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"What, Palestinians suffer from traumas and anxieties?"  

i n f o p a l -- The Independent Palestinian Information Network*

Médecins Sans Frontières is providing Palestinians in the Gaza Strip with mental health services alongside medical care. Psychologists talk with parents who have trouble getting up and with children who wet their beds.

By Amira Hass

Ha'aretz, Sunday 25 March 2000

Recently, a group of some 20 schoolchildren in their early teens was in the Saja'iya neighborhood in the eastern part of Gaza. The children are devoted to the symbolic action of the Intifada: throwing stones at well-fortified IDF positions or at military jeeps and settlers' cars on the road connecting Netzarim to the rest of Israel. 

While hundreds of these children's friends have stopped believing in the purpose of this symbolic act and return home at the end of the school day, this local group continues to look eastward, to the Karni-Muntar crossing. On February 26, a new IDF position, consisting of a concrete observation post, an armored personnel carrier (APC) and occasionally, a military jeep or two, was set up there. The entire area around the position is open; hundreds of acres of former orchards were razed and any movement in the area is visible to the soldiers observing the area. The children from Saja'iya are well aware that the stones they throw, even if they use a slingshot, will just barely bounce off the post or the well-protected jeeps. The soldiers fire straight at them from an APC, the post or a jeep. The children know they may get injured or killed, that throwing a stone or two will not give them all enough time to hide, yet they continue to come. The adults around them have noted that recently these kids have become increasingly devout in their religious observance. They make sure to attend the funeral of every person killed by IDF fire and when they come to the cemetery, they rub their faces with earth as an act of purification before the prayer service. Their devoutness is seen as a way of coping with the fear, which is the lot of every adult and child living in the Gaza Strip. Neighborhood activists from each of the two rival Islamic organizations - Hamas and Islamic Jihad -tried to convince the group to announce its affiliation with their respective organizations. The children rejected the idea outright and stressed they were independent. 

One member was Mohammed Hilis, 13. On Tuesday, February 27, he approached the border area where Netzarim residents drive pass by with their escort of military jeeps. At around 2:30 P.M., witnesses told an investigator from the Palestinian Center for Human Rights, some 30 children moved to about 50 meters away from the border with Israel and started throwing stones at the jeep leading a convoy of Netzarim residents' cars. The jeep stopped and a soldier fired two live bullets at the kids. Hilis was hit on the left side of his head. Witnesses said the soldiers did not use any non-lethal methods to warn the kids. Hilis died from his critical injury on March 1. 

The stone throwers are not the only ones wounded by live ammunition. On the same Tuesday when Hilis was fatally injured, 5-year-old Fatma Abu Salah was hit by a bullet. Her family lives in the village of Absan, east of Khan Yunis, close to the border with Israel. Her mother told the Palestinian Center for Human Rights investigator that shooting could be heard in the area starting at 4:30 that morning. At 7:30 A.M., Fatma was at the entrance to her kindergarten, around a kilometer west of the border, when she was hit by a bullet. Was it a stray bullet from the area where there was an exchange of fire? In Gaza, they do not believe in stray bullets. People there believe the IDF has the most advanced equipment that lets them see every target, day and night, and therefore, every shot fired, from far away or from nearby, is intentional - even one that hits an 8-year-old boy. 

Unlike Fatma Abu Salah, Mustafa al-Luka, 15, was shot from close range. A resident of the Brazil refugee quarter in Rafiah, Luka was sitting in front of the Al Nur mosque on February 26 at about 4:30 P.M., when he heard some shots and an explosion. The mosque is 10 meters away from the Gaza-Egypt border and the adjacent security road controlled by Israel. He noticed the head of an Israeli soldier sticking out of a tank driving along the border from west to east and another tank coming from the east. The two tanks met at a point opposite the mosque, he told the Palestinian Center for Human Rights investigator. 

"I saw an Israeli soldier aiming his machine gun at me. I heard three shots fired. I felt something hot penetrating my right elbow and chest. I managed to run away into the neighborhood and from there I was taken to Jenina hospital (in Rafiah)," the boy said. 

