When the guns fall silent in Gaza, trauma will still haunt the innocent

When the guns eventually fall silent in Gaza and the full devastation of the war becomes apparent, there will also be an urgent need to address the less visible, albeit no less harmful, impact on the mental health of hundreds of thousands of innocent people on both sides of the border. Special attention will have to be paid to so many children who have suffered an unimaginable trauma, and who, without adequate care, will carry this with them for the rest of their lives, with an adverse effect on themselves and their societies.

Both Israeli and Palestinian societies have been and are being traumatized, and as a result many children and adolescents are enduring a post-traumatic stress disorder that manifests itself in different ways and should leave no one in any doubt about its long-term ramifications, including how they will view the idea of peace, reconciliation and coexistence between the two peoples. One of the many tragedies of war, and a heart-wrenching one, is that those who are the most vulnerable in society are those who face the gravest consequences of such hostilities, both physically and psychologically. According to the human rights organization Save the Children, 68 million children, more than one in six worldwide, live in areas affected by armed conflict, and the numbers are on the rise. Moreover, children are far more likely to die from conflict than are armed actors.

Thanks to visual media, we can witness in real time the horrors that take place during conflicts and inflict unbearable suffering on civilians, especially children. In the Gaza Strip, almost half of the population is under 18 and bears the brunt of the war’s horrors. Every day for nearly eight months we have watched the cruel and brutal violence that was committed by Hamas on Oct. 7, and since then by the Israeli military in response to it. Even without a single shot fired or bomb dropped, it is enough for a child to constantly hear the roar of assault aircraft or of advancing tanks, or see fully armed soldiers on their streets; to be terrified, even traumatized, particularly when they are exposed to this day and night for months on end. But in the case of the war in Gaza in all its intensity, it is not about seeing or hearing the war machines, but being on the receiving end of their full firepower, and being caught up in the crossfire between two sworn enemies.

Exposure to trauma in childhood can affect behavior later in life

Yossi Mekelberg

Children are paying with their lives daily, and many have physical and mental injuries that they will bear for the rest of their lives. At the beginning of this month, the UN estimated that 7,797 children have been killed in Gaza since the beginning of the war, and their numbers are rising every day. However, beyond the terrible tragedy of individual lives being cut short, it is also their families, and their young siblings and friends, who are left scared and scarred, fearing that they might be the next to die and feeling guilty for surviving.

Research conducted by the UK government has established that exposure to trauma in childhood can affect behavior later in life, and that in cases of prolonged trauma, “children can suffer ‘toxic stress,’ which can become biologically embedded.” Further findings show that the prevalence of mental health problems in conflict zones is extremely high, with 47 percent of children showing symptoms of PTSD and 43 percent of depression. Frightening as these figures are, they should come as no surprise, as those children experience, as we are witnessing in Gaza, the loss of loved ones, war-related injuries, and other types of violent scenes and events.

Even before the current war, data show that 71 percent of Gaza’s people suffered from depression, and 80 percent reported being in a perpetual state of fear, worry, sadness and grief, while three-quarters of its children were bedwetting in fear, and a growing number were exhibiting reactive mutism. We can only imagine what the figures must be right now, after months on end of daily bombardments and being constantly displaced, without access to medical treatment and not knowing when and from where they will get their next meal or have access to clean water or sanitary facilities. On the one hand the mental state of many children is deteriorating and with it the need for treatment is on the rise. But on the other hand the mental health system in Gaza has collapsed, with psychiatric facilities damaged or depleted, severe shortages of medication, and due to Internet disruptions even access to teletherapy is not possible.

The moral obligation to protect children needs little elaboration

Yossi Mekelberg

The moral obligation to protect children needs little elaboration. The UN Convention on the Rights of the Child is a legally binding, international agreement setting out the civil, political, economic, social and cultural rights of every child, regardless of their race, religion or abilities. The convention has been signed by 196 countries, including Israel, and by that these countries have committed themselves to defending the children’s lives, survival and development, and to protect them from violence, abuse and neglect. Right now, no child in Gaza could possibly believe that their rights, as enshrined in these conventions, are being even remotely respected.

It can be argued that the moral argument should suffice to mobilize the international community to protect children from being victimized in wars, but sadly this is not the case in most conflicts. However, there are also political reasons for shielding children from the horror of wars, as one of the consequences of it is radicalization. Young people, even children, in their anguish and anger, become fertile ground for radicalization and being brainwashed to participate in political violence. Recent research published in The Lancet, one of the most respected peer-reviewed medical journals, argues that “ensuing psychological distress can increase children and young people’s susceptibility to radicalization, as extremist groups often exploit feelings of hopelessness.” One can hardly imagine a situation that has generated more hopelessness than that of Gaza, even before the war began, never mind since.

Neglecting the suffering of children in war seriously blemishes our humanity. Whatever the justification for war, the protection of children should remain sacrosanct. In the aftermath of the current war in Gaza, one of the most urgent and important tasks will be to ensure that children receive mental support and the necessary tools to overcome the horrendous ordeal they are enduring. We owe that to them for the sake of the health of their societies and for the cause of peace when it eventually arrives.

• Yossi Mekelberg is a professor of international relations and an associate fellow of the Middle East and North Africa Program at international affairs think tank Chatham House. X: @YMekelberg