

22 ) @ Norwegian Doctor Gilbert / If Sweden Acted Like Gaza
16/07/2014 04:11
It is "very simple of stop the bombing, and end the blockade: - Hamas Ends The Terrorism. - Hamas Ends The Kidnappings. - Hamas Ends The War Crimes, of targeting Israel's civilians, and - Hamas Accepts Living In Peace With Israel. * THE BOMBING & BLOCKADE are bad for everyone, but they * RESULTED FROM GAZA'S ACTIONS (Not Israel's), which produced legitimate, and very real security concerns of Israel. * STOP BLAMING ISRAEL, for acting just as Norway would, If Sweden acted like Gaza !!

23 ) @ norwegian doctor ^ / Britain
16/07/2014 14:00
You cannot compare any country to palastine Norway n Sweden? Both have armies does palastine have an army? Hamas? Who are they - freedom fighters who want to end Israeli occupation of THEIR land. It's The Zionist (Israel) ends the terrorism, the kidnappings, the wars inhumane war crimes of killing PALESTINIAN CIVILLIANS (especially children), the use of Dense Inert Metal Explosives (DIME) which is a weapon of mass destruction..*ISRAEL ARE THE TERRORISTS WHO ARE GUILTY OF CRIMES AGAINST HUMANITY*

24 ) Randi / NJ
17/07/2014 13:09
i can only add that sadly 99% of the reson for the onslaughts is the average Israeli sits in a safe house or even their house. laughs, sings, plays games reads the paper and says: "now it's their turn" is it? do i deserve the same with no voice? there is little difference but nobody at all speaks verbally for me ever.

25 ) david / israel
17/07/2014 14:20
the real psychiatric cases are the leaders of hamas, who for the sake of the questionable glory of raining rockets on Israeli cities are sacrificing their own people's lives, property and sanity.

26 ) ian / australia
20/07/2014 06:13
"As a psychologist I want to say that Israel has to be very afraid about how these acts affect their community, because they are full of hatred. Those soldiers...will not only hate Palestinians but will cause harm in their own lives." What he's saying is Israel risks becoming a nation of sick racist f***s, blank to the suffering of anyone else, blindly patriotic, belligerent, self-righteous, with the hate, sadism and fear of the bully/coward eating away at (what's left of) their souls...

27 ) ian / australia
20/07/2014 06:14
(contd.) a process well underway if comments from Israel-lovers like Outlier, Tibi, Tobias, ben Zalman, southparkbear and david are an indication. Congrats guys. You're almost ISRAELIS.

28 ) ian / australia
20/07/2014 06:17
#22 "STOP BLAMING ISRAEL, for acting just as Norway would, If Sweden acted like Gaza !!" Ah, analogy time. But, it's a bit different isn't it as Norway didn't invade Sweden 67 years ago and establish a racist Norwegian theocracy on Swedish soil (i.e. three quarters of it). Nor has it OCCUPIED the remaining quarter for 47 years populating it with insane Norwegian religious fanatics in illegal settlements. And it didn't "disengage" from an isolated "strip" of Sweden creating a blockaded

29 ) ian / australia
20/07/2014 06:18
(contd.) concentration camp of 1.8 million Swedes kept on starvation rations in a cynical effort to divide and demoralise Swedish society. Did it? And so the analogy is ridiculous. Isn't it?

30 ) Andrew / The World
22/07/2014 05:28
If the Gazans are in such turmoil, should they not look at who has brought them to this point? Hamas is of course the answer, but if the people complain they will be hung from lampost or construction cranes. Israel, continue the battle until the poor people of Gaza realize it's their controllers, Hamas, that causes them all this suffering. Golda Meir wisefully said that she resents the Arabs more because they want to destroy us but that they make us perform that kills their children.

31 ) spb / usa
22/07/2014 17:27
interesting fairy tell, can i have another latte?

32 ) ian / australia
23/07/2014 14:58
#30 Interesting, Andrew. That cloying deep thought of Golda Meir's has always made me wanna puke (that and the kitsch photo of awestruck paratroopers at the Western Wall) essentially because of the brazen denial of criminality in both. Mel had a good quote a while ago from Dr Daniel Bar-Tel (at TAU) about what characterises "Israeli Jews consciousness" including "...a sense of victimization, a siege mentality, blind patriotism, belligerence, self-righteousness, dehumanization of Palestinians

33 ) ian / australia
23/07/2014 15:01
(contd.) and insensitivity to their suffering..." YOUR post, Andrew, culminating in Golda's timeless stomach-turner ticks ALL boxes. Congratulations! You're almost an Israeli Jew (though still a way to go to match #31 in grinning psychopathic idiocy). (No offence.)
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