Nine Months of Israel's War on Gaza: The Mental
Health Impacts and the GCMHP's Response(October 2023 – June 2024)

Nine Months of Israel's War on Gaza: The Mental Health Impacts and the
GCMHP's Response

Contents
Contextualization .................................................................................................................. 2
MHPSS Situational Analysis ..................................................................................................... 3
Gaza Community Mental Health Programme (GCMHP) ................................................................. 4
GCMHP Emergency Response Plan & Services Provided ............................................................ 4
GCMHP Emergency Response Achievements (October 2023-June 2024) ....................................... 5
Psychological Impacts and Needs (GCMHP Observations) ......................................................... 6
Findings......................................................................................................................... 8
Stories of Victims..................................................................................................................11Children’s Drawings..............................................................................................................13
Recommendations ...............................................................................................................141

Nine Months of Israel's War on Gaza: The Mental Health Impacts and the
GCMHP's Response

Contextualization
Israel initiated a military operation in the early afternoon hours of October 7th, declaring that
it was at war. It soon closed all border crossings that allowed the import of food, fuel, andother goods, and laid siege to the Gaza Strip, turning off the supply of electricity and waterfrom Israel. The Israeli military forces carried out unprecedented airstrike attacks targetingneighbourhoods, cities, towns, affecting mostly innocent civilians, including women, children,
elderly, and those with disabilities. This was followed by a ground attack and a military
operation inside the Strip beginning from October 27, specifically in the North and Gaza
governorates, with a series of air strikes and widespread bombing that led to the cutting of
power supply and telecommunication lines.
A collapsing healthcare system, continuous human rights violations, many massacres, and ascarcity of necessities like food, clean water, and medicine, were the hallmarks of the ongoing
offensive that started in October. Various reports considered the level and speed of destruction
to be the very worst in recent history. Persistent shelling over the Gaza Strip resulted in themass displacement of a people who were forced to escape to often even more perilous areas.
Figure (1) below shows the direct results announced by the UN and local agencies.
37,365

15,694

10,0181,049

498

PeopleKilledChildrenKilledWomen
killedElderly
People Killed

MedicalStaff Killed

150

246

152

70

10,000

Journalists Killed

Education
Staff Killed

UNRWA
Staff Killed

Civil Defence
Staff Killed

Missing
People

4,700

4,000

86,429

6,168

5,000

Childrenmissing

Injuries

Injuries(children)

PeopleArrested

25,010297,000

110

321

Partially
Damaged
Housing units

Destroyed
Schools andUniversities

Partially
Destroyed
Schools andUniversities

Missing children
and Women

87,000Destroyed
housing units

Destroyed
Buildings

25

131

Hospitals
damagedAmbulances
Damaged1.7 million(50%
children)

Who lost one or
two parents

IDPs

3000

2000

Children
Deprived fromChildrenAmputees

Treatment

17,000625,000
Children
Deprived from
Education

500,000 Sources: PCBS, UNRWA, UNICEF, MoH
Children need
MHPSS support(June 2024)2

Nine Months of Israel's War on Gaza: The Mental Health Impacts and the
GCMHP's Response

MHPSS Situational Analysis
GCMHP conducted a desk review to analyse
the current situation regarding the mental
health and psychosocial support (MHPSS).
People are more prone to have a variety ofmental health conditions during and after
disasters, and the majority including children
could be severely traumatized. Some people
develop new mental disorders after any
disaster, such as depression, and posttraumatic stress disorder (PTSD), whileothers experience psychological distress. The
World Health Organization (WHO) further
confirmed that "people are more likely tosuffer from a range of mental healthproblems during and after emergencies."
Following an emergency, some people
experience psychological distress, including
grief, distress, substance abuse, depression,anxiety, and post-traumatic stress disorder(PTSD).
Reports from numerous internationalorganizations that were released before
October 7 described the psychological issues
that the people of the Gaza Strip already
faced in terms of response and readiness.
The Humanitarian Needs Overview (HNO),
2023, showed that 495,600 children in the
Gaza Strip needed Mental Health andPsychosocial Support Services (MHPSS) andanticipated that this figure has increased in
2023. In all, Palestinians have been enduring
the financial, emotional, and safety
implications of occupation for the past 55
years. Particularly, Gaza still has restricted
access to vital health treatments as well as
mental health and psychosocial care 1 .
UNESCWA issued a report in October 2023
stating that the ongoing conflict in Gaza and1

