Enkazın ardında: Savaş ve insan hakları ihlallerinin Gazze’deki kadın ve çocuklar üzerinde yarattığı psikolojik travma

Year 2024, Volume: 29 Issue: Special Issue on Gaza, 119 - 136, 28.12.2024

Iman Farajallah

https://doi.org/10.21673/anadoluklin.1575372

Abstract

Bu çalışma, Gazze’deki çocukların ve kadınların on yıllardır süren çatışma, işgal ve askeri saldırılar sonucunda yaşadıkları derin psikolojik travmayı incelemektedir. İsrail ablukası ve tekrarlayan askeri saldırılar sürekli bir şiddet döngüsü yaratarak Gazze nüfusunun, özellikle de en savunmasız gruplarının ruh sağlığını sistematik olarak aşındırmıştır. Gazze’deki kadınlar ve çocuklar bu durumdan orantısız bir şekilde etkilenmekte, birçoğu iyileşme fırsatı bulamadan travmaya kronik olarak maruz kalmaları nedeniyle Karmaşık Sürekli Travmatik Stres (CCTS) yaşamaktadır. Bu travma, TSSB, anksiyete, depresyon, gelişimsel gecikmeler ve bilişsel bozukluklar dahil olmak üzere ciddi ruh sağlığı bozukluklarında kendini göstermektedir. Ayrım gözetmeksizin işlenen cinayetler ve temel altyapının tahrip edilmesiyle birlikte 7 Ekim 2023’ten bu yana yaşanan soykırım şiddeti bu sorunları daha da derinleştirmiştir. Ruh sağlığı müdahaleleri önerilmiş olsa da, baskının altında yatan nedenler ele alınmadan gerçek iyileşme başlayamaz. Bu makale, Gazze’deki ruh sağlığı krizinin ayrılmaz bir şekilde İsrail işgaliyle bağlantılı olduğunu savunmakta ve anlamlı bir psikolojik iyileşmeyi kolaylaştırmak için işgalin sona erdirilmesini ve Filistinlilere temel insan haklarının geri verilmesini içeren kapsamlı bir yaklaşım çağrısında bulunmaktadır.

Keywords

Gazze şeridi, insan hakları ihlalleri, psikolojik stres, savaş, stres bozuklukları, yaşam değiştiren olaylar

Behind the Rubble: Psychological trauma of wars and human rights abuses on women and children in Gaza

Abstract

This paper examines the severe psychological trauma experienced by women and children in Gaza, resulting from prolonged conflict, occupation, and repeated Israeli Occupation Forces (IOF) assaults. The Israeli blockade and frequent attacks have generated a pervasive environment of violence that continuously undermines the mental health of Gaza’s population, with women and children being particularly vulnerable. Many are affected by Complex Continuous Traumatic Stress (CCTS), a condition arising from chronic trauma exposure without respite. This trauma has manifested in significant mental health issues, including post-traumatic stress disorder (PTSD), anxiety, depression, developmental delays, and cognitive impairments. The genocidal violence since October 7th, 2023, has intensified these issues, with indiscriminate killings and the destruction of essential infrastructure further devastating the population. While mental health interventions have been proposed, this paper argues that meaningful psychological recovery requires addressing the root causes of the ongoing conflict. It concludes that the mental health crisis in Gaza is deeply interconnected with the Israeli Occupation and that a comprehensive approach involving the restoration of fundamental human rights and the cessation of hostilities is essential for true psychological healing.

Keywords

Gaza strip, human rights abuses, life change events, psychological stress, stress disorders, war

