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Nabila Hamada gave birth to twin boys in Gaza at the beginning of the war, in a hospital reeking of rotting bodies and full of displaced people. When Israeli forces threatened the hospital, she and her husband fled with only one baby, as medical staff said the other was too strong to leave. Soon, Israeli forces attacked the hospital, the largest in Gaza, and they never saw the boy again.
The trauma of losing one twin left the 40-year-old Hamada so terrified of losing the other that he became frozen and unprepared to deal with the burdens of daily life.
“I can’t take care of my older children or give them the love they need,” she said.
They are among hundreds of thousands of Palestinians struggling with mental health after the nine-month war. Trauma has no mercy. He has suffered the killing of family and friends in Israeli bombings. They are injured or disabled. They huddled in their homes or camps because the war was raging and they fled again and again, with no safe place to recover.
Anxiety, fear, depression, lack of sleep, anger and general aggression, experts and practitioners told The Associated Press. Children are the most vulnerable, especially since many parents are unable to hold themselves together.
There are a number of resources to help Palestinians process what they are about to do. Mental health practitioners say the turmoil and the overwhelming number of traumatized people limit their ability to provide genuine support. So they offer a form of “psychological first aid” to alleviate the worst symptoms.
“There are about 1.2 million children in need of mental health and psychosocial support. This means almost all the children of Gaza,” said Ulrike Julia Wendt, emergency child protection coordinator with the International Rescue Committee. Wendt has visited Gaza since the war began.
She says simple programs, like games and art classes, can make a difference: “The goal is to show that it’s not just bad things.”
The trauma of repeated displacement compounds: an estimated 1.9 million of the 2.3 million Gazans have been driven from their homes. Most of them live in poor tents and struggle to find food and water.
Many survivors of the October 7 attack by Hamas in southern Israel that sparked the war in Gaza also suffered traumatic injuries, and are looking for ways to heal. The militants killed more than 1,200 Israelis and took about 250 hostages.
Sheltering near the southern city of Khan Younis, Jehad El Hams said he lost his right eye and a finger on his right hand while picking up what he thought was a can of food. It is a non-explosive weapon that explodes. His son almost got hit.
Since then, he has experienced sleepiness and disorientation. “I cry every time I look at myself and see what I’ve done,” she said.
He approached one of the mental health initiatives in Gaza, run by the UN agency for Palestinian refugees, known as UNRWA.
Fouad Hammad, UNRWA’s mental health supervisor, said he usually sees 10 to 15 adults a day at the shelter in Khan Younis with eating and sleeping disorders, extreme anger and other problems.
Mahmoud Rayhan saw his family destroyed. Israeli attacks kill sons and daughters. Her husband’s leg was amputated. Now he isolates himself in his tent and sleeps all day. He barely spoke to anyone.
She said she didn’t know how to express what happened to her. He was nervous. He was sweating. “I have cried and felt nothing but heaviness in my heart.”
One brother, Abdul-Rahman Rayhan, lost his father, two brothers and four cousins ​​in the attack. Now when he heard the bomb, he was shaken and dizzy, his heart pounding. “I feel like it’s a nightmare, waiting for God to wake me up,” the 20-year-old said.
For children, the mental toll of war can have long-term effects on development, Wendt said. Children in Gaza have nightmares and burn their beds because of stress, noise, noise and constant change, he said.
Nashwa Nabil in Deir al-Balah said her three children have lost their sense of security. The eldest is 13 and the youngest is 10.
“He couldn’t control his urination, chewed his clothes, screamed and became verbally and physically aggressive,” she said. “When my son Moataz hears planes or tanks, he hides in the tent.”
In the central city of Deir al-Balah, a psychosocial team with the Al Majed Association works with dozens of children, teaching them how to respond to the reality of war and giving them space to play.
“When there is a strike, they put themselves in the fetal position and seek safety from buildings or windows. We introduce scenarios, but anything in Gaza is possible,” said project manager Georgette Al Khateeb.
Even for those who escaped Gaza, the mental toll remained high.
Mohamed Khalil, his wife and three children were displaced seven times before reaching Egypt. His wife and children arrived in January and he joined them in March. Her 8-year-old daughter hid in the bathroom as the gunfire and gunfire erupted, saying, “We’re going to die.”
A 6-year-old boy can only sleep after his mother tells him that dying as a martyr is an opportunity to meet God and ask for fruits and vegetables that are not available in starving Gaza.
Khalil remembers the terror of walking down a designated “safe corridor” with Israeli gunfire nearby.
Even after arriving in Egypt, the children became introverted and fearful, Khalil said.
He has enrolled in a new initiative in Cairo, Psychological and Academic Services for Palestinians, which offers art and play therapy sessions and math, language and physical education classes.
“We see a need for these children who have seen more horror than they will find,” said the founder, psychologist Rima Balshe.
On a recent field trip, she recalls, the 5-year-old twins from Gaza were playing and suddenly froze when they heard helicopters.
“Is this an Israeli fighter plane?” they asked. He explained that it was an Egyptian plane.
“So Egyptians like us?” they asked. “Yes,” he reassured them. They have left Gaza, but Gaza has not left.
There is hope that children traumatized by the war can heal, but it is still a long way off, Balshe said.
“I wouldn’t say ‘healed’ but I definitely see evidence of recovery. He may not recover from the trauma he endured, but now we are working hard to overcome the loss and grief,” he said. “It’s a long process.”
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Associated Press writers Julia Frankel in Jerusalem and Kareem Chehayeb in Beirut contributed to this report.
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Find more AP coverage at https://apnews.com/hub/israel-hamas-war
