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How do we protect mental health in Gaza during the COVID-19 pandemic?

Mental Health expert Dr. Yasser Abu Jamei lives and works in Gaza. In this guest blog he describes the challenges for people in Gaza who are facing COVID, domestic violence, economic blockade, and ongoing conflict.

Gaza closes parks during Eid celebrations marking the end of Ramadan in order to stop Covid-19 spreading. Photo : Mohammed Asad/Middle East Monitor. Gaza closes parks during Eid celebrations marking the end of Ramadan in order to stop Covid-19 spreading. Photo : Mohammed Asad/Middle East Monitor.

Before COVID-19 arrived in Palestine, people were already facing huge mental pressures. Already one in four children in Gaza was in need of some sort of psychological support.

People in Gaza experience crushing poverty due to the economic blockade. This is on top of having had three wars in the past decade, and frequently military escalations that cause extreme fear among the population.

On top of these pressures, we now have the COVID-19 pandemic. There are over 600 cases of COVID-19 now in Palestine, with over 50 in the Gaza strip. Thankfully the numbers are still small, although we have tragically experienced our first death in Gaza.

The authorities have taken measures including stopping prayers in mosques, open market gatherings, funerals, and public meetings. Anyone who comes from outside Gaza is put into quarantine for three weeks. So far, this strategy has kept the numbers low.

However, with zero immunity in wider society and without a vaccine or an effective treatment, we’re still very afraid for the future. At the moment we are buying time. The health system in Gaza is very weak. For a population of two million people we only have about 100 ventilators, most of which are already in use in intensive care units. In contrast, Ireland has around 2,000 ventilators.

We also have extremely crowded areas in Gaza. It’s one of the highest density populations in the world, particularly in the refugee camps. We have more than 1.3 million refugees, most of them live in incredibly crowded camps. If COVID-19 breaks out in these camps, it will be a disaster. We are almost on the brink, almost on the edge.

Hamed Al-Sheikh Khalil, whose wife and six other family members were killed during Israeli airstrikes on their home in 2014. Hamed’s daughter Maha (13) was also paralysed due to the strikes on their house. Photo : Garry Walsh Hamed Al-Sheikh Khalil, whose wife and six other family members were killed during Israeli airstrikes on their home in 2014. Hamed’s daughter Maha (13) was also paralysed due to the strikes on their house. Photo : Garry Walsh

The impact on mental health

My organisation, the Gaza Community Mental Health Programme, conducted a survey in April to understand how communities are coping during the COVID-19 crisis. 78% of people say that their main worry is how to help their children. People in Gaza depend on their extended family for support, and that isn’t possible right now.

Children aren’t going to school and this has resulted in a lot of extra burden being placed on the shoulders of women in Gaza. Women in Gaza are expected to take care of the children, prepare meals and to manage the household.

There is already a lot of strain on families due to the economy. A lot of people live from hand to mouth. The unemployment rate amongst under 30s is 70% and for women it is almost 90%. The poverty rate was 54% before COVID-19 and now an additional 10,000 families are seeking support. Most families rely on humanitarian aid to survive.

Some organisations are also reporting an increase in the rate of violence against women. Many men are anxious and frustrated and, sadly, they are then becoming abusive and violent.

Ola Dweek is a child psychologist in Gaza: Ola Dweek is a child psychologist in Gaza: "I counsel the children affected by the trauma of war. They have constant nightmares. They are bed wetting. They have completely changed. They have lost their minds, in a way. It's heart-breaking." Photo: John McColgan / Trócaire

THE POWER OF TALKING TO SOMEONE

For thirty years we have been working to address the mental health challenges in Gaza. Our three community centres are continuing to operate, with social distancing measures in place between our therapists and clients. We also reach people through outreach including through school counsellors, and we are visiting people in the quarantine centres.

With the support of Trócaire, we also provide a free telephone hotline, which aims to support people who cannot reach our community centres. Some women experiencing violence are not allowed to leave the house. Other women are so poor they cannot afford the cost of transport to the centre.

Since the crisis has hit the percentage of female callers has dropped from 60% to 30%. This is very worrying. Women used to call when almost no one was at home, when they would feel safe to speak confidentially. We are worried now that since the house is full of people, with children and husbands at home, that women now don’t have enough space and time to call our services.

So we have increased our operating times, and the lines are now open 8am and 8pm, seven days a week. We have also increased our awareness raising campaigns, through radio, television and through social media.

Providing these supports can make a huge difference to these women, helping them to cope through some of the most difficult times in their lives.

Dr. Yasser Abu Jamei meeting Armagh’s All-Ireland winner and professional counsellor Oisín McConville in December 2019. Photo : Garry Walsh Dr. Yasser Abu Jamei meeting Armagh’s All-Ireland winner and professional counsellor Oisín McConville in December 2019. Photo : Garry Walsh

Thank you, people in Ireland

We are very proud as Palestinian people that we are supported by Ireland.

We are extremely proud of our partnership with Trócaire. We are really grateful that we can continue this cooperation during these difficult times in Gaza. To continue to provide hope in the darkness.

Dr. Yasser Abu Jamei is director of the Gaza Community Mental Health Programme

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