Middle East conflicts and crises take a hidden but heavy psychological toll

The father of one of the victims cries at the site of a factory explosion in the Burj Al-Barajneh area in Beirut's southern suburbs on August 30, 2021. (AFP/File Photo)
The father of one of the victims cries at the site of a factory explosion in the Burj Al-Barajneh area in Beirut's southern suburbs on August 30, 2021. (AFP/File Photo)
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Updated 10 October 2021

Middle East conflicts and crises take a hidden but heavy psychological toll

Middle East conflicts and crises take a hidden but heavy psychological toll
  • The Middle East and North Africa’s fragile or failed states are home to millions of people living without hope
  • One in five people is estimated to suffer from mental-health problems after a conflict has ended

DUBAI: In May, the world’s television screens were filled with images from the Gaza Strip of tower blocks collapsing, rocket fire erupting from densely populated areas, and ambulances, sirens blaring, ferrying the dead and the wounded to hospitals as Israeli fighter jets roared overhead.

More than 250 Palestinians died in the 10 days of fighting, which also left 13 dead in Israel. Four months on, the violence has subsided but its effects linger.

One of the little-noticed consequences of the May 2021 escalation is the impact on the mental health and well-being of Gaza’s 2 million people, as 47.5 percent of them are under 18 years of age. According to UNICEF, nine out of 10 children in the territory now suffer from mental trauma as a result of the conflict.

Despite a tenuous ceasefire, the specter of renewed violence persists. Most recently, on Sept. 12, Israeli jets again struck Gaza after two rocket attacks on southern Israel in less than 24 hours.

“Our teams on the ground observed an increase in cases of acute anxiety among children,” Imene Trabelsi, spokesperson for the International Committee of the Red Cross (ICRC), told Arab News from Beirut.

“We believe that supporting people’s mental health, what we call ‘less visible scars’ during times of crisis, can be as lifesaving as stitching together wounds and providing food and water.”

Trabelsi said that generally one in five people is estimated to suffer from mental-health problems after a conflict has ended.

The Arab Youth Survey of 2020 found that nearly a third of all young people living in 15 countries in the Middle East know at least one person suffering from some form of mental illness.

Until recently, mental health was not a priority in the Middle East. Psychiatric issues were often taboo and largely dealt with in the family. “It is a relatively new area for international aid groups but now we are realizing how important it is for the wellbeing of a population to recover after a period of conflict,” Trabelsi said.




Women react on August 18, 2021, during the funeral of four members of the Shteiteh family in the village of Al-Daouseh in Lebaon's Akkar region, killed in a fuel tank explosion. (AFP/File Photo)

It is not just in Gaza. Almost every day images and stories of violence, poverty, loss, and bereavement dominate the region’s news. In Libya, Syria, Iran, Iraq, Houthi-held Yemen, and Lebanon, millions of people have been suffering through long periods of economic privation.

For instance, in Iraq, a 2018 Save the Children survey found that 43 percent of children in Mosul, the erstwhile capital of the self-declared caliphate of Daesh, reported feeling grief “always or a lot of the time.”

“The tragedy is that persecution, oppression, conflict, and aggression are almost now the norm in these countries,” Dr. Summer Fakhro, a psychologist at The Lighthouse Arabia, a clinic in Dubai, told Arab News.

Post-traumatic stress disorder (PTSD) is common, she said.

“There is a functionality and adaptation that has developed to be able to live with unbearable circumstances,” Fakhro said. “However, these populations bear the burden of complex trauma, which means the trauma is not limited to symptoms of PTSD and endures over several phases of life.”

The effects can be long-lasting on all aspects of life, leading to mood disturbance and, in extreme cases, personality change, she said.




Abderrazaq Khatoun, reacts as he shows on a mobile telephone a video taken on the day when rescuers searched for survivors after an air raid that killed seven of his sons, inside a tent in an encampment in the village of Harbanoush, in the northern countryside of Syria's northwestern province of Idlib, on March 11, 2021. (AFP/File Photo)

The situation in Lebanon is a case in point. A perfect storm of crises — the deadly Beirut Port explosion in August 2020 was followed by an economic collapse along with national fuel and medicine shortages — have affected the wellbeing of its people. The effects are even felt by the many Lebanese who have left the country.

“It does not get any easier,” 25-year-old Marwa Darazi, who left Lebanon to move to the UAE in January this year, told Arab News.

Currently a PR professional in Dubai, she said: “The explosion finds its way out of the back of your mind and into your conversation or thoughts at least once a day. It is part of who I am. Sometimes I recall it to feel grateful. Sometimes I recall it to support the idea that everything happens for a reason.”

Several psychologists Arab News spoke with after the Beirut explosions said they themselves also suffered from PTSD and struggled to deal with the multiple calls from survivors they received.

“There can be a general sense of helplessness in these populations,” Fakhro said. Aside from her work in Dubai, she is a co-founder of Elaa Beirut, a Lebanese charity that provides mental health and other kinds of support to populations in times of struggle and conflict.