So not a day goes by in the Gaza Strip without a few children being injured by Israeli shooting and not a week goes by without at least one or two adults, or maybe one, two or three children, being killed in circumstances similar to those described above. The people here experience firsthand the reports in the Israeli press about "an easing up of the open-fire regulations." At first glance, it seems that people have accepted the fact that their lives are in constant danger, because wherever they may be, they will be within range of the Israeli weapons. The expressions on peoples' faces, the jokes they make about the situation and their ever present smiles do not reveal any fear or panic and indicate an incredible ability to adapt to every situation, however crazy it may be. 

That is why one Israeli reserve soldier, a psychotherapist serving at the Tel al-Sultan post, was so surprised to hear from Herve Landa, a fellow psychotherapist, that the Palestinians are also suffering emotionally from the long days of fire from machine guns, tanks, helicopters and rocket launchers that is aimed directly at their homes. "And I was convinced that the Palestinians don't experience any traumas or anxieties," the Israeli soldier-psychotherapist said. "They pass in front of us at the roadblock and their faces don't show any emotions." 

The two psychologists met by chance at one of the roadblocks in the Gaza Strip. The soldier wanted to know who this Frenchman was and why he was in such a dangerous place and they started to chat. Landa works for the French humanitarian organization, Médecins Sans Frontières (MSF, or Doctors Without Borders), which was founded in 1972 to provide medical aid to places afflicted by wars, disasters and bloody conflicts. In recent years, after gaining experience in places like Chechnya, Bosnia and Kosovo, the organization realized that it is not enough to send only medical teams to treat physical injuries and that the emotional pressures and resulting physical symptoms are widespread and no less paralyzing. In the shadow of the renewed Israeli-Palestinian conflict, MSF has opened two new branches in the Palestinian territories - one in the Gaza Strip and one in the Old City of Hebron. Doctors and psychologists work together there, coordinating with each other, exchanging information and using similar methods: They do not wait in clinics for people to come, but make house calls, mainly because of the travel restrictions Israel has imposed on the Palestinians since October 2000. The interpreters working with them are Palestinians who spent many years in Algeria. 

The families in the Khan Yunis refugee quarter, which is closed in from the west by the Gush Katif settlements and some IDF posts, warmly welcome Landa and his interpreter. They are given some simple chairs to sit on in the courtyard of a building or next to a room destroyed by missile strikes or a wall pocked with bullet holes, or they may sit on a mattress in the guest room of a house. Sometimes they talk to the whole family, parents and children, and sometimes they ask to speak in private with one family member. As Landa speaks and listens, he looks straight into peoples' eyes, as if they shared a common language. He remembers every detail people told him during previous meetings. He remembers who this child had a fight with after he was injured in the leg by Israeli shooting, and what was the dream of the girl who caught a bullet near her heart and whom no expected to survive for long and yet she is still alive. People are amazed that he remembers every detail and that seems to be part of the treatment: the sense that someone is so interested in what they have to tell him, that every detail is so important to him that he does not forget any of it. Why are the legs trembling? Palestinians are not used to having intense conversations. No one needs a psychologist from abroad to know that deaths every day and so many wounded people, ruined homes and so much shelling and shooting affects people's emotional state; that because of it, parents have trouble getting out of bed in the morning and children are more violent at school and wet their beds. But Landa is a big believer in the power of talking things out and in the importance of digging underneath their fears and physical symptoms. It seems that the Palestinian girls agree with him and are a lot more open and eager to talk, even about deep- rooted emotions and about their bad dreams. It is a lot harder to get the boys to talk. 

He believes that thanks to the talks they have had, K., who has a bullet lodged near her heart, started getting out of the bed she had holed up in for many long weeks and smiling. She was injured while inside her house, by shots fired from a helicopter hovering over the neighborhood. K. lives in constant fear that the bullet will move and she will die. A dull pain next to her heart is a constant reminder of the injury. She is afraid to exert herself. She does not carry textbooks and notebooks to school; Landa suggests she start off by carrying one book. She bakes just eight pitas, while her sisters bake dozens and half-jokingly tell her that she is not doing her share of the family chores the way they do. Before she met Landa, she did not bake any pitas. "People help themselves through me," he says. K. relates a dream: The Jews are shooting at us, half of the people are killed, half live. "Who are you with?" Landa asks. K. is confused by the question. "Are you among the living or among the dead?" he asks again, and she remembers that not only did she remain alive, but also, she helped with the rescue efforts. The dream is not a good one, she says, and Landa tells her that he thinks it is a positive dream, because she is active in it and does everything. 

