Psychology in Gaza and the West Bank
The Gaza Strip and the West Bank have a combined population of
around three and a half million. They were part of the British Mandate
of Palestine, which lasted until 1948 and which also included
present-day Israel. When the British announced their intention to
withdraw, a UN partition plan outlined the establishment of both a
Jewish and an Arab state within Palestine, but an Arab state never
emerged. By 1949 military action by neighbouring Arab countries against
the newly formed Israel had failed. The ceasefire lines left Israel in
control of much of Palestine, with the exception of the West Bank (held
by Jordan) and the Gaza Strip (held by Egypt). These areas eventually
came to be occupied by Israeli troops after the Six-Day War in 1967.
Armed resistance by the Palestine Liberation Organisation continued
throughout the 1970s and 1980s, leading in 1987 to the first
intifada, a popular uprising aimed at ending Israeli occupation. In
1993, as part of the peace process, Israeli forces withdrew from major
areas in the territories, and some powers were transferred to the
Palestinian Authority (PA). The peace process collapsed in September
2000, and the second intifada erupted, after Israeli prime minister
Ariel Sharon’s controversial visit to the Al-Aqsa mosque in Jerusalem.
However, Sharon came to accept that Israeli security would be best
served by withdrawal from the occupied territories.
In summer 2005 Israel transferred full control of Gaza to the PA.
Psychology in universities
Psychology is taught at four main Palestinian universities:
An-Najah, Birzeit, Bethlehem and the Islamic University of Gaza. The
Islamic University of Gaza also offers postgraduate psychology courses
in the faculty of education and an undergraduate course in
psycho-counselling. Bethlehem University offers a minor in psychology
as part of its social work and sociology degrees.
Postgraduate courses are generally lacking in the territories. Clinical
psychologists and those engaged in research train abroad – generally
either in neighbouring countries such as Egypt and Jordan or in Europe
and the United States.
Clinical training
The Gaza Community Mental Health Programme (GCMHP) was founded in
Gaza City in 1990, to provide mental health therapy, training and
research in the Gaza Strip. It is chaired by the prominent Palestinian
psychiatrist and human rights activist Dr Eyad el-Sarraj. The training
and education department offers a two-year postgraduate diploma in
community mental health and human rights, accredited by the Islamic
University of Gaza and the Palestinian Ministry of Higher Education.
The course is also accredited by the medical school at Suez Canal
University
in Egypt as part of its master’s degree in psychiatry. The department
has also established links with Oxford University. Senior staff from
seven overseas universities work with local trainers to teach the
course. The long-term aim is to establish an Arab Institute for
Community Mental Health that will be a leading institute in the Middle
East. At present the GCMHP relies on international links for senior
research and teaching staff but hopes to organise distance-learning
programmes at master’s and PhD level to enable local staff to take on
this role.
Research
Areas of special interest in research are of course the effects of
trauma related to political violence, and motivational factors for
suicide bombing attacks.
The research department at GCMHP analyses how the population of Gaza
has been affected by political violence. They say that through research
the extent of psychological problems in Gaza are explored, and by
communicating them to the world they can help to relieve them. GCMHP
organises international conferences and workshops for local and
international experts to discuss mental health issues and to raise
international awareness of the difficult situation confronting the
Palestinian people. In 1998 the Palestinian Ministry of Health adopted
a GCMHP study on stress-related disorders. Prior to this, mental health
issues had been largely disregarded; they are now part of a five-year
health plan.
Attacks by Palestinian groups such as Hamas and the Al-Aqsa Martyrs
Brigades may often be termed terrorism, but the Palestinians themselves
refer to them as armed resistance. Particularly following the 11
September 2001 attacks on the United States, much research on the
psychology of terrorism has been undertaken by researchers around the
world.
From studies that have been undertaken within Gaza and the West Bank on
both suicide and non-suicide bombings, Dr el-Sarraj’s have gained the
most international prominence in both the research community and the
media. Dr el-Sarraj says that 36 per cent of boys and 17 per cent of
girls said they wanted to be a martyr when they reached 18 years old.
Research has shown that for (Palestinian) boys especially, seeing their
fathers beaten or humiliated by Israeli soldiers – who are often only
teenagers – is a powerfully traumatic image. For Arabs the image of the
father as an all-powerful force is an important one. Boys turn to
militant groups as a substitute father figure that can both protect
them and seek revenge on the enemy – in their eyes the Israeli
soldiers, government and civilians. Losing their homes – when destroyed
by the Israeli army after suicide attacks or if they believe it is home
to a member of an armed group – is also a highly traumatic event for
children; the safe world they knew is literally shattered. Joining a
group allows the individual to identify his personal trauma with that
of the group. Dr el-Sarraj says that the children of the first intifada
in the 1980s became the suicide bombers of the second, having carried
that trauma with them.
