Mental health professionals struggle with Gaza’s overwhelming trauma

Children hold protest signs amid Israeli destruction in Deir al-Balah — Palestinians who survive Israel’s genocidal bombing campaign face enormous loss and psychological trauma.
Ali Hamad ZUMAPRESS

Fady is a 30-year-old psychologist working in a school in Gaza’s Nuseirat refugee camp where tens of thousands of displaced Palestinians are taking shelter.

He has refused to abandon his job although traveling to work is extremely dangerous. Fady and two others interviewed in this article gave only their first names due to safety and/or job security considerations.

“I have to help these poor people. They know me very well and consider me as a backup,” he told The Electronic Intifada.

When the Israeli army ordered the residents of the middle area of Gaza to evacuate to Rafah in December, however, Fady and his immediate and extended family members were crammed into a densely populated school there, where the simple act of using the toilet was an ordeal.

“Imagine having to line up for a few toilets shared by tens of thousands, with no hygiene,” he said. “I used to wait for my wife and 2-year-old daughter to sleep so that they wouldn’t see me crying due to my helplessness.”

After several grueling weeks, Fady made the difficult decision to return to Nuseirat refugee camp, despite the danger, where he continued his work.

On 14 May, the Israeli army bombed the school where Fady worked, killing Palestinians taking shelter there.

The next day, when he returned to the bombed site, he was overcome with grief, witnessing the destruction and the loss of so many lives.

“I couldn’t take it anymore,” Fady said. “I knew everyone who survived, and I knew those who were killed. I felt utterly helpless and overwhelmed.”

Yet amidst the devastation, he found himself drawn back to his role as a psychologist.

“Children run to me when they see me. I had to do some activities for them and provide a little psychological support for the survivors although I myself was shattered into pieces.”

Leaning on colleagues

For Fady, the weight of living and hearing the horrors of war is tough.

“The most difficult job in the war is being a psychologist. Imagine living the war and listening to heartbreaking stories every day from grieving people.”

Alaa, another psychologist working at the school, shares Fady’s struggles. He, too, juggles fears for his family, the scarcity of food and water, and the daily trauma of war.

Like all Palestinians in Gaza, he has to secure food, water, firewood and other basics after finishing work.

“I remember I slept three days in line to get a gas cylinder and then went straight to work the next day,” he told The Electronic Intifada.

The heartbreaking stories and horrors he sees at work have made him break down in tears many times.

“I remember I talked to some people whose families were killed and stuck under the rubble. I cried with them out of helplessness,” he said. “Sometimes I have to give people a glimmer of hope although I’ve lost it.”

To cope, Fady and Alaa have leaned on their colleagues and supervisors, sharing their fears. They have also made sure to participate in activities with children.

“Our real suffering hasn’t even started yet as we are totally busy with securing the basics now,” Alaa said. “When the war ends, it will be even tougher for us. I just pray that God helps us.”

Massive toll

The war has taken a massive toll on Gaza’s healthcare workers, including those in mental health.

Nearly 900 healthcare professionals have been reported killed over the past year’s genocide, according to the United Nations.

Médecins Sans Frontières reported in April that healthcare workers suffer from “constant fear, stress and anxiety” due to the horrors of injuries they witness such as “crushed limbs and burns from explosions.”

The well-known psychiatrist Yasser Abu Jamei, who heads the Gaza Community Mental Health Programme (GCMHP), told The Electronic Intifada of the unique burden on mental health workers and the complex challenges they are facing.

These mental health workers are not only experiencing the same traumatic conditions, but also work with the most affected and traumatized people. They are often themselves displaced, a reality which leads to secondary trauma.

Abu Jamei said his staff helped with 16,000 cases during the first six months of the war.

The lack of mental health medications in Gaza has further exacerbated the situation.

“Lacking mental health medications is extremely bad,” the veteran psychiatrist said. “These medications are a lifeline for some patients.”

Although some international organizations have secured occasional medications for GCMHP in the south of the coastal strip of territory, it is far from enough to meet the demand due to the Israeli closure of the Rafah crossing.

The constant displacement due to the Israeli evacuation orders has also forced nongovernmental organizations, like GCMHP, to operate from temporary offices, hindering Palestinians from safe and easy access to the psychological support they need, especially in the north of Gaza.

Even mountains

Hamza, 22, was injured in an Israeli airstrike that killed his friend in Jabaliya a few months ago.

With hospitals overwhelmed, he was sent home despite needing further treatment. Shortly after, his neighborhood was blockaded by the Israeli army, trapping him in unimaginable terror.

“The horrors we lived were indescribable. Even mountains can’t hold it,” he said. “I have been having nightmares since then and my mental health has deteriorated. I do need psychological support, but I can’t find any in the north.”

Hamza has been awarded a scholarship to pursue a master’s degree in Spain, but with the borders closed, his dreams are slipping away.

“When I think about my future, I panic. Even if Israel opens the Rafah crossing, I will have to pass through the Israeli military checkpoint at Netzarim” in central Gaza, he said. “I could be arrested, tortured or even killed. I don’t even dare to think about it. It’s another nightmare that has made my life hell.”

Somaia Abu Nada, who fled her home in Gaza City with her family, shares Hamza’s despair. An Israeli airstrike in October 2023 hit the building where they took shelter in Rafah, killing her sister Hiba in front of her.

Somaia survived with minor injuries, but the trauma left deep scars.

“I needed psychological support, but I couldn’t find any, and I couldn’t even call a hotline because we were all living in the same tent,” she said.

Somaia managed to leave for Egypt, but her family remains trapped in Gaza. She lives with survivor’s guilt, plagued by nightmares and a devastating new phobia of closed spaces after she was pulled from beneath the rubble.

“I’ve lost the taste for life,” she admitted.

Though Somaia has a scholarship to study in Ireland this fall, her past haunts her, making it difficult to imagine a future free from an Israeli missile’s shadow.

Ahmed Al-Sammak is an MBA student in Dublin. He previously worked as a journalist in Gaza, where he grew up.