In Gaza, where despair is everywhere, hope is the vital currency offered to children and their families by Dr Yasser Abu Jamei, the psychiatrist in charge of running Gaza’s biggest mental health charity.
“Without hope, we cannot pass anything on to those families, to those children,” says Abu Jamei, who for the past 12 years has directed the Gaza Community Mental Health Programme (GCMHP). “Without hope, we wouldn’t be here. We can’t give up on 1 million children who live in Gaza, struck every day by the difficulties they are facing. We need to find the hope in their lives.”
Even before the current war, four in five children in Gaza were living with depression, fear and grief.
More than a year of intense bombardment, displacement and the 17-year Israeli/Egypt blockade that restricts freedom of movement have intensified trauma so that now, nearly all of the Palestinian territory’s 1.2 million children are said to be in need of mental health support.
This year, supported by the charity War Child, the organisation treated 3,000 people in its four community centres in Gaza. The 90 team members have also offered one-off psychological support to at least 30,000 people living in tents, shelters, schools and bombed-out buildings.
They are only scratching the surface of need, says the psychiatrist.
“Gaza’s 2.1 million population, 90% of whom are now displaced into overcrowded shelters, is severely affected psychologically. But without enough food or clean water, they are in survival mode,” says Abu Jamei.
Children take on the role of adults, standing in line for provisions or searching for empty milk and juice cartons they can burn for warmth. There is no time to mourn relatives or even parents. About 17,000 of Gaza’s children are separated or unaccompanied, according to Unicef.
Paradoxically, Abu Jamei says, it is often when the worst bombing is over that people seek mental health support. Then there is time to reflect and time to mourn.
“During war, people are in survival mode. When there is a ceasefire, their attention will shift to other needs, such as education and their psychological symptoms will start to appear. Usually, three to four weeks after a ceasefire is when we get an influx of people seeking support.”
The GCMHP, which is supported by War Child, one of this year’s three Guardian and Observer appeal charities, offers counselling, support and “psychological first-aid kits” to families. Simple things such as drawing materials for children can allow a break for a conversation to take place in overcrowded camps of thin canvas and plastic tents where the displaced civilians of this war have no privacy.
“We were impressed by how parents react positively to these kits,” says Abu Jamei. “They’re extremely happy to see their children drawing, and it brings about a change in the family.”
Over many years of working with families traumatised by years of conflict in Palestine, he has learned that children often respond to toys as prompts to better explain their feelings.
“Through drawing, they can talk. Then you can talk to the parents, to give advice about what they can do to calm their children and themselves and somehow reduce what they are dealing with. And this makes a really big difference.”
Abu Jamei says very few families are untouched by the war and by the long-running regional conflict. He knows this all too well – in 2014, an Israeli missile killed 28 members of his extended family. This year, after being displaced multiple times to temporary shelters, the father of six made the difficult decision to leave the territory. While in Cairo, where he now lives, he learned the house he had built in Gaza had been reduced to rubble.
He suffers from “survivor guilt”, he says. But he accepts to be outside Gaza, to work with mental health professionals on better treatment methods and with the international community and donors. He carries on, even as the outlook in Gaza is bleak, by hearing of the positive impact his team has. “We try to draw a smile on the faces of children,” he says.
He gets daily updates via WhatsApp when the intermittent wifi works. Last week he heard from a social worker and psychologist with 15 years’ experience. Visiting camps in Deir al-Balah, she had been told of a mother deeply concerned about her 12-year-old son who had stopped eating and speaking after his friends were killed in front of him.
“The social worker went to that tent, to that lovely boy, who had brightly coloured eyes. She said: ‘I know you have not spoken for three days. I am here just to listen to you, to give you space, for whatever comes to your mind.
“For 15 minutes, they sat in silence, and then the child started to cry. Then, in the first words he had spoken since the attack, he said: ‘I saw my friends die in an apartment. They told me that they had gone to heaven but one of my friends, when they found him, he was decapitated. How can he go to heaven without his head?’
“The psychologist was able to reassure him, telling him heaven is a different reality and he did not need to worry. She persuaded him: ‘Let’s eat something together.’ The mother was so grateful, she was tearful, to see her child crying and eating. It is really important people get to express themselves and mourn their loved ones.”
Abu Jamei does not discuss politics; he concentrates on his team and their patients, but says he believes in a ceasefire because he has to. He also urges the international community to keep an eye on Gaza, especially when the war ends.
“It’s very important to maintain that hope, among our supporters, and also the international community. Because if you give up on us, and we give up on our people, then what’s going to happen? It shouldn’t be like that. We learn from history that injustice cannot continue for ever.”