Humanitarian Needs Overview 2023 | United Nations
Office for the Coordination of Humanitarian Affairs occupied Palestinian territory (ochaopt.org)

Israel's siege of the Strip have left the people
in a state of unparalleled hardship andmultifaceted poverty, resulting in ahumanitarian crisis. Poverty and deprivation
will affect a sizable portion of the population
for years to come, even if a ceasefire isagreed upon and humanitarian aid ispermitted to enter Gaza. This is primarily
because of the extent of human life and limb
loss, loss of human capital and capabilities,
anddestructionofsocioeconomic
infrastructure2.
According to the report "Trapped and
Scarred/ The Compounding Mental Health
Inflicted on Palestinian Children in Gaza" by
Save the Children in 2022, the prolonged andfrequent exposure of children to traumatic
events and harsh living conditions in Gaza
had already resulted in a mental health crisis.
Palestinian children will bear the mental
consequences for years to come. However,with adequate support, these negative
impacts can be reversed. Appropriate
interventions can offset the impact ofconflict– assuming that safety, security, andnurturing environments are restored.
Parents and caregivers need mental healthsupport too to cope with this crisis. Researchshows that providing such mental healthsupport for parents can help mitigate theeffects of potential trauma on their children3.
In November 2023, Médecins du Monde also
published a report stating that even before
the current crisis Palestine had one of thehighest levels of mental health issues andpsychological disorders in the eastern
Mediterranean region. Some 543,000
children were already in need of MHPSS
services, and two-thirds of the population
were showing signs of psychological distress.
2

https://www.unescwa.org/publications/war-gazaunprecedented-devastating-impact
3
https://resourcecentre.savethechildren.net/pdf/Trapped and-Scarred-Final-1-1.pdf/

3

Nine Months of Israel's War on Gaza: The Mental Health Impacts and the
GCMHP's Response
It is expected that as the war continues,
those numbers will grow exponentially, andevery child will need mental health support.
This crisis extends to the mental healthproviders too – carers who are part of Gazansociety and are directly impacted
themselves4.
In its update from December 29, 2023, the UN
Office for the Coordination of Humanitarian
Affairs (OCHA) noted that diseases werespreading more widely in Gaza, most likely
due to the recent mass displacement thattook place throughout the southern part of
the territory.
Many families haveexperienced multiple moves. This situation
adds to the strain on an already overworked
health system that is struggling to meet theenormous needs of the public5.
Over 2.2 million people living in the Gaza Strip
have been impacted by this war, and many ofthem will have psychological and physicalwounds that last a lifetime and can impact
future generations. Where untreated mental
health conditions can result in impairment,
aggressive behaviours, substance abuse, andsuicide, the services provided via GCMHP are
critically needed. The impact of suchconditions can be contained and reduced
through appropriate and effective support,
counselling, and therapy. The gradualincrease in demand for the GCMHP’s services
in earlier non-emergency situations andprevious military attacks has laid thegroundwork for its current responsivenessand preparedness.

Gaza Community Mental Health
Programme (GCMHP)
GCMHP Emergency Response Plan
& Services Provided
GCMHP was established as a nongovernment organization (NGO) in 1990 to
introduce community mental healthcare to
Gaza and provide specialized mental healthand psychosocial services guided by theprinciples of justice and human rights. As the
only NGO providing specialised mental healthservices in the Gaza Strip, GCMHP aimed to
improve the mental health sector in the Gaza
Strip through awareness raising, education,
capacity building, scientific research,
advocacy, lobbying, mobilization, treatment,
and rehabilitation activities.
Considering the context mentioned above
and its consequences, GCMHP finds that
there is an urgent need to expand a set ofservices provided to the population in the
Gaza Strip, which are as follows: (1) Providing
psychological first aid to affected people anddisplaced families, which include women,men, children, the elderly, and people withdisabilities. (2) Providing community
awareness and psychological counselling
services including the free telephonecounselling line 1800222333 advisingcommunity members on how to deal withcrises and identify symptoms that require
psychological interventions. (3) Providing
specialized mental health services to children
and adults who have developed severe
psychological symptoms. (4) Providing
supportive professional supervision and carefor professionals who provide MHPSS
services in the frontlines. (5) Networking
with other service providers in the fields of4

https://www.medecinsdumonde.org/en/news/each-momentfeels-like-it-could-be-our-last-a-few-words-from-nourpsychologist-for-mdm-in-gaza/

5

Hostilities in the Gaza Strip and Israel | Flash Update#106 [EN/AR/HE] | OCHA (unocha.org).