References

• Van der Kolk BA. The body keeps the score: Brain, mind, and body in the healing of trauma. New York: Penguin Books: 2014.
• American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013. p. 612-613.
• Barton J. Doing qualitative research with interpretative phenomenological analysis. In: Enjoying research in counselling and psychotherapy: Qualitative, quantitative and mixed methods research. 2020. p. 51-69.
• Van Manen M. Researching lived experience: Human science for an action sensitive pedagogy. 2nd ed. Routledge; 2016 Jun 16.
• Merriam-Webster. War. In: Merriam-Webster.com dictionary [Internet]. [cited 2024 Sep 24]. Available from: https://www.merriam-webster.com/dictionary/war
• Clausewitz C. On war. Translated by Howard M. New York: Knopf: 1976.
• Kalyvas SN. The logic of violence in civil war. Cambridge: Cambridge University Press; 2006.
• United Nations. Convention on the Prevention and Punishment of the Crime of Genocide [Internet]. United Nations; 1948 Dec [cited 2024 Sep 24]. Available from: https://www.un.org/en/genocideprevention/documents/atrocity-crimes/Doc.1_Convention%20on%20the%20Prevention%20and%20Punishment%20of%20the%20Crime%20of%20Genocide.pdf
• Lemkin R. Genocide: A Modern Crime [Internet]. 1944 [cited 2024 Sep 24]. Available from: https://www.un.org/en/preventgenocide/adviser/pdf/lamin-leadership-program-genocide.pdf
• Schabas WA. Genocide in international law: the crime of crimes. New York: Cambridge University Press; 2009.
• Luxenberg T, Spinazzola J, Van der Kolk BA. Complex trauma and disorders of extreme stress (DESNOS) diagnosis, part one: Assessment. Directions in Psychiatry. 2001;21(25):373-92.
• Courtois CA, Ford JD. Treatment of complex trauma: A sequenced, relationship-based approach. New York: The Guilford Press; 2016.
• Foa EB, Keane TM, Friedman MJ, Cohen JA, editors. Effective treatments for PTSD: practice guidelines from the International Society for Traumatic Stress Studies. Guilford Press; 2010 Oct 27.
• World Health Organization. Gaza mental health report [Internet]. Geneva: WHO; 2023 [cited 2024 Sep 24]. Available from: https://apps.who.int/gb/COVID-19/pdf_files/2023/13_11/Item1.pdf
• United Nations Development Programme. One Year After: Gaza Early Recovery and Needs Assessment - UNDP Report [Internet]. Question of Palestine. 2019 [cited 2024 Dec 20]. Available from: https://www.un.org/unispal/document/auto-insert-196946/
• Aldabbour B, Abuabada A, Lahlouh A, Halimy M, Elamassie S, Sammour AA, Skaik A, Nadarajah S. Psychological impacts of the Gaza war on Palestinian young adults: a cross-sectional study of depression, anxiety, stress, and PTSD symptoms. BMC Psychol. 2024;12(1):696.
• Palestinian Center for Human Rights. Psychological distress in Gaza [Internet]. Gaza: PCHR; 2022 [cited 2024 Sep 24]. Available from: https://www.pcrf.net/news/gaza-pediatric-mental-health-team-assesses-trauma-from-war.html
• Save the Children International. After 15 years of blockade, four out of five children in Gaza say they are living with depression, grief, and fear [Internet]. 2022 [cited 2024 Sep 24]. Available from: https://www.savethechildren.net/news/after-15-years-blockade-four-out-five-children-gaza-say-they-are-living-depression-grief-and
• Farajallah I. The Invisible Wounds of Palestinian Children [Internet]. Psychiatric Times; 2024 [cited 2024 Sep 24]. Available from: https://www.psychiatrictimes.com/view/the-invisible-wounds-of-palestinian-children
• Al-Krenawi A, Graham JR. The impact of political violence on psychosocial functioning of individuals and families: The case of Palestinian adolescents. Child Adolesc Ment Health. 2012;17(1):14-22.
• Pappe I. The ethnic cleansing of Palestine. Simon and Schuster; 2007 Sep 1.
• United Nations. Convention on the Rights of the Child [Internet]. OHCHR. United Nations; 1989 [cited 2024 Sep 24]. Available from: https://www.ohchr.org/en/instruments-mechanisms/instruments/convention-rights-child
• B’Tselem. 50 days: More than 500 children killed [Internet]. B’Tselem; 2015 [cited 2024 Sep 24]. Available from: https://www.btselem.org/press_releases/20160720_fatalities_in_gaza_conflict_2014
