Speech on mental health problems of the children of Gaza, as an aspect of humanitarian aid to Gaza, delivered at the European Parliament in Brussels (*) on October 15, 2014, by Dr Christophe Oberlin, during the Conference titled “Children in Conflict Zones”.
It may seem odd to hear a surgeon talk about mental health. In fact, as doctors, we should not separate physical and mental wellbeing. And you probably know that, in its definition of health, in Alma Ata in 1978, WHO declared that health includes “physical, mental and social wellbeing”. One cannot contemplate improving health in Palestine, and in Gaza in particular, without considering the physical (me as a surgeon), mental (subject of my talk), and social (your subject as politicians!) aspects and I will discuss all three of them.
Regarding children’s mental health, I must mention a prominent Palestinian psychiatrist I met in 2001 during my first stay in Gaza: Eyad Al Sarraj. He is well known for his studies on the effects of war trauma on children’s mental health. He told me at the time that “after a study covering 3 000 children in Gaza, we found that 40% had seen the body of someone killed by the Israeli army”. (But is it different today after the barbarian attack against civilians last summer?)
So what are the consequences of war on a child’s brain?
The consequences of such stress are the same in Gaza as anywhere else in the world: sadness, depression, sleeping disorder, nightmares, enuresis (bed-wetting), anger attacks, learning difficulties at school. I won’t give you statistics, because statistics have no name and no face. Very good studies have been published by Hatem Abu Zaideh, a Palestinian neuropsychologist.
But as, for the past 13 years, I have travelled three times a year to the Gaza Strip, I will give you some short accounts from my own experience in the field, concerning patients I have treated together with my friend Dr Maryvonne Bargues, who is a psychiatrist.
When I go to Gaza, the first day is dedicated to a huge consultation: 50 to 100 patients. On one occasion, I saw Ahmed, who was 8 years old and had developed total paralysis of both upper limbs. His shoulders and elbows were completely paralyzed. Only his hands were moving, hanging down. He was unable to dress, wash or eat alone. I examined him carefully, and did not diagnose anything wrong. I explained to his father that unfortunately I could not suggest any treatment. Then I examined his father: he had been in an Israeli jail for months, tortured every day, suspended by his wrists for long periods and beaten many times. He was a tetraplegic (paralysis of 4 limbs) due to irreversible medulla injury. In particular he was unable to move his shoulders or his elbows. So the child in his suffering had developed a simulation of his father’s problem…
Jihad is 14 years old. For the past four years he has been a sleepwalker. But an unusual one: every night he wakes up, picks up a heavy object and rushes to the door to try to get outside and harm the soldiers and run in front of the tanks he sees in his dreams. Every night his parents try to wake him up, to draw him out of his nightmare, without success; they block the door with an old sofa. The day after, Jihad has no memory of the night, he is a quiet pupil. But when you talk to him, his conversation is all about mass killings in his surroundings. A friend’s father was killed in his sleep by a stray bullet. In one year four of his friends were killed, one by one. His uncle is a prisoner. Jihad is having premonitions about his father’s life. And every night he is a warrior.
But, as Hatem Abu Zaydeh explained to me, these children have no choice but to develop escape strategies (stratégies d’échappement): in the family, the group, society. I have seen six- to ten-year-old children playing on the roof of a house. They had built miniature houses with corrugated cardboard. They were playing « Israelis and Palestinians » like we used to play “Cowboys and Indians ». And surprisingly the children preferred to be the Israelis because, at the end of the game, they released all their energy by destroying the cardboard houses completely!
Some children escape the nightmare by taking up religion.
Others escape into resistance, fighting and violence. I had a long talk with Moussa. His mother told him that his grandfather had been killed by the Israelis when he was just a guard outside a school. His uncle was a prisoner and, as a young child, Moussa heard accounts of how he was tortured. Moussa saw children with broken limbs after Rabin’s order “to break their bones”. He explained that he saw Israeli soldiers pushing a man in the street to kiss a donkey’s anus. Then, when he became a young adult, Moussa decided, without telling anyone, that he was going to fight. At that time, just before the first intifada, there were no guns available in the Gaza Strip. So Moussa bought a Swiss army knife (a type of pen-knife). He went to the market on Saturday. In those days Israelis used to come to shop in the markets in the Gaza Strip. And Moussa killed an Israeli. He ran away, closed his knife, and went quietly back to school without saying a word about it to his friends, or his family. Nobody was aware of what he had done. And he did it again four times in one year.
So today we are thinking of providing so-called humanitarian help to the Gazans, especially the children. But I must tell you that such help may also give rise to a certain degree of anger among the people you are intending to help. After the bombing of families, the “humanitarians” arrive. They take photos, giving rise to some reactions: “We are not in a zoo!” Some of them focus on the children. Why separate the psychological problems of the children from those of their parents? Is a child less humiliated by his parents’ inability to protect him than the parents themselves? Is a child less affected by his father being unemployed than the father himself?
Reading a witness’s account of the situation of the children in the aftermath of the Nakba in Gaza, a United Nations official wrote:
« We went to see the refugees – thousands of men and women exposing their suffering in a mood of utter despair beneath a grey winter sky. Children by the hundreds, most of them half-naked – shoeless, shivering – conveyed the depths of their misery in gestures that were more eloquent than words. The parents showed us the camp, they showed us the holes in the ground – deep, like wells – where the children were living in total darkness, piled one on top of the other on the icy rock ».
Is the situation really different sixty years later?
What have you done in the European Parliament this summer to protect the population of Gaza? What has the Representative for Foreign Affairs, Catherine Ashton, done to stop the bloodshed? What has the Council of European Foreign Ministers done? What pressure has the Commission brought to bear? Has it ever entered your mind to break the special economic agreement between the European Union and Israel?
You have done nothing, and you are responsible for having created, for the first time in Palestine’s long history, Palestinian boat people.
By following the American administration like a little dog and declaring the first political party of Palestine that won the last free elections to be a “terrorist organization”
, the behaviour of the European Union is racist, anti-democratic and terrorist. All of you are involved in what has happened.
I denounce the schizophrenia of the European Union, on the one hand giving money to pay the civil servants in Palestine, while on the other authorizing Israel to commit massive war crimes. You are (will be?) responsible for the next war. Children in Gaza are not beggars. They don’t ask for humanitarian aid. They ask for Justice.
By Christophe Oberlin | October 15, 2014