4

Nine Months of Israel's War on Gaza: The Mental Health Impacts and the
GCMHP's Response

3,647
53
831
312

Capacity
Building(Training
PFA)

20

523

3,003
44
569
59

3,296
15
195
100

2,983
12

Free TelephoneCounseling
Line

232

•
•

Publicawareness andpsychoeducati
on sessions

W

29

•
•

Affected and Displaced Families(women, men, boys, girls)
including those with/without
disabilities.
Victims of TortureChildren and Adults with Mental
Disorders
MHPSS Staff
Community Members

M

4

•

Specialized
Mental HealthG

0Through its ERP, GCMHP targeted thefollowing groups:

stressmanagement,
supervisionsessions

211

Supportive
Supervision
and Caring

Psychologicalfirst aid (12 PFA
teams)

74

Specialized
MentalHealthCapacity
Building

B

27

ERP 20232024

Total
BeneficiariesService
Provided

0

GCMHP

Psychoeducat
ion,
psychologicalsupport andCounselling

12,929Community
awareness,
Networking
andAdvocacy

124

Psychologic
al First Aid

Despite these challenges, GCMHP managed
to ensure that the affected individuals hadaccess to a range of mental health services
and emergency interventions. Table (2)below shows a summary of the GCMHP
achievements under its ERP during theperiod form 7 October 2023 to 15 June 2024.

1,806

Accordingly, GCMHP launched its emergency
response plan (ERP) 2023-2024 that includes
all services which are shown in the chart
below:

756

FIRST AID VISIT TO FAMILY IN A TENT

During the ongoing war, GCMHP lost two of
its three premises (Gaza City and Khan Yunis
community centers), while the third one in
Deir El-Balah was partially damaged. Most
painful was the loss of three female
colleagues (psychologists). One man, aproject coordinator, and his wife weremoderately to severely injured. They losttheir children and family members. A female
administrative assistant was moderately
injured, her daughter was killed, and herfamily members were injured.

575

PHOTO 1 PSYCHOLOGICALGCMHP Emergency Response
Achievements (October 2023-June
2024)

49

MHPSS and humanitarian work to ensure theprovision of comprehensive services.

on5

Nine Months of Israel's War on Gaza: The Mental Health Impacts and the
GCMHP's Response

Psychological Impacts and Needs(GCMHP Observations)

PHOTO 2 PSYCHOLOGICALSUPPORT SESSION IN A TENTPHOTO 3 T HERAPEUTIC CHILD DRAWING SESSION IN A TENTThis war came amid critical humanitarian
conditions characterized by a long-standing
blockade imposed on the Gaza Strip, internal
political division and fragile economic
situation. The situation has heavily impacted
the mental health wellbeing of Palestinians in
Gaza. The Israeli aggressions have led toalarmingly high rates of trauma and disorders
among most community groups, particularly
children and women. This situation has madethem more vulnerable to many social andpsychological problems, which are likely toremain over the generations to come.
Such difficult conditions and prolonged andmultiple exposure to traumatic events haveseverelyaffected the psychologicalwellbeing of the Gaza population andincreased feelings of anger, frustration, anddespair. Also, this has increased anxiety
symptoms especially among children andwomen.

PHOTO 4 A T RAINING ON PFA AT UNRWA SCHOOLPHOTO 7 I NDIVIDUAL PSYCHOTHERAP Y SESSION AT GCMHP TEMPORARY
CENTER

PHOTO 5 PSYCHOEDUCATIO N SESSION WITH WOMEN AT A CAMPPHOTO 6 STRESS MANAGEMENT SESSION WITH WOMEN AT A CAMPGCMHP observed three different feelings
among Gazan people. One is the feeling ofanticipation based on questions about theoverall situation, their own situation, theirown memories, their own houses. They
wonder how is my home now? What is myhome going to look like when this war is over?
Everyoneis
talkingabout
their
neighbourhood. Is their house still standing
or not?

