Veronese and colleagues find that the psychological functioning of Palestinian children, embedded in an environment rife with uncertainty, loss, and grief, is strengthened by a sense of political agency and activism. Through a qualitative approach, collecting children’s narratives living on the Gaza Strip, the researchers underscore the impact of political and environmental conditions on how children make meaning within their contexts, adapt to conflict, and establish their identities.
“Palestinian children’s psychological adaptability and ability to reposition themselves along the continuum between ease and disease is underpinned by constant political agency and activism – a dimension that guides sense-making activities in a traumatizing environment marked by continuous uncertainty, loss, and bereavement,” the authors write.
This study stands in contrast to the current push to export Western measures of mental illness to address the “global health burden of depression.” The authors note that the western bio-medical models risk obscuring the complexities experienced by children living within war zones. They write:
“In many cases, such as that of Palestinian children, psychiatrizing the violation of children’s human rights risks undermining resources for agency and self-recovery, and normalizing abnormal conditions of chronic violation of human rights instead of offering alternative strategies for healing and enhancing children’s global mental health by supporting their political commitment and claims for social justice.”
Veronese and colleagues instead encourage researchers to take a comprehensive or holistic approach to assessing subjective well-being within war-torn zones. This includes the consideration of significant areas of well-being (psychological, personal, spiritual, and family) as subdomains within a broader political context. For example, for children and families living in the Gaza Strip, the researchers contend that any attempts to understand individual well-being must account for the facts of living under occupation and being politically controlled.
Palestinian children are affected by ongoing military violence, with over 400,000 deemed in need of child protection services and psychosocial support since the recent war on Gaza in 2014. Palestinian children “have been daily coping with historic existential insecurity and a continuous sense of danger due to Israeli military occupation of land, sky, and underground.”
Thus, clinical interventions aimed at addressing symptoms of a western diagnosis such as post-traumatic stress disorder (PTSD) deleteriously neglect the continuation of the uncertainties of daily life and “reproduce colonial power and risk expropriating Palestinian children from coping resources and adjustment strategies for dealing with continuous trauma.”
The authors proclaim that Palestinian children have been exposed to disturbances such as war, domestic violence, chronic stress, death of loved ones, and insecurity that result in behaviors similar to symptoms described in PTSD, anxiety, depression, and mood disorders. The question lies in whether these behaviors benefit from or necessitate a diagnosis and specialized treatment or whether these symptoms of sadness, anger, or fear are rather normal reactions to the violent exposure and can be addressed through familial and community support.
The authors call into question if these children “ultimately require a socio-political resolution as opposed to a medical one,” and offer the alternative resolution of “long-term community-based interventions in which meaning, culture and context are viewed as valuable resources for Palestinian children’s wellbeing and life satisfaction.”
The study consisted of a two-day program of play and experiential activities involving 200 Palestinian children (104 boys, 96 girls) from primary schools at four different refugee camps in the Gaza Strip. The sample included only children who had experienced or witnessed at least one violent encounter in the past 3 months. Through a narrative lens, the children engaged in “story-telling activities that reinforced their natural abilities to cope with dangerous events and protect themselves psychologically and emotionally and/or in practical terms.”
To nurture emotional awareness, the children participated in narrative games, art therapy, and theatrical techniques that invited them to share their war experiences and coping strategies. For example, the children were asked to illustrate “what makes you afraid” or “talk about an episode that makes you afraid.”
Through a thematic content analysis and emic perspective (from the voice of the participants), the researchers identified thirteen themes that capture the children’s representations of wellbeing: family, coping strategies, war-related issues, constraints of movement, beauty, relationships with peers and other significant adults, health, among others. Gender differences were evident in the data, such that girls seemed to enjoy more protective factors than boys, like “friends, family, personal resources (myself), sociality, school, and spirituality,” while boys felt more at risk and less protected.
“The main themes emerging from the children’s narratives may be viewed as multiple dimensions of life satisfaction and activism contributing to their psychological well-being,” the authors write.
“In the case of Palestinian children, ongoing violence and war make these dimensions oscillate between risk and protective factors: the children live in an uncertain and unpredictable context that they constantly need to reinterpret as a function of sudden and unexpected changes from a state of quiet to bursts of violence and vice versa.”
As living conditions continue to suffer, which can potentially transform children’s perceptions and adaptability over the long-term, the researchers call for more longitudinal studies and ethnographic methodologies that observe protective factors among communities living in chronic circumstances of occupation.
Ultimately, this study returns to the increasingly pertinent question:
“Is it right, in a traumatic environment where there is no follow-up work, to treat symptoms with short-term interventions, when they will most probably occur repeatedly in the children’s lives?”
The researchers conclude, “The Gazan children’s experience of suffering is a unique source of witness and resistance that may be of value to other contexts in which children are experiencing political violence and ongoing violation of basic human rights.”
Veronese, G. , Pepe, A., Jaradah, A., Murannak, F., Hamdouna, H. (2017). “We must cooperate with one another against the enemy”: Agency and activism in school-aged children as protective factors against ongoing war trauma and political violence in the Gaza Strip. Child Abuse & Neglect, 70, 364-376. https://doi.org/10.1016/j.chiabu.2017.06.027 (Abstract)