• Human Rights Watch. World Report 2014: Israel and Palestine [Internet]. Human Rights Watch; 2014 [cited 2024 Sep 24]. Available from: https://www.hrw.org/world-report/2014/country-chapters/israel/palestine
• Farajallah I. My Life Is a War: Voices of Traumatized Palestinian Children under Israeli Occupation. USA: Sumud LLC; 2024.
• Farajallah I. Continuous traumatic stress in Palestine: The psychological effects of the occupation and chronic warfare on Palestinian children. World Soc Psychiatry. 2022;4(2):112-20.
• Khamis V. Post-traumatic stress disorder among school-age Palestinian children. Child Abuse Negl. 2005;29(1):81-95.
• Somasundaram DJ, Sivayokan S. War trauma in a civilian population. Br J Psychiatry. 1994;165(4):524-7.
• Defense for Children International Palestine (DCIP) [Internet]. Defense for Children Palestine; 2016 [cited 2024 Dec 20]. Available from: https://www.dci-palestine.org/july_24_update_death_toll_of_palestinian_children_spirals_as_israel_expands_gaza_offensive
• United Nations Relief and Works Agency for Palestine Refugees (UNRWA). Gaza emergency UNRWA [Internet]. 2015 Sep [cited 2024 Sep 24]. Available from: https://www.unrwa.org/gaza-emergency
• Growing up between Israeli settlements and soldiers [Internet]. Defense for Children International Palestine; 2014 Jun [cited 2024 Sep 24]. Available from: https://www.dci-palestine.org/growing_up_between_israeli_settlements_and_soldiers
• Human Rights Watch. World report 2017: Events of 2016 [Internet]. New York: Human Rights Watch; 2017 [cited 2024 Sep 24]. Available from: https://www.hrw.org/sites/default/files/world_report_download/wr2017-web.pdf
• Fragmented lives: Humanitarian Overview 2014 [Internet]. United Nations Office for the Coordination of Humanitarian Affairs - occupied Palestinian territory; 2015 [cited 2024 Dec 20]. Available from: https://www.ochaopt.org/content/fragmented-lives-humanitarian-overview-2014
• 2021 – Gaza Emergency Food Security Assessment Following the escalation of hostilities and unrest in the State of Palestine in May 2021 [Internet]. World Food Programme; 2021 [cited 2024 Dec 20]. Available from: https://www.wfp.org/publications/2021-gaza-emergency-food-security-assessment-following-escalation-hostilities-and
• El-Khodary B, Samara M. The relationship between multiple exposures to violence and war trauma, and mental health and behavioural problems among Palestinian children and adolescents. Eur Child Adolesc Psychiatry. 2020;29(5):719-31.
• Thabet AA. Psychological well-being of Palestinian children and adolescents in Gaza Strip and West Bank: Review paper. EC Psychol Psychiatry. 2019;8(3):197-205.
• Qouta S, Punamäki RL, El Sarraj E. Child development and family mental health in war and military violence: The Palestinian experience. Int J Behav Dev. 2008;32(4):310-21.
• Thabet AA, Vostanis P. Post-traumatic stress reactions in children of war. J Child Psychol Psychiatry. 1999;40(3):385-91.
• Manzanero AL, Crespo M, Barón S, Scott T, El-Astal S, Hemaid F. Traumatic events exposure and psychological trauma in children victims of war in the Gaza Strip. J Interpers Violence. 2021;36(3-4):1568-87.
• Thabet AA, Tawahina AA, El Sarraj E, Vostanis P. Exposure to war trauma and PTSD among parents and children in the Gaza Strip. Eur Child Adolesc Psychiatry. 2008;17:191-9.
• Thabet AA, Thabet SS. Stress, trauma, psychological problems, quality of life, and resilience of Palestinian families in the Gaza Strip. Clin Psychiatry. 2015;1(2):1-6.
• Thabet AA, Tawahina AA, Tischler V, Vostanis P. PTSD, depression, and anxiety among Palestinian women victims of domestic violence in the Gaza Strip. Br J Educ Soc Behav Sci. 2015;11(2):1-12.
• Khamis V. Post-traumatic stress and psychiatric disorders in Palestinian adolescents following intifada-related injuries. Soc Sci Med. 2008;67(8):1199-207.
• UNICEF in the State of Palestine Humanitarian Situation Report No. 1 on the recent escalation [Internet]. UNICEF; 2023 Oct 12 [cited 2024 Sep 24]. Available from: https://www.unicef.org/documents/state-palestine-humanitarian-situation-report-no-1-recent-escalation-12-october-2023