6

Nine Months of Israel's War on Gaza: The Mental Health Impacts and the
GCMHP's Response
The second one is denial. They haveexperienced five or six previous attacks andthink that this is just a nightmare, and it
should stop, or that this is not happening.
The third one is anger. People are angry. They
can easily get into problems with each other.
They talk badly about everything. They ask
why is this happening, why is no one caring
about them, why have there been more than
270 days of this and there are nointerventions?

PHOTO 8 SUPPORTIVE SUPERVISION SESSION WITH
STAFF

On the other hand, most of Gaza's children
are suffering from fear and anxiety, lack ofsleep, and are displaying other signs of
distress, such as constant shaking andbedwetting. GCMHP believes that children
who live in constant fear may suffer fromprolonged
anxieties
anddeveloppsychological responses to stress which canhave long -lasting effects.

“All my children get really scared from thesounds of airplanes, bombings, and drones.
One of my children started wetting the bed. I
do not know what I should do?” A father told
a GCMHP clinician.
Adults also have their share of remembering
atrocities: A woman, 42 years old, resident of
Al-Mughraqa, who was displaced in a tent inRafah, and the complaint on her lips was: “Ikeep imagining corpses, and I keep
remembering my son with his intestines
coming out. Thank God, we were able to bury
him.’”
Symptoms this woman showed included
nervousness over the most trivial things,
resulting in screaming and hitting her sons.
She was also breaking anything in front ofher, feeling suffocated most of the time,
having sleeping problems, disturbing dreams
related to the war, remembering the event
repeatedly with sweating and suffocation as
if the event had not ended, decreased
appetite, not wanting to do anything, andwishing to die. This combination of being
traumatized and living in despair was noticed
among many people who came for therapy
or were seen during Psychological First Aid(PFA) visits.

GCMHP

professionals working withfamilies and victims during the ongoing war
were asked to answer the following mainquestions:••

PHOTO 9SESSION.

A TRAUMATIZED

What are the most important needs
expressed by the beneficiaries,
whether adults, children, the elderly,or people with disabilities, from theirpoint of view?
What are the most common
complaints
andpsychologicalsymptoms that appeared during thewar?

CHILD’ S DRAWING DURING A THERAP Y

7

Nine Months of Israel's War on Gaza: The Mental Health Impacts and the
GCMHP's Response•••

Are there new symptoms that thebeneficiaries are feeling for the firsttime in this war?
How is the current war different fromother previous wars?
How did the beneficiaries deal withthese complaints during the war – didthey have negative or positive coping
mechanisms?

Findings
First: Regarding the people’s needs: The
need to find a shelter or house or even a tent
was the most urgent need for many of thebeneficiaries. The professionals reported
beneficiaries’ distress at their lack of shelter,a house, or even a tent to protect them fromthe cold of winter and the heat of summer.
Many were displaced more than 3 times insearch of a safe place because of thefrequent expansion of Israeli attacks and air
bombardment. One beneficiary said: “I used
to have a five-floor house, and now I live in atent, and I don’t even have a bathroom. I feelthat I am not a human being”. Another one
said: “I need a place where me and my family
can settle. I am in one place and the rest of myfamily are in another place.”
Other people conveyed their need forbalanced food and food designated forpeople with chronic diseases, specificallykidney patients and infants. Their suffering
was also reflected in the lack of clean water
for drinking, or water for everyday use. The
scarcity of water and the lack of sanitation
were painfully felt. The professionals also
expressed the beneficiaries' urgent need for
medicine and some medical supplies, inparticular for kidney and cancer patients,
epilepsy patients, high blood pressure anddiabetes patients. Access to life necessities
such as clothes and diapers for children andthe elderly, hygiene tools, and money wasurgently needed.

