Hassan al-Zeyada has spent decades counselling fellow residents of the Gaza Strip who suffer from psychological trauma. Now, as he prepares to aid his neighbours after a new round of combat and carnage, he has a challenging new patient: himself.
An Israeli airstrike demolished Zeyadas’ 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.
Zeyada, 50, works to de-stigmatize mental health care for a Palestinian population exposed repeatedly to war and displacement, practicing at the Gaza Community Mental Health Program. Zeyada is not the only Palestinian caregiver to become a trauma victim. In the three weeks of attacks, one of Zeyadas’ 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.
PowerlessIt 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 neighbourhoods, but even U.N. 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,” 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.
“You are,” he said, “like a prison doctor treating a victim of torture, making the prisoner healthy to be interrogated and tortured again.”
“I am so afraid in this building,” the doctor said, pointing out his sixth-story window. “Several apartments here,” he said, “are crammed with 60 people or more as residents take in fleeing relatives.”
“They may hit it at any time,” he said of the Israeli military. “There is no safe place. Psychologically, that is the problem.”
Tough road aheadAs they visit the grieving in their homes and shelters, and prepare to reopen their clinics, Gaza’s mental health counsellors face a huge job.
One-third of Gazan children showed signs of post-traumatic stress disorder even before the latest outbreak of fighting, according to Dr. James Gordon of the Washington-based Center for Mind-Body Medicine, which runs a program in the territory. Now, with the death toll for the last three weeks exceeding 1,500 Palestinians relative to the population, the equivalent of nearly 200,000 deaths in the United States nearly every Gazan has heard or witnessed shelling, and most know someone personally who was killed or injured.
A few blocks from Zeyada’s apartment, Younis al-Bakr, 9, sat curled on a sofa, chewing on his fist like a much younger boy. His family said he had not spoken a word since he witnessed the shelling that killed four of his cousins on the Gaza City beach on July 17. Younis and three more cousins survived the attack, suffering shrapnel wounds along with less visible ones.
“We didnt lose four,” said his uncle, Hamis al-Bakr. “We lost eight.”
For his own part, Zeyada said that he would seek peer counselling and go back to work, not least because, as the oldest surviving brother in his extended family, he is now responsible for 11 of his dead siblings’ children.
“There is no other choice,” he said.
Published - August 06, 2014 06:58 pm IST
