A Costly Diagnosis

Land disputes can hardly be called a novelty in the region between the Tigris and the Euphrates Rivers, where Israel and Palestine have both made religious and cultural claims. While the Gaza Strip and West Bank areas have long witnessed the political ramifications of arms conflict, government controls, and economic sanctions, there is another deeper, though less tangible implication of these developments:  the Israeli occupation has taken a costly toll on the mental health of the Palestinian population.

Since the British Mandate over the region ended in 1948, there has been a rift over the control of the Gaza Strip and West Bank areas. After World War I, the entire area of Palestine was under British possession. Later, a steady influx of Jewish immigrants from Europe in the aftermath of the Holocaust radically transformed the demographics of this region. The change of demographics brought with it a change in the control of authority, for the establishment of Israel asserted the Israeli presence within a predominantly Arab Middle East. The Israeli-Palestinian conflict has thus been a product of religious strife as well as nationalistic aggression.

Despite attempts at peace deliberations, such as the Camp David Summit in 2000 hosted by former US President Bill Clinton, there has not been much in the form of resolutions between the Palestinians, led by the Palestinian Liberation Organization (PLO), and the Israeli government. Following its unilateral disengagement plan in 2005, Israeli forces pulled out of the Gaza Strip, which removed all Israeli occupants from the area. In the 2007 Battle of Gaza, the Hamas militant group ousted Palestinian President Mahmoud Abbas to retain control of the area.

As of now, Hamas still controls the area of Gaza while the economic blockade from Israel and Egypt remains in effect. The ongoing warfare between the Hamas militant group and the Israeli army has continued to plague both Israeli and Palestinian inhabitants. In addition to the political and military effects of the occupation, there have also been significant health consequences, particularly psychological health. The occupation forces severe limits on the Palestinians, geographically as well as socially. There is a loss of any sense of achievement, since there are not many chances for growth economically and politically. Even more importantly, there is a pervading sense of homelessness, despite the fact that family homes were uprooted generations ago. This sense of homelessness also contributes to their reduced aspirations and growing depression. According to an article published in the Lancet, the trauma and pain of the displacement of Palestinians in 1948 has not left the minds of the community today, but rather remains imprinted in their “collective consciousness.” This idea of a “collective consciousness” goes hand in hand with the idea presented by Arthur Kleinman, Veena Das, and Margaret Lock that social suffering is an interpersonal and social experience that occurs due to a range of factors that vary across political, economic, and cultural areas. 

According to a United Nations Conference on Trade and Development (UNCTAD) study, the violence that inhabitants of the occupied regions of the Gaza Strip and West Bank witness has an impact on mental health. For example, the Gaza Mental Health Program has reported that the sonic booms caused by low-flying Israeli air force jets caused fear in children, with long-term effects ranging from headaches to shortness of breath, among other emotional disorders. The mental health of the inhabitants of the occupied regions must also be affected by the lack of control in their life. As the UNCTAD study states, access to water and electricity is often a political reward rather than a guaranteed service.

Living with the burden of a collective past, as well as the knowledge that one does not have control over the present, poses severe mental health issues. In addition, the UNCTAD study also shows that more provisions for mental health care need to be made in these areas, as the UNRWA currently only provides about 75 mental health beds for refugees. Access to mental health care is an area that needs to be scaled up in this region, and cost-effectiveness analysis shows that this can be achieved with a low budget of only two dollars per person, according to a study by the Lancet Mental Health Group.

The Israeli occupation could be seen as a case of structural violence, in which the political and social policies of a society induce and intensify health problems. The case of the Arab-Israeli conflicts raises several important questions regarding the effects of occupation on health in general. In spite of provisions that the Israeli government makes for Palestinian settlements, such as health personnel training and medical services availability, there remains a correlation between the occupation and the population’s mental health. Does a link between regional occupation and adverse mental health condition exist in other areas? How would medical ramifications in a given circumstance influence political or even military decisions? These are the questions that we must ask, for the health of a nation rests upon the well-being of its citizens. Until Palestine can find a solution for its psychological pain, it may have to continue to bear the burden of  “collective consciousness.”


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Divya Seth

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