Some professionals mentioned the need of
the beneficiaries for psychological support asthey expressed their need to speak, express
themselves, be cared for, and have someone
listen to their difficult experiences. Theyrequested assistance in learning and applying
special coping mechanisms for dealing withthe difficult circumstances in which they live.
Especially in need of this were those female
prisoners who have been exposed to difficult
experiences, in particular, arrest and abuseby the Israeli army during the war.
Second: Regarding psychological complaints
and symptoms among adults:The
professionals reported high levels of feelingsof helplessness and despair among thebeneficiaries, and that they had lost hope in
coping and solving their problems. This led tothem losing their self-care practices, to being
unable any more to play with their children
and enjoy life as they did before. They arenow
preoccupied
with
new
life

responsibilities that resulted from thewar, such as baking bread and trying to fillwater containers and secure a means ofliving.
Many professionals also reported theprevalence of trauma symptoms among
beneficiaries and expressed them as“complex traumas” that negatively affected
their behaviours, such as the refusal toacknowledge the problem, or denial,
avoidance, loss of interest in personal
activities, and social isolation. The
professionals also mentioned that many
traumatizedpeoplehave
becomedisconnected from their feelings, as if thesituation does not give the events their true
magnitude. And some of them have lost theability to express themselves. (Theprofessionals express this with the term
“psychological numbness”). A professionalsays, “There is one case where he talks about
his problem in a continuous narrative without
8

Nine Months of Israel's War on Gaza: The Mental Health Impacts and the
GCMHP's Response
really showing his feelings”. Anotherprofessional confirms, “Some beneficiaries
tell stories of losing their father, mother, wife,and children, and they are in a state ofstagnation and dullness, as if the matter was
simple and ordinary.”
Another professional said, “I have a case of afemale prisoner who laughs when she is talking
about the practices of strip searches andhumiliation by the Israeli army.”
In addition, many of the beneficiaries sufferfrom depression, a feeling of anger or
resentment over their life conditions, loss ofappetite, and have thoughts and attempts ofsuicide, and their view of life is dark. Some ofthem also developed behaviour such as
aggression and nervousness as a result, andthe frequency of violence in all its forms
increased, especially domestic violence,
represented by harm, beating, deprivation,and obscene words. A professional says in
the words of some of the beneficiaries, “I amgetting angry at the simplest things”.
In terms of fear and panic, many beneficiaries(adults and children) suffer from bouts offear and panic at the sounds of bombing andany sound like it, and this is also reflected intheir sleep in the form of night terrors andnightmares. Some beneficiaries also
complained of anxiety. Others expressed theloss of their ability to think, plan goals, andmake important decisions. Some of them
indicated that they do not feel safe, haveanticipation and fear of the unknown, andlive in a state of fear, as if they were saying:Will I be the next victim?
From another perspective, the beneficiaries
show physical complications, which aresevere psychosomatic symptoms that
express their anxiety. Many of themcomplain of joint pain, stomach pain, nerve
pain, fatigue, rapid heartbeat, and shortnessof breath. These physical messages are aclear expression that the beneficiaries do notgive their problems a real size and do not
express them completely, so the body begins
to express them in the form of physical aches
and pains. A beneficiary says while going toclinics and repeating the lab tests, “I need amedicine that will comfort me.” Another, in
her fifties, lost her son, who was dear to her.
“I feel like there is something sitting on mychest, and I can’t breathe.”Third: Regarding the psychologicalcomplaints and symptoms among children:
The professionals emphasized that children
live a state of endless tragedy, as they are a
fragile and vulnerable group and have acomplete inability to protect themselvesfrom Israeli attacks on the one hand and fromfamily and societal attacks on the other hand.
Other than that, there are no institutions or
authorities that provide quick and effective
services, support their rights, protect them,and support them through these difficult
developments, and at least guarantee that
attacks on them will not be repeated. Fromthe point of view of professionals, parents
suffer either from a lack of awareness of how
to deal with their children or a loss of theability to deal with them.
One of the professionals adds that some of
the beneficiaries indicated that their children
do not exercise their rights to life as theyshould, especially not their right to play andlearn. Some families also place responsibilityon their children, and the lifestyle of many
children during this war has changed fromthe lifestyle of a normal child to the lifestyleof a responsible adult. In fact, children are
helping their families secure life’s necessities,
such as: bringing food from charitable
hospices, filling water into heavy containers
and carrying it on their weak bodies, standingin line for long hours to register relief
requests, or searching for wood, cartons, andeverything possible to start a fire for cooking
and baking bread.

