Gaza’s kids affected psychologically, physically by lifetime of violence

Beyond the immediate loss in Gaza — destruction of property, infrastructure, and the deaths of more than 1,600 people, mostly civilians — Israel’s onslaught will have long-term mental and physical effects on the Palestinian children who survived weeks of airstrikes and naval and tank shelling. 

Many of them watched as family members were killed and homes, schools and mosques bombarded. Others suffered life-altering injuries. Israel’s military campaign may also affect the unborn, as mothers and fathers struggle with traumatic stress, health experts warn.

Palestinian children in Gaza are exposed to more violence in their lifetime than any other people, any other children, anywhere in the world. If you look at children right now who are 10 years old, they’ve been through Cast Lead in 2008 and 2009, the invasion in 2012 and now the invasion and destruction in 2014, in addition to the siege. If you look at the statistics, for example, even before Cast Lead, 80 percent of Palestinian children in Gaza have witnessed some sort of violence against them, a friend or a family member. And now you’re getting to the point where probably close to 99 percent of children in Gaza are being exposed to a level of violence where they have seen family members be killed, murdered, burned alive. There’s nothing like the levels of traumatic exposure that any child in the world has ever been exposed to on a chronic and daily basis.

We can rebuild a broken bone, but when it comes to rebuilding someone’s psychological integrity, this is something that the people in the West and the Israelis don’t understand. They’re creating psychological damage for these kids that will be with them for the rest of their lives.

The psychological damage makes it difficult to function, to be successful in school, to have relationships with friends and family, to take care of yourself and at a more profound and deeper level — when we’re talking about creating a solution for the Palestinian-Israeli conflict and the West wanting peace between the Israelis and Palestinians — they aren’t growing up interested in peace and wanting to make things better. They just grow up deeply traumatized and very distraught and angry.

You’ve got a situation where grandparents, parents and uncles are already very stressed, and that would show in a number of ways: depression; certain clampdowns of emotions; and a tendency to get very upset at small incidents.

All of this really has an impact on kids growing up. They’re realizing that their entire structure for safety and protection is not doing very well.

I would say that in all studies of disaster and in war crisis, the fundamental feature that protects the children from serious psychological stress is their certainty and their confidence that their parents or grandparents will be able to protect them and hold them. If they can get the sense that the parent is OK, then they will be able in the long-term. In the short term they may be upset, but in the long term they will be OK.

You have now complete disruption of the very structures for psychological stability of the parents, and grandparents are also suffering greatly.

It will be important for — as soon as possible — stability to be restored and the parents to get it together for themselves to create a sense of confidence in themselves for their children. But I think the odds of that are not high for two reasons: One is there’s going to be ongoing violence and lingering uncertainty for some time in Gaza, even if there is hopefully a cease-fire that can be arranged. The worry will continue on the part of the adults and the children will remain terrified and unable to relax, literally and figuratively, in the arms of their family.

And then secondly, the parents and grandparents and others themselves, are in no psychological position to be able to convey that umbrella of hope and safety for the children. The resilience of the Palestinian population in general is not going to be as deep or robust as any of us want it to be and certainly as they would want it to be, just because this have been extraordinary series of acute stress on top of chronic stress.

Leaning: The hospitals there are valiantly overwhelmed and short of supplies, and in those situations they inevitably have to perform triage. They can operate only on people whose injuries are within the skill set of the doctors and the capacity operating rooms have and nurses to treat.

There are people who are coming into these hospitals with traumatic wounds from the bombings and machine-gun fire, who in a well-equipped and highly skilled or emergency area in the West would survive. But in these hospitals, they won’t survive because there’s just not the capacity to care for these extremely extensive wounds. There are more people dying of wounds in Palestine now than there would be if they had a stable and fully equipped trauma center.

The wounded range from being rather minor to chronic. And the Gaza Strip at the moment does not have the capacity to handle chronic wounds. You can’t keep people in the hospital for long because it’s overrun by new injuries. Nursing care is very short.

A number of these people who are wounded are going to have difficulty surviving over the longer run. They may have left with wounds to be cared for at home, but taking care of those injuries is a skill situation. Another point is that people need to be in one place to heal. They are running from places. That’s very difficult, and there are very few safe havens for people where they could rest for a week and have their bones knit or their abdominal wounds begin to close or their head injuries not reopen. I worry that there is going to be a significant number of people with longer-term disabilities because they have not been treated adequately or taken care of enough in the immediate term.

The number of dead and the number of wounded convey a false impression that the wounded are going to be OK.

In Gaza we learned that among the population with children born with birth defects, if you compare them with those who are born normal, regardless of other factors, in the ones with birth defects the mothers reported exposure to white phosphorus, white phosphorus and bombing or bombing in Cast Lead in 67 percent of the cases.

One very important thing we learned from a study conducted two years after Cast Lead was that children born two years after the operation — therefore the mothers in the next year or so before becoming pregnant were not directly exposed to ammunition — still were constant correlation. That can be because the mothers were continuously exposed to a toxicant, which is compatible with the fact that the mothers have been staying in the same place as when Cast Lead occurred. Most of the people have fixed their houses or cleaned the mat from the rubble and used the materials to rebuild them.

There’s not much space in Gaza to go and build somewhere else. So if contaminants were in the ground, the contaminants would have stayed there. Of course, contaminants that may have been there will stay in the environment and in the body of the people who got contaminated, which persist in the organisms and stay in the organisms.

We already studied and knew that toxicants and teratogens — that is, substances that can cause reproduction malformation — were present in the land and in the weaponry used in Gaza. These metals were at one point in people who were wounded by different kinds of metals. So we studied, and eventually, if the children with malformation were in fact contaminated by teratogen or toxicant metals, we found very specific contamination for some elements in children with birth defects different from the children born premature and different from the normal births. High levels known to be teratogenic were found in the birth defects of children that were not found in premature children.