Nowhere to run: Gazans struggle with trauma after 11-day war

Psychologists report a surge in demand from civilians who have lost homes or been injured in Israeli bombing

The empty square in between one of Beit Hanoun’s tight-knit communities had, for years, been used by its residents as a favourite place to hang out and meet up.

“We now start to determine whether the traumatic events of the war turn into post-traumatic stress or not,” Mahmoud Awad, a psychologist with Médecins Sans Frontières at Al-Awda Hospital in northern Gaza explained. Here, he sits with one of the patients who lost his leg.

The empty square in between one of Beit Hanoun’s tight-knit communities had, for years, been used by its residents as a favourite place to hang out and meet up. It has been reduced to rubble during the 11-day war between Israel and Hamas.

Taghrid Nassir, 37, sits with her children. She says she is plagued by nightmares since the bombing of her neighbourhood.

Taghrid Nassir's daughter Dunya, 13, sits in what used to be her bedroom.

Jawaher Nassir is a 24-year-old mother living in the same Beit Hanoun square.

Jawaher Nassir (left) said she had been running to the nearby hospital after the first bomb fell, forgetting to grab her five-month-old son Mohammad.

Ibrahim Amman, 30, is recovering at Al-Awda hospital, his legs sitting in external fixtures.

After seven surgeries, the fate of his legs isn’t yet clear - but he hopes they can be saved.

The empty square has been reduced to rubble during the 11-day war between Israel and Hamas.

The empty square in between one of Beit Hanoun’s tight-knit communities had, for years, been used by its residents as a favourite place to hang out and meet up. It has been reduced to rubble during the 11-day war between Israel and Hamas.

The empty square in between one of Beit Hanoun’s tight-knit communities had, for years, been used by its residents as a favourite place to hang out and meet up. It has been reduced to rubble during the 11-day war between Israel and Hamas.

The empty square in between one of Beit Hanoun’s tight-knit communities had, for years, been used by its residents as a favourite place to hang out and meet up. It has been reduced to rubble during the 11-day war between Israel and Hamas.

The once vibrant square in one of Beit Hanoun’s tight-knit communities was a favourite place for residents to hang out, drinking sugared mint tea late into the night, and lighting small fires in the absence of electricity.

Israeli air bombardments reduced it to rubble during the 11-day war with militants in the Gaza Strip in May.

All of the residents survived, but the trauma — and an onset of post-traumatic stress — sticks with them.

“We now start to determine whether the traumatic events of the war turn into post-traumatic stress or not,” said Mahmoud Awad, a psychologist with Medecins Sans Frontieres at Al Awda Hospital in northern Gaza.

“A natural response to any traumatic event is usually to ‘fight, flight or freeze’," he added.

“In any other war, people have the opportunity to escape, but in Gaza, you can’t run anywhere; you can’t run from the bombs. There is nowhere to go; no border to cross.”

Mr Awad and his colleague Merva Abu Anour see dozens of patients each week. The hospital has just hired a third psychologist, determining that mental health needs are higher than expected.

Gaza has been under a blockade since June 2007, which has restricted imports, exports and the movement of people. For a person to cross the border, they must obtain a permit through a long bureaucratic process. Leaving — even to take a mental break — is nearly impossible.

“Gaza is in a constant state of humanitarian crisis due to the long-running blockade, and the escalation of violence over recent weeks has compounded an already catastrophic situation,” said Helen Ottens-Patterson, the MSF head of mission in Gaza. She said she was worried about how people were going to cope and rebuild what has been destroyed.

Taghrid Nassir, 37, has been plagued by nightmares after her apartment on the top floor of a family house near the square was reduced to rubble.

“I wake up screaming most nights,” she said.

More than one month on, she sits with her fingers nervously shaking as she tries to put a confident smile on her face for her children. Like most Gazans, she had never really considered seeing a psychologist — the opportunity is largely unavailable. But with her neighbourhood among the most devastated in Beit Hanoun, teams of mental health workers have regularly visited the affected families, including Ms Nassir.

“What broke me was my son Mahmoud reciting the Shehada after the first bomb fell,” Ms Nassir said, referring to the Islamic proclamation of faith. “He is only four years old, but he mumbled the words because he was sure he’d be dying. He had accepted it.”

While the family survived the bombings, the trauma haunts them.

“Earlier today Mahmoud asked me why I was cleaning the apartment because it would surely be bombed again in the future,” Ms Nassir said. “My children live in constant fear. I don’t know how they will overcome this.”

The 11-day war killed at least 256 Palestinians and 13 people in Israel. More than 2,000 homes were destroyed and thousands more damaged in the Gaza Strip, according to the Palestinian territory's Ministry of Public Works, uprooting tens of thousands of people. There is little prospect of rebuilding starting soon.

Jawaher Nassir, 24, said she ran to the nearby hospital after the first bomb fell on May 10, forgetting to grab her five-month-old son Mohammad from their home near the square.

“I screamed when I realised,” she said. “Above, I could hear airplanes as I was running back for my child, the roads empty and dark. I saved him minutes before the next bombs fell.”

More than a month later, the young mother said she was struggling. “Each time I hear a drone or a plane in the sky, the memories come back. I see images of my son at home, alone. I am terrified.”

While Israel and Hamas agreed on an Egypt-brokered ceasefire, the situation in the strip remains volatile. A lasting truce with binding agreements from both sides has yet to be signed.

“A ceasefire is solely a cessation of fighting, without dealing with the underlying causes,” said Dr Basem Naim, a member of the Hamas group that rules Gaza and head of the Council on International Relations, adding that it could break down at any moment.

Fear of a new escalation is widespread among Gazans.

Last month’s hostilities resulted in more than 9,000 injuries, according to the World Health Organisation. Many, such as those who lost limbs, must get used to completely different lifestyles, which can cause severe depression.

Ibrahim Amman, 30, is recovering at Al Awda hospital, his legs in supports. After seven operations, it is still not certain that they can be saved.

“One of the missiles hit our house directly,” he said, sitting in a wheelchair. “I was trapped under rubble for hours, screaming.”

Mr Amman said he never expected his house to be hit. “I didn’t think we were at risk at all. My family isn’t political and neither is anyone else in the neighbourhood.”

Three of his sisters and his father were killed in the blast. Mr Amman — then in intensive care — could not attend their funerals. What haunts him are the hours trapped under rubble. Since being admitted to hospital, he has been talking to Mr Awad regularly, processing the events of the last month.

“Here in Gaza, people have developed high levels of resilience, and this might help them overcome the trauma they have experienced,” Mr Awad said.

Mr Amman said he did not see a future in Gaza, but did not have the choice to leave. “It’s not an option; it’s impossible for us,” he said. “That’s why I don’t think about it."

He rolls up the sleeve of his T-shirt to show a fading tattoo on his right upper arm, created by an amateur friend: three birds around the word “free”.