9

Nine Months of Israel's War on Gaza: The Mental Health Impacts and the
GCMHP's Response
As for the most common complaints andpsychological symptoms that children suffer
from: night terrors, nightmares, phobias,
bedwetting, sleepwalking, stubbornness,and intense attachment to the mother. Somemothers also complained about theirchildren's sensitivity and irritability, which
was represented by excessive nervousness.
Some also developed aggressive behaviour
and assaulted their peers, either by hitting oruttering obscene words.
Some children develop serious mental
disorders. A professional mentions that he isfollowing up a case of a 13-year-old child, who
suffers fromvisual and auditory
hallucinations resulting from the war period
and the difficult scenes he witnessed.
Fourth: Regarding the new psychologicalsymptoms that appeared during the war:The
professionals mentioned somedistinctive psychological symptoms related
to the conditions of war, such as: lack of selfconfidence and low self-esteem. A
professional says that most of the female
prisoners, after being subjected to theexperience of strip searches in front ofpeople, lost the ability to communicate
visually with people, and their view ofthemselves became negative. As aprofessional recounts, “a case of a woman’s
displacement from Gaza to the south, andher exposure to a harsh experience whilecrossing Israeli army checkpoints, where she
saw one of the soldiers shoot a young man
and kill him in front of her. She screamed as aresult, so the Israeli army pulled her out fromamong the people, took off her clothes
completely, blindfolded her, and beat her
and verbally abused her using obscenewords, in front of people on the Salah al-Din
Road."
There were also reports about theoccurrence of sexual assaults for both sexes
and for all age groups. A professional states,“The director of one shelter says that 3 casesof sexual assault by young men as young as
18 years of age have been observed on minor
children at school,” and as a result, families
have become very afraid for their children
and prevent them from going out. A
professional says, “There is one case who
told me that girls should never go out of thehouse, and even young boys should not go
out either.”Also, many professionals stated that theabsence of security personnel and legalorganizations has added more burdens andpsychological pressures as a result of anxiety
and fear of crimes being committed byothers. A professional described a case he isfollowing of “a quiet, respectable young man
who lost his home and was displaced several
times and is currently living in a crowded
place. Because of his inability to adapt to the
new situation, he has changed radically andhas become a person who abuses, steals, andhas bad morals.” The professional also
described the current situation as that of asociety suffering from a lack of security andmoral disintegration, and that he witnessed
many young men themselves carrying (knives
or scalpels) to defend themselves from
trespassing strangers.
Fifth: How is the current war different fromother previous offensives?
The professionals answered that this war
differed quantitatively and qualitatively in all
aspects of life. The war affected all membersof society without exception, and people
witnessed real clashes, real soldiers’ battles,
and repeated violent scenes of killing andwounding that they had never seen before.
The community was also exposed to realtests of hunger, cold weather, and disease, in
addition to the suffering of people in theexperiences of forced displacement multiple
times.

10

Nine Months of Israel's War on Gaza: The Mental Health Impacts and the
GCMHP's Response
On the internal level, in light of this war,people are suffering from a lack of security,and the presence of bandits and thieves, andthe lack of security personnel, somethingthat society has never witnessed before.
Sixth: How did the beneficiaries deal withthese complaints during the war - were
there negative or positive coping
mechanisms?
The professionals' answers varied regarding
the coping mechanisms used by thebeneficiaries. Some of them used spiritualand religious practices as a refuge to alleviate
the trauma of war, while others sought help
and social support from their family
surroundings and psychological institutions,while many lost their ability to manage stressand behave properly. Many of thebeneficiaries are helpless and frozen, denying
the problem they are experiencing due to thehorror of the shocks they have been exposedto.
A professional mentions the case of a man
who lost his wife and children in the war, andhe has a son who is being treated in Turkey asa result of an injury. He lives alone in a tent
and suffers from psychosomatic symptoms.
His private doctor referred him to a
psychologist. He did not react and did not
express his problem to the professional. He
simply said: “But I need blood pressure
medication, what can you offer me as a
psychologist?

Stories of Victims
GCMHP Provides Urgent MH Support forVictim of Torture, Subjected to Multiple
Traumas.
It never occurred to A.D* that the direly
needed job opportunity he had in Israel
would make him earn bread that is dipped inblood.

