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Palestinian children exposed to violence are suffering from PTSD and depression

JUANA SUMMERS, HOST:

The Israeli military continues its airstrikes and ground campaign in Gaza in response to the attacks by Hamas on October 7. That assault left more than 1,400 Israelis dead and more than 200 taken hostage. As the conflict continues, the impact on Gaza's children has become shockingly evident. According to Palestinian health officials, of the more than 9,000 Palestinians who have been killed, nearly half were children. Thousands more have been injured and have lost family members. Kids growing up in Gaza have never known a life without the threat of violence and conflict. That kind of cumulative trauma researchers say can have a profound impact on a child's emotional development unless they're given a chance to recover. NPR's Rhitu Chatterjee has more.

RHITU CHATTERJEE, BYLINE: Iman Farajallah grew up in Gaza but has lived in the United States for nearly 20 years. She's a psychologist working with refugee kids at a community clinic in San Francisco, but most of her family is still in Gaza.

IMAN FARAJALLAH: My siblings, all of their homes has been bombed - all of them. My siblings, my nephews, my everybody - they have no home.

CHATTERJEE: The last time she saw them, she says, was last summer, and it was a stressful visit.

FARAJALLAH: As we were there, the Israeli bombed twice. Of course, there, you cannot even sleep, sit or rest because you have the drones buzzing over your head 24/7.

CHATTERJEE: She says her own kids, born and raised here in the U.S., have come to dread going there. But when she was growing up, there was no escape.

FARAJALLAH: The experience was so vicious, so scary, so harmful that there is no words that you can actually describe it. How can you describe when the Israeli soldiers, they come and jump from the walls to our home - beating up my brothers, beating up my mother?

CHATTERJEE: And yet, as a child, she was never able to talk to anybody about how traumatic those experiences were for her. So in recent years, Farajallah has returned to Gaza to talk to kids, to document how the violence is affecting them. She says most children are struggling with a range of mental health symptoms.

FARAJALLAH: Fear of darkness, general tension, flashback, nightmares, avoidance, difficulty sleeping and a recollection of their trauma.

CHATTERJEE: Scores of other studies have documented high rates of post-traumatic stress among kids in Gaza and the West Bank. Eric Dubow is at Bowling Green State University.

ERIC DUBOW: It's completely debilitating, and their sense of the world is shattered. They don't feel secure in their families. They don't feel secure in their relationships with others. They're constantly on guard.

CHATTERJEE: In fact, Dubow and his team followed Palestinian and Israeli children for seven years. They wanted to know just how much ethnic political violence kids were being exposed to.

DUBOW: We were able to look at exposure to violence from middle childhood, around age 8, all the way through late adolescence, emerging adulthood.

CHATTERJEE: They found that 55% of Palestinian children had at least one friend or acquaintance die due to political or military violence. In comparison, 13% of Israeli Jewish kids and only 3% of Israeli Arab kids had the same experience. The researchers looked at a whole range of other kinds of exposures to violence, and Dubow says...

DUBOW: There's no question that the Palestinian kids are being exposed to a lot more political violence than the Israeli kids.

CHATTERJEE: The researchers also wanted to know how children growing up with violence were reacting to it on the inside. So they did an experiment and showed the kids a violent video to gauge their emotional reaction to it.

DUBOW: We actually hooked up kids to this machine that basically has little straps that go around the fingers and measures the amount of sweat under the skin.

CHATTERJEE: Because the more someone sweats, the more emotionally aroused they are. They found two opposite reactions among the kids. One group got sweaty and anxious after watching the video.

DUBOW: Those kids actually show more post-traumatic stress symptoms because they are emotionally aroused by the violence.

CHATTERJEE: But the other kids weren't aroused by the violence. They seemed numb to it. And these are the kids, Dubow says, who had become aggressive towards others. And they were more likely to participate in violent political protests as young adults. Dubow's colleague, Paul Boxer, is at Rutgers University. He says when kids are surrounded by violence from a young age, some start to believe that's how the world works.

PAUL BOXER: That the world is a more violent place, that aggression is a good way to solve problems and the world in the broader sense, is a very hostile environment where there may be others who are consistently out to get them.

CHATTERJEE: Boxer and his colleagues found that kids in the West Bank and Gaza fared worse for every outcome they looked at than children in Israel. The ongoing conflict, he says, is not going to change that.

BOXER: It's almost unfathomable to think about what's happening to kids there.

CHATTERJEE: What kids there need most urgently, he says, is to be safe.

BOXER: So making sure kids are warm and clothed and fed, kept physically safe.

CHATTERJEE: Only then, he says, can they receive any mental health care. But Iman Farajallah, the Palestinian American psychologist, says mental health care alone can't heal children in Gaza.

FARAJALLAH: Even when you work with a child, he's going to ask you - but what if another war broke out? Can you protect me? Can you protect my parents? Our answer is no, we can't.

CHATTERJEE: She says for children in Gaza to have a real chance to recover from their traumas, the conflict needs to end once and for all.

Rhitu Chatterjee, NPR News.

(SOUNDBITE OF JONATHAN HANNAU'S "WE WATCHED THE COASTLINE")

SUMMERS: If you or someone you know is in a mental health crisis, call or text the Suicide and Crisis Lifeline at 988. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Rhitu Chatterjee is a health correspondent with NPR, with a focus on mental health. In addition to writing about the latest developments in psychology and psychiatry, she reports on the prevalence of different mental illnesses and new developments in treatments.