Clinical services
The Palestinian Authority’s National Mental Health Plan focuses on
the need to introduce community-based mental health care through
establishing community health centres, staffed by one psychiatrist, two
psychologists, two mental health nurses, two social workers and an
occupational therapist. GCMHP runs four clinics and emphasises the
importance of the family in the therapeutic process in order to achieve
a successful outcome. Therapy is rooted in a culturally sensitive
approach, adapting Western approaches to Palestinian society. GCMHP has
200 staff trained in psychology and psychiatry as well as hundreds of
community workers.
Since its establishment, the GCMHP has worked to raise awareness of
mental health issues through holding public meetings, and distributing
brochures
and posters. It issues Amwaj, the first specialised mental health
magazine in Palestine. The programme’s Crisis Intervention Project was
launched one month after the Al-Aqsa intifada in September 2000 to deal
with the psychological effects of the violence. Often symptoms are
somatic, not psychological. ‘A problem is how to recognise
psychological conditions in people presenting with somatic symptoms and
how to educate health workers,’ says Dr el-Sarraj. The project provides
free telephone counselling services for those unable to get to the
clinics.
There is also a Women’s Empowerment Project, dealing specifically with
female victims of violence – both political and domestic. There are
high rates of domestic violence, as men released from prison turn their
suffering on the women in their household, who in Arab society are
traditionally dependent on male family members.
The Union of Palestinian Medical Relief Committees (UPMRC) runs a
counselling programme in Gaza and the West Bank. It estimates that 30
per cent of the Palestinian population could benefit from psychological
counselling, but that only about a third of this group will receive
appropriate care. The organisation says that children are particularly
vulnerable to the consequences of political violence and are prone to
problems with development and personality. UPMRC deploys teams to
conduct home visits to help mothers and children deal with fear and
anxiety. It has also conducted workshops on mental health needs
assessments in some areas, enabling people to take part in creating a
mental health support structure for their community. UPMRC also uses
theatre to create dramas that address various mental health issues in a
reassuring fashion that is devoid of stigma.
Dr Rasmiyya Abdul-Qader, a clinical psychologist working in the West
Bank, has said that although the Palestinian people have suffered
negative psychological effects due to the socio-political conditions in
the region, they are more resilient to such pressure than others would
be, due to the long-period of suffering they have endured. As Dr
el-Sarraj put it: ‘Palestinians have high coping skills because they
believe in a divine justice that one day will come.’
Looking to the future
Following the Israeli withdrawal from the Gaza Strip in 2005, there
may be greater opportunities for academic organisations in Gaza to
collaborate with overseas organisations and improve research ties, as
the PA takes full charge of national affairs. The Council for British
Arab Understanding (CAABU) is one organisation that aims to foster
links between Britain and the Arab world and will continue to do so in
the sphere of education and healthcare – the two sectors which
psychology embraces. More postgraduate courses are undoubtedly needed
to allow Palestinians to undertake professional training and doctorate
level research without going abroad.
The socio-political change resulting from the Israeli withdrawal will
itself provide fertile research ground for social psychology. On the
clinical side, the withdrawal may go someway to alleviating political
and religious tensions and lead to a reduction in stress-related
disorders; although the political situation in the
West Bank is set to remain unchanged. Furthermore, there is already
much lawlessness and fighting between rival groups in the two
territories, so overall violence may not significantly decrease.
- Anna Costin is a terrorism reporter at Jane’s Information Group, and
co-author of An Introduction to Peace Psychology (Cambridge
University Press, 2005).
Further reading
Punamaki, R.L., Kanninen, K., Qouta, S. & El-Sarraj, E. (2002).
The role of psychological defenses in moderating between trauma and
post-traumatic symptoms among Palestinian men. International Journal of
Psychology, 37, 286–296.
Samir Qouta, J. & Odeh, J. (2004). The impact of conflict on
children: The Palestinian experience. Ambulatory Care Management, 28,
75–79.
Weblinks
Union of Palestinian Medical Relief Committees:
www.upmrc.org
Council for Arab–British Understanding:
www.caabu.org
Gaza Community Mental Health Programme:
www.gcmhp.net
(Please note that some pictures may have been removed for copyright reasons)
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