The 31-year-old father and his family thought
they were lucky to secure this opportunity
which so many Gazans wished to have.
However, before even seeing the economic
impact, AD* was among the first victims to be
hit by the consequences of October 7. Being
in Israel, he was arrested and kept in custody
together with many other Gazan workers,
where they were subjected to unspeakabletypes of torture.
He was interrogated for 24 days, every
minute of which was a nightmare. They werestarved, deprived of sleep, beaten up cruelly,
and mentally tormented. Then the Israeli
occupation forces decided to release him
together with a group of other workers. They
thought that the nightmare they experienced
was coming to an end. But contrary to their
expectations, there was still much more to
endure. The soldiers led them to ‘Karm Abu
Salem’ Crossing and told them: “You have to
run in one direction,” so they can reach theclosest point that leads to Gaza.
They did just as they were told. But for the
Israeli soldiers it was a moment of fun thatthey couldn’t just waste. They started
shooting at released prisoners.
“The bullets were coming from all directions.
Some prisoners were injured, and others
were shot dead. I ran as fast as I could, andthen one of the men just running next to me
was injured and fell on the ground, I carriedhim on my shoulders and kept going until I
reached an UNRWA medical point. We were
provided with first aid and sent to Abu Yousef
Al-Najjar Hospital in Rafah”.
It was now a time for having a sigh of relief;
filled with the strong emotions of seeing his
loved ones, including his children, parents
and wife, for whose living he was striving.
But the heinous face of the occupation was
lying in wait for him. He found out that his
wife, all of his children, his mother, all of his
siblings, his uncles and aunts had all died11

Nine Months of Israel's War on Gaza: The Mental Health Impacts and the
GCMHP's Responsewhen their home was bombed on the 17th ofOctober. The only one who survived was hisfather, 57, who was not at home when it was
targeted. However, he can’t see him as he is
in Gaza City which is cut off from the south.
The mental pain was incredibly excruciating
for the bereaved man. He has become alone
overnight. He lost his loved ones who were
his strength and gave his life purpose.
Enduring such pain, AD* asked for GCMHP’s
professional support. The PFA team visited
him in his tent (in a very harsh environmentthat hundreds of thousands of displaced
people suffer from). AD* was diagnosed
with PTSD.
As part of our intervention, AD* has beenplaced on drug therapy and he will be
provided with psychological sessions
according to the protocol.

Torture Survivor Tells of His “Journey inHell”
AM* is a young man who was taking shelterin the premises of Al-Aqsa University,
Western Gaza City. He and his family,
together with hundreds of other families
thought that the premises would be safe asbombs rained down on their neighbourhoods
and residential areas across the city.
Unfortunately, their sanctuary soon became
a concentration camp, when the Israeli tanks
besieged the university campus for 10 days
before invading it and segregating womenfrom men, and then arresting them.
AM* was among those men who lived
through that horrifying experience. “TheIsraeli soldiers invaded the premises andstarted to blow up one building after
another. Then they tied us up, blindfolded us
after they had made us to strip down tounderpants,” the survivor said.
“They almost shot me dead on several
occasions. They beat me up and hit me on thegroin and on the head. It was early in
February and the weather was bitter,” headded.
Sadly, all that was just a prelude to 80 days of
incomprehensible torture. AM* was dragged
into a hole filled with decomposed bodies;
thrown on the ground where passing tanks
touched his legs. He was made to see otherprisoners being executed point blank.
“The next day they transferred us on a truck
to Gaza borders. I was still tied up,
blindfolded and naked. They threw us off thetruck and one soldier kicked me in the
scrotum. I couldn’t walk for 16 days becauseof the impact of that hit on the private part,”
he explained.
“In the concentration camp they made me
take off my underpants to be starkly naked,
my arms were tied to my back and pulled up
in a very painful position. I spent the wholenight in such posture which made it
impossible for me to sleep. For a whole night
I remained in such a position till I felt that myarms did not exist. Then I was transferred to
Al-Eizariya prison in Jerusalem. I was in a very
bad health condition.” AM* spoke of his
tragic experience.
In AL-Eizariya Prison they had to literally
follow the cruel instructions of the warders.
For example, if the warder asked one ‘how
are you?’ and one answered, ‘Thanks be to
Allah’, one was tortured for a whole day. And
anyway, the torture did not stop
“throughout our detention”. “They stormed
our cells while sleeping and put the guns to
our head and pretended they were going to
execute us,” he added.
“After that, we were brought to court and nocharges were proven against me, but I wasarrested until further notice. I dared to ask
for the reason, and I was answered that
‘according to the classified items of the State

