One in three #Gaza children already showed signs of PTSD before the latest war

The New York Times reports: Hassan al-Zeyada has spent decades counseling fellow residents of the Gaza Strip who suffer from psychological trauma. Now, as he prepares to aid his neighbors after a new round of combat and carnage, he has a challenging new patient: himself.

An Israeli airstrike demolished Dr. Zeyada’s family home on July 20, killing six close relatives, including his mother and three of his brothers.

“You try to help the people with their suffering,” the doctor said recently in his Gaza City living room lined with psychology textbooks. “It’s totally different when you have the same experience. You lose six from your family — three brothers, your mom, one of your nephews, your sister in-law. It’s really” — he paused, red-eyed — “unexpected.”

He took a mental step back, to diagnose the hallmarks of trauma in himself: He was exhibiting dissociation, speaking in the second person to distance himself from pain, as well as denial. When he heard about new shelling near where his family lived in the Bureij refugee camp, he picked up the phone to call his oldest brother there. He had forgotten that the house was already gone, his brother already dead.

Dr. Zeyada, 50, works to destigmatize mental health care for a Palestinian population exposed repeatedly to war and displacement, practicing at the Gaza Community Mental Health Program, which was led by the pioneering Palestinian psychiatrist and human-rights advocate Dr. Eyad El-Sarraj until his death from leukemia in December.

Dr. Zeyada is not the only Palestinian caregiver to become a trauma victim. In the three weeks of attacks that Israel has said are meant to root out militant rocket fire and destroy clandestine tunnels into Israel, one of Dr. Zeyada’s colleagues at the program lost a brother, and their boss, Dr. Yasser Abu Jamei, lost 26 members of his extended family, including 19 children, in a single bombing.

It is difficult — even absurd, the clinicians say at their darkest moments — to try to mend psyches in the Gaza Strip, where even in calmer times the conditions are hardly conducive to psychological health, and safety is never more than provisional under the many cease-fires that have come and gone.

People cannot flee from Gaza; Israel and Egypt keep their borders virtually sealed. Residents can flee their neighborhoods, but even United Nations schools being used as shelters in Gaza have come under deadly fire. And in downtown Gaza City, where Israel has urged people to go for safety, Israeli airstrikes have repeatedly hit apartment buildings packed with residents and refugees. One strike collapsed most of a building and killed the family of a bank employee who had fled there on Israeli instructions.

The border restrictions, stemming from an eight-year standoff between Israel and Hamas, the militant group that dominates Gaza, have steadily eroded livelihoods in Gaza, adding to a sense of powerlessness. Even during relative lulls in violence, Israeli strikes periodically kill militants — and bystanders. People who do not want Hamas and other militants to use their farm fields to fire rockets, for fear of return fire from Israel, say they cannot always stop the combatants.

The healthy processing of grief and fear works best when sufferers feel they are out of danger, Dr. Zeyada said. But that is impossible in Gaza as long as the larger conflict persists.

Sometimes, he said, he was troubled by the ethics of treating people who were likely to be traumatized again. [Continue reading…]

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