Stress, trauma strain Palestinians


WHILE MANY eyes focus with a mix of cautious optimism and horror on Gaza, the turmoil in Israel and the rage and sorrow of Jewish settlers, the lack of attention to the lives of more than 1 million Palestinians who share the tiny stretch of coastline is striking.

As Avraham Burg, former Knesset member, recently wrote: "Take all the settlers' screams about discrimination and laments about suppression, multiply them many-fold, and you will feel what the Palestinians have lived with for many years without our seeing or feeling."

In a recent trip to Gaza with a Jewish-American medical delegation, we witnessed the devastating consequences for the civilian population of years of Israeli military operations. The checkpoints, closures and the severe restriction on movement and economic activity have contributed to rising unemployment, poverty accompanied by unusually high rates of infant mortality, acute and chronic malnutrition and inadequate outpatient and hospital care.

The academic and medical institutions in Gaza are also severely stressed. Yet we were impressed by the resilience of those institutions. We also were impressed with the decency, moderation and endurance of the vast majority of Palestinians.

While settlers express outrage at the government that once supported and encouraged them, where is the outrage for thousands of Palestinians who have been humiliated, displaced, left homeless, wounded and killed because of the perceived needs of the settler movement and aggressive Israeli incursions, home demolitions and checkpoints?

At the Gaza Community Mental Health Program, Dr. Eyad el Sarraj spoke of an entire population suffering from the symptoms of post-traumatic stress disorder, anxiety and depression, a consequence of high unemployment, extreme poverty and massive exposure to violence.

"The chronic disease of Palestinian life is settlers and settlements," remarked Dyaa Saymah, a mental health worker at the program.

We visited a family in southern Gaza where a child was suffering from PTSD after losing his father to Israeli army bullets and his home to a bulldozer. In the ghost town of Rafah, we stood in a sea of devastation - 1,500 demolished homes, crumpled concrete and twisted wire.

A recent study by the program of 10- to 19-year-olds in Gaza found that two-thirds have seen a friend or neighbor killed or wounded, more than one-third have been tear-gassed and 82 percent suffer from moderate to severe PTSD. We know that the more trauma and violence occur in a child's youth, the more risk-taking and violence happen in later life.

Where is the talk of the psychological needs, human rights or financial compensation for these people? Are they any less human, any less entitled to a safe and healthy life than Jewish settlers?

It is hard to imagine the long-term value of disengagement if Israel maintains exclusive authority over the borders, air space and coast, the right to make military incursions into Gaza, to keep a military presence along the border with Egypt and to control international crossings and any foreign presence.

How can Palestinian leader Mahmoud Abbas put his own house in order when Jewish settlements in the West Bank are expanding, the construction of the "separation barrier" continues apace and Palestinian East Jerusalem is threatened with strangulation? Will the deplorable conditions under which Palestinians live improve after disengagement?

Israeli Prime Minister Ariel Sharon's adviser, Dov Weisglass, described disengagement's goal as "the freezing of the peace process. ... Effectively, this whole package called the Palestinian state, with all that it entails, has been removed indefinitely from our agenda. ... All with a presidential blessing and the ratification of both houses of Congress."

Gaza disengagement can fulfill its promise only if it signals the beginning of an end to the Israeli occupation and if there is an international commitment to rebuilding a devastated civic and economic infrastructure in Palestine.

Even the World Bank has said that Palestinian viability requires contiguity and open borders, full economic access to Israel and freedom of movement within Palestine. In health care, the Palestinian Authority, Israel and the international community can work together to ensure desperately needed medical access throughout the occupied territories.

The international community can play a positive role politically and financially; building a foundation of trust, a mutual cessation of hostilities and future coexistence. It must also develop and fund social and economic infrastructures for this devastated community. The 8,000 Gaza settlers have a commitment. Why not 3.5 million Palestinians?

Alice Rothchild, M.D., is co-chair of Visions of Peace with Justice in Israel/Palestine, based in Boston.

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