The state of mental health in Gaza has to be contextualised in the history of the last 75 years of colonization and occupation; the 17 years during which Gaza has been the world’s largest outdoor prison; and the current constant bombing and invasion of Gaza that has shocked so many people around the world. 

As a clinical psychologist with 33 years’ experience, I must acknowledge feeling helpless when asked to speak about Gaza.  I can easily talk about what has become known as post-traumatic stress disorder experienced by all soldiers on the Western Front during the 1st World War or about the same disorder suffered by survivors of the Nazi concentration camps.  I can also talk endlessly about depression and the various forms it takes, often including escape in alcoholism and drug addiction.  But to what avail? 

Nothing ‘post’ about the trauma

There are two important differences between the two horrors of the First World and the concentration camp survivors, on the one hand, and Gaza on the other.  Firstly, the survivors of both the war and the camps were taken to safe hospitals far from the conflict, where they received loving and, if needed, prolonged care.  In stark contrast, the people of Gaza are endlessly re-experiencing the trauma within the very place of their suffering. They are forced to relive the trauma during repeated military incursions by Israel. 

So, when it comes to talking about Post Traumatic Stress Disorder (PTSD), it is a diagnosis that doesn’t fit in with the horrifyingly unique realities of Gaza.  For the people of Gaza of all ages, there is nothing “Post” about their traumas: theirs is indeed an endless nightmare.  

The slaughter of children

I am haunted by a TV picture I recently saw of a child sitting alone in the midst of what is now nothing more than rubble.

Secondly, there are the children.  The children!  What can one possible say about them other than weep.  Instead of a childhood they have never known, they have never lived life without the fear of death – theirs as well as members of their family – or the experience of aerial bombardments and destruction, especially now including their very homes.  In my case, the distraught feeling is compounded by my professional impotence, aggravated still further because, as a Jew, Israel’s war crimes are supposedly done in my name.   

I am haunted by a TV picture I recently saw of a child sitting alone in the midst of what is now nothing more than rubble.  Then I saw a picture of an old woman trying to put food together, and thought of her resilience and her will to survive against all the odds.  

There are a number of studies on mental health in Gaza.  But virtually nothing can usefully be done until there are the physical conditions that make any professional interventions possible.  

I heard on the radio the other day of a doctor in one of Gaza’s then-still-standing hospitals about a mnemonic for “living child with no surviving family”.  This is the reality that reduces psychological analyses to empty talk.  At least for now. 

What is immediately needed are not mental health specialists but an immediate cease-fire that leads in quick succession to a liberated Palestine.  That is when there will be the need for thousands of mental health specialists from around the world who might, at last, be able to bring some long-awaited relief to those who survive Zionist Israel’s strategy of accumulative genocide.   

Suzanne Hotz is a clinical psychologist in Cape Town.