• Save the Children. Children are paying the heaviest price as violence in Israel and the occupied Palestinian territory escalates [Internet]. 2023 Oct 8 [cited 2024 Sep 24]. Available from: https://www.savethechildren.net/news/children-are-paying-heaviest-price-violence-israel-and-occupied-palestinian-territory-escalates
• UNRWA. Situation Report #98 on the situation in the Gaza Strip and the West Bank, including East Jerusalem - All information from 31 March–1 April 2024, is valid as of 01 April 2024 at 22:30 [Internet]. 2024 Apr 7 [cited 2024 Sep 24]. Available from: https://www.unrwa.org/resources/reports/unrwa-situation-report-98-situation-gaza-strip-and-west-bank-including-east-Jerusalem
• OHCHR. Civil society and civilians must be protected in “harrowing” Gaza conflict [Internet]. 2024 Apr [cited 2024 Sep 24]. Available from: https://www.ohchr.org/en/statements-and-speeches/2024/04/civil-society-and-civilians-must-be-protected-harrowing-gaza
• Buheji M, Buheji B. Mitigating risks of slow children development due to war on Gaza 2023. Int J Psychol Behav Sci. 2024;14(1):11-21.
• Taha AM, Sabet C, Nada SA, Abuzerr S, Nguyen D. Addressing the mental health crisis among children in Gaza. Lancet Psychiatry. 2024;11(4):249-50.
• Allen D. Situation Overview Internally displaced* 1.7M in Gaza (75% of Gaza) 2,840 in West Bank [Internet]. 2024 Apr [cited 2024 Sep 24]. Available from: https://www.unfpa.org/sites/default/files/resource-pdf/Palestine%20Situation%20Report%20-%20April%202024.pdf
• UN Women. Press release: Two mothers are killed in Gaza every hour as fighting exceeds 100 days [Internet]. 2024 [cited 2024 Sep 24]. Available from: https://www.unwomen.org/en/news-stories/press-release/2024/01/press-release-two-mothers-are-killed-in-gaza-every-hour-as-fighting-exceeds-100-days
• Eyad U, Baba E. UN Women rapid assessment and humanitarian response in the occupied Palestinian territory: Situation overview [Internet]. 2023 [cited 2024 Sep 24]. Available from: https://www.unwomen.org/sites/default/files/2023-10/un-women-rapid-assessment-and-humanitarian-response-in-the-occupied-palestinian-territory-en.pdf
• UN Women. Gender alert: The gendered impact of the crisis in Gaza [Internet]. 2023 [cited 2024 Sep 24]. Available from: https://www.unwomen.org/en/digital-library/publications/2024/01/gender-alert-the-gendered-impact-of-the-crisis-in-gaza
• UNICEF. “Barely a drop to drink”: Children in the Gaza Strip do not access 90 percent of their normal water use [Internet]. 2023 [cited 2024 Sep 24]. Available from: https://www.unicef.org/press-releases/barely-drop-drink-children-gaza-strip-do-not-access-90-cent-their-normal-water-use
• ReliefWeb. Gaza Crisis: Gender Based Violence Concerns and Priorities - Information & Advocacy Note: 20 October 2023 [Internet]. 2023 [cited 2024 Sep 24]. Available from: https://reliefweb.int/report/occupied-palestinian-territory/gaza-crisis-gender-based-violence-concerns-and-priorities-information-advocacy-note-20-october-2023
• UNICEF. UNICEF in the State of Palestine Escalation Humanitarian Situation Report No.3 [Internet]. 2023 [cited 2024 Dec 20]. Available from: https://www.unicef.org/sop/reports/unicef-state-palestine-escalation-humanitarian-situation-report-no3
• United Nations. Common Country Analysis for the Occupied Palestinian Territory [Internet]. 2022 [cited 2024 Dec 20]. Available from: https://palestine.un.org/en/200011-united-nations-common-country-analysis-occupied-palestinian-territory
• ACAPS. Palestine: Social impacts of the humanitarian situation - Overview [Internet]. 2021 [cited 2024 Dec 20]. Available from: https://www.acaps.org/fileadmin/Data_Product/Main_media/20211019_acaps_thematic_report_palestine_social_impact_analysis_0.pdf
• Middle East Eye. War on Gaza: The terrible toll on women’s mental and physical health [Internet]. 2024 [cited 2024 Sep 24]. Available from: https://www.middleeasteye.net/opinion/war-gaza-terrible-toll-women-mental-physical-health
• UNRWA. Mental Health and Psychosocial Support (MHPSS) in Gaza [Internet]. 2024 [cited 2024 Nov 23]. Available from: https://www.unrwa.org/resources/reports/mental-health-and-psychosocial-support-mhpss-gaza