12

Nine Months of Israel's War on Gaza: The Mental Health Impacts and the
GCMHP's Responseof Israel, you pose a threat to the State ofIsrael.’“After several days, we were transported in atruck as usual, but this time was different. We
were 34 men and one woman. On the way,
we were subjected to insults and beating. We
reached Gaza border, and there we were toldthat we would be released. A soldier asked
sarcastically, ‘How is the journey?’ and theanswer must be ‘we’re perfect’, in fact it wasa journey in hell. We were threatened that if
we talked about what happened to us, wewould be arrested again, even if we were in
the middle of Gaza.”Children’s Drawings
GCMHP shares here some drawings oftraumatized children.

“When we arrived the UNRWA received us at
the Karm Abu Salem Crossing and we were
given water to drink. They asked me if I knew
where my family was. I shook my head,
indicating no. Then they gave me a phone so
I could call my family, who told me that they
were still in Gaza City and did not evacuate to
the south. Here I felt a strange feeling mixed
with fear and joy. Thank God they are fine. I
felt so overwhelmed by emotions that I
passed out. However, my father was not in
Gaza City with the rest of the family. He wasforced to leave to the south by the Israeli
soldiers. So, he came and took me with him
to the shelter where he stays in Al-Maghazi.
There, I was not treated as I was supposed tobe. A mattress was not provided for me tosleep on for several days - I did not receive thehelp and attention I needed.”
GCMHP team has visited AM* in his shelter
where he was diagnosed with PTSD. He wasprovided with drug therapy and thentherapeutic sessions to help him overcome
the symptoms of the PTSD. Also, GCMHP
visited the shelter management andexplained the special needs for AM* andmade sure that he was provided with hisneeds such as a mattress, food and water. He
is still under therapy and being closely
followed up.
13

Nine Months of Israel's War on Gaza: The Mental Health Impacts and the
GCMHP's Response

RecommendationsFirst: Mental health is a human right, and wecall for the international community andglobal mental health organizations to secure:(1) An immediate and lasting ceasefire. (2)The entry and distribution of adequate
supplies of fuel, water, food, and otherhumanitarian necessities. (3) Psychosocialand mental health support should be given
top priority as an essential part ofhumanitarian aid to Gaza.
Second: An unprecedented level of mental
health crisis has resulted from the ongoing
war in Gaza. A comprehensive humanitarian
response is essential, including evidencebased psychological interventions, toprevent trauma that lasts a lifetime.
Third: GCMHP recommends paying more
attention to the following vulnerable groups:•••

People with mental health disorders
who were already on medication:
they need to continue to be on
medication.
GCMHP calls forprioritizing psychotropic medications
among drugs that can enter Gaza
Strip and for this medication to bemade accessible by the cases in need.
People who were subjected totorture or severe trauma and show
serious mental health symptoms:
they need expanded specialized
mental health services that should bemade accessible through out Gaza
Strip.
Support for the helpers: most of themental health carers were displaced
more than once. They need caring
services and supportive supervision
to enable them to provide highquality services and to avoid
secondary trauma.

What Do We Need as Mental HealthProfessionals?
First: to be able to operate or help the people
mentally we need safety. People need to feelthat they are safe for the society to bereconstructed. Safety requires putting an
end to all human rights violations andremoving visible signs that trigger trauma,including clearing all the rubble now on thestreets.
Second: we as mental health workers and thesociety at large need to have elements ofhope. We urge the international community
to undertake to support people inreconstructing their homes and work toensure that they have a future.
Third: GCMHP needs additional funding.
When it is possible to do so, we need help torebuild our destroyed community centres
which will enable the organization to provide
the best quality care and give thebeneficiaries a feeling of privacy andconfidentiality. There are more than 3,000
unemployed psychologists in Gaza Strip.
With sufficient investment we could give
many of them additional training and involve
them in MHPSS interventions and in theprovision of PFA and basic counselling
services.

Gaza Community Mental Health Programmewww.gcmhp.org
https://www.facebook.com/gcmhptested
info@gcmhp.org

14