A., who was hit in his leg and hip by live ammunition while he was part of a group throwing stones at soldiers, noted that since he was wounded, he is prone to outbursts, goes wild and scares people away from him. When he hears the sounds of shots being fired, the area of his wound throbs and irritates him. By talking to Landa, he learns not to be afraid of pain, to accept himself even when he has outbursts, to admit that it is not his friends' fault so that next time he will count quietly to himself for a bit before letting loose. 

Landa tries to talk to the adults and the children about the fear they feel. If the fear strikes when they hear shots fired, that is only natural; if the fear also strikes when there is no shooting, they try together to identify causes that spark such fear. Many people told him that they are especially afraid at night: In the refugees' homes, the bathroom is located in the courtyard. The houses sit in full view of the Israeli observers. They are afraid that if they move in the courtyard or turn on a light, they will be shot at immediately. The parents, he notices, have trouble getting up in the morning because it is hard to find hope and a reason to get up for. They are short-tempered with their children to cover up the helplessness they feel: Without any income, they cannot provide for their children and cannot protect them from the shooting. In the evenings, when the shooting starts, the great flight away from the houses begins. Entire neighborhoods are emptied of their residents at night. During the flight, someone always stays behind or gets lost and the trauma will affect the family for days afterward. The most serious symptom of anxiety is physical pain in the legs. People discovered that their legs were trembling and could not carry them. Talking with Landa helps them understand that these are real, logical pains, and not the result of some mysterious bodily injury and therefore they are not incurable. 

In February, MSF's doctors and psychologist dealt with a particularly difficult case involving a mixture of physical and emotional injuries. On February 12-13, the IDF used tear gas to disperse Palestinian rioters near the Tufah gate, at the end of the seaside road linking the center of Khan Yunis to its refugee camp, which continues to the sea (near Gush Katif). Instead of the grayish white clouds, which the neighborhood residents were familiar with from the past, a yellow and black gas spread through the neighborhood. People initially thought that something was on fire and instead of running away from the smoke, they moved closer to it and were then injured even more. People vomited for several days, suffered stomach pains, had tremors in their hands and legs and were unable to move. A storm arose when some Palestinians, led by Yasser Arafat, claimed that Israel was using a banned type of poisonous gas. The IDF quickly denied the charge. 

Helen Briso, one of MSF's doctors, spent several days in the Khan Yunis hospital checking the patients. Contrary to the Israeli claims that the tremors and other reactions were staged, she confirmed that all the ailments were genuine. MSF representatives concluded that the gas used by the IDF was indeed in very high concentrations, which the people were not used to. Most of the Palestinian doctors reached the same conclusion and some of them also readily acknowledged that the ongoing physical reactions were a kind of hysteria caused by the unfamiliar gas. 

Landa encountered people who were convinced the gas would cause cancer. M., K.'s older sister, was hospitalized for several days, unable to move. "I'd rather be injured by gunfire, just as long as I don't inhale any tear gas," she says repeatedly. At the schools, there are guidance counselors who talk with the children; teachers are told to listen to the problems. Nevertheless, K., a teacher at a school in Rafiah, wonders whether the heart-to-heart conversations can help, when the circumstances around them - the reason for the traumas - are not changing. K.'s oldest son, 12-year-old Basel, thinks every day about his friend who was killed; every corner of the crowded refugee camp reminds him of when they played together. When he fights with his mother, he says: "I'll go to the border, a Jew will shoot at me and I'll die." And K. asks - just as many Palestinian parents and teachers are asking - what can she do, what can possibly be changed when every day, children continue to be wounded and killed. 

According to many Palestinians, everyone simply adapts or gets used to the fear or else they stop being afraid. K. has a hard time answering her students' questions. One girl in her class who lives near the border fence - a place that attracts IDF fire - was hit in her back by live ammunition. "Didn't the soldier know that I just went to bring some bread home," she asks her teacher again and again. And another boy who was wounded asks the adults in his neighborhood repeatedly if the Jews have no children and if that is why "they shoot at us indiscriminately".

(c) copyright 2001 Ha'aretz. All Rights Reserved. 

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