• UN Women. Gender alert: The gendered impact of the crisis in Gaza. New York: UN Women; 2024 [cited 2024 Nov 23]. Available from: https://www.unwomen.org/en/digital-library/publications/2024/01/gender-alert-the-gendered-impact-of-the-crisis-in-gaza
• UNRWA. Psychosocial support in conflict zones: Gaza [Internet]. UNRWA Reports. 2024 [cited 2024 Nov 23]. Available from: https://www.unrwa.org/sites/default/files/content/resources/22.8.24_-_mhpss_300_day_report_final.pdf
• Al-Jadba G, Zeidan W, Spiegel PB, Shaer T, Najjar S, Seita A. UNRWA at the frontlines: managing health care in Gaza during catastrophe. Lancet. 2024;403(10428):723-6.
• UN News. “Fear of war” causing speech problems in Gaza [Internet]. 2024 [cited 2024 Sep 26]. Available from: https://news.un.org/en/story/2024/09/1154621
• UNICEF. Education in crisis: How crises around the world are impacting children’s learning [Internet]. 2024 [cited 2024 Dec 20]. Available from: https://www.unicef.org/blog/education-crisis-how-crises-around-world-are-impacting-childrens-learning
• ACAPS. Palestine: Impact of the conflict on children in the Gaza Strip [Internet]. 2024 [cited 2024 Sep 26]. Available from: https://www.acaps.org/fileadmin/Data_Product/Main_media/20240201_ACAPS_thematic_report_Palestine_-_impact_of_conflict_on_children_in_the_Gaza_strip.pdf
• Veronese G, Cavazzoni F, Russo S, Sousa C. Risk and protective factors among Palestinian women living in a context of prolonged armed conflict and political oppression. J Interpers Violence. 2021;36(19-20):9299-327.
• ACAPS. Palestine: Impact of the conflict on mental health and psychosocial support needs in Gaza [Internet]. ReliefWeb; 2024 [cited 2024 Nov 23]. Available from: https://reliefweb.int/report/occupied-palestinian-territory/acaps-thematic-report-palestine-impact-conflict-mental-health-and-psychosocial-support-needs-gaza-03-september-2024
• WHO. Health conditions in the occupied Palestinian territory, including east Jerusalem [Internet]. World Health Organization; 2024 [cited 2024 Nov 23]. Available from: https://apps.who.int/gb/ebwha/pdf_files/WHA77/A77_12-en.pdf
• WHO. WHO’s Health Emergency Appeal 2024 [Internet]. World Health Organization; 2024 [cited 2024 Nov 23]. Available from: https://www.who.int/emergencies/funding/health-emergency-appeals/2024
• Snider A. Project Smile: How a community-based psychosocial intervention is transforming mental health in the Middle East [Internet]. Speaking of Medicine and Health. 2024 [cited 2024 Nov 5]. Available from: https://speakingofmedicine.plos.org/2024/10/25/project-smile-how-a-community-based-psychosocial-intervention-is-transforming-mental-health-in-the-middle-east/
• UNICEF. Community-based mental health and psychosocial support in humanitarian settings [Internet]. 2019 [cited 2024 Nov 23]. Available from: https://www.unicef.org/reports/community-based-mental-health-and-psychosocial-support-guidelines-2019
• Thabet AA. The impact of decades of political violence on Palestinian children in the Gaza Strip and the West Bank. In: Social justice for children and young people: International perspectives. 2020 Aug 27:388.
• El-Khodary B, Samara M, Askew C. Traumatic events and PTSD among Palestinian children and adolescents: The effect of demographic and socioeconomic factors. Front Psychiatry. 2020;11:4.
• Save the Children. Gaza: A mental health crisis for children and women under blockade [Internet]. Save the Children International. 2022 [cited 2024 Nov 23]. Available from: https://www.savethechildren.net/news/after-15-years-blockade-four-out-five-children-gaza-say-they-are-living-depression-grief-and
• Thabet AA, Abdulla TA, Elhelou M, Vostanis PA. Effect of trauma on Palestinian children’s mental health in the Gaza Strip and West Bank. In: Protection of children during armed political conflict: A multidisciplinary perspective. 2006:123-42.
• UNICEF USA. Children trapped in Gaza conflict face generational trauma [Internet]. 2023 [cited 2024 Nov 23]. Available from: https://www.unicefusa.org/stories/children-trapped-gaza-conflict-face-generational-trauma