Fakhro pointed to the prevalence of “learned helplessness,” a condition whereby people feel like they have no control over what happens, and therefore, tend to simply give up and accept their fate.




An aerial picture shows mourners carrying coffins wrapped in the Iraqi flag in a procession during a mass funeral for Yazidi victims of Daesh in the northern Iraqi village of Kojo in Sinjar district, on February 6, 2021. (AFP/File Photo)

“As humans who face suffering, we will initially protest and fight back and use every resource to resist,” Fakhro said.

“We want to preserve our original state and way of being. However, if every effort you make fails because of the relentlessness of the conflict and issues, we eventually wear out and develop learned helplessness, a state where we feel nothing that we do can change our state or fate.

“We lose our ‘self-efficacy,’ which is our belief that we can confidently cope with demands and struggles. We lose agency to act and cope.”

Fakhro said “dissociation” is a major mental-health concern in unstable parts of the Middle East.

This is when most people who experience severe trauma during conflict and unrest learn unconsciously to dissociate — “fragmenting their consciousness to numb the pain in their psyche and body. They can be in the worst of situations and be very detached and almost impervious because they have built these walls to protect themselves.”

According to the ICRC, people living in conflict-affected areas are three times more likely than the general population to suffer from conditions such as depression, anxiety, and PTSD.




Palestinian protesters run from tear gas fired by Israeli security forces during a demonstration against the establishment of Israeli outposts on their lands, in Beit Dajan, east of Nablus in the occupied West Bank, on April 16, 2021. (AFP/File Photo)

For the past several years, organizations such as ICRC have put increased importance on treating mental wellbeing in conflict zones in addition to their regular assistance during times of crisis.

From 2018 to 2019, the ICRC helped build the capacity of mental health professionals working for the Syrian Arab Red Crescent by providing training and technical supervision. Currently, the ICRC operates a psychological and mental services program for patients with physical disabilities at a rehabilitation center in Aleppo.

In November 2020, the ICRC set up a mental health support unit in a field hospital in northeast Syria’s Al-Hol Camp, which has a growing population of displaced people.

The service offers individual sessions and family sessions, depending on need. Workers provide psycho-educational activities for children and adapt activities to strengthen the self-esteem and self-confidence of children.

“The massive mental health needs of people affected by humanitarian emergencies In the Middle East are far from being fully addressed,” Trabelsi told Arab News.




Iraqis inspect the site of the explosion in a popular market in the Shiite-majority Sadr City neighbourhood, east of the capital Baghdad on July 20, 2021. (AFP/File Photo)

“This lack of treatment also increases stigma, exclusion, and discrimination. It is doubly important for people living and affected by violence to receive the right help, to be able to recover from these less visible scars generated by the conflict. This will also have an impact on rebuilding communities and the social fabric.”

In Lebanon, the ICRC set up a dedicated hotline to address mental trauma in the wake of the Beirut explosions. A total of 188 patients continue to receive mental health support and physiotherapy sessions.

“Sometimes it is a conversation starter. Sometimes I tear up looking through pictures and videos and remembering my family and the event,” Darazi, the Lebanese expatriate in Dubai, told Arab News, referring to the blast.

“In fact, it feels like yesterday. There is no way it has been over a year since the blast happened. My scars have not healed.”

Decoder

World Mental Health Day

October 10 is designated as an international day for global mental health education, awareness and advocacy against social stigma. World Mental Health Day was first celebrated in 1992 at the initiative of the World Federation for Mental Health, a global mental health organization with members and contacts in more than 150 countries.


Help build solid basis for Libyan elections and don’t fixate on dates, Security Council told

Stephanie Williams, UN Secretary-General Antonio Guterres’s special adviser on Libya, recently reiterated the importance of holding elections “in the shortest possible time frame.” (Reuters/File Photo)
Stephanie Williams, UN Secretary-General Antonio Guterres’s special adviser on Libya, recently reiterated the importance of holding elections “in the shortest possible time frame.” (Reuters/File Photo)
Updated 25 January 2022

Help build solid basis for Libyan elections and don’t fixate on dates, Security Council told

Stephanie Williams, UN Secretary-General Antonio Guterres’s special adviser on Libya, recently reiterated the importance of holding elections “in the shortest possible time frame.” (Reuters/File Photo)
  • Lawyer and activist Elham Saudi condemned “weak” vetting that resulted in candidates implicated in corruption and crimes against humanity being cleared to stand
  • US envoy highlighted concerns about deteriorating human rights situation in the country and continuing reports of violence and abuse targeting migrants, asylum seekers and refugees

NEW YORK: Mediators need to take into account the lessons learned in Libya in the past two years and focus on “creating milestones” for the country’s political transition, rather than fixating on the time frame involved, according to Elham Saudi, co-founder and director of Lawyers for Justice in Libya.

These milestones include an electoral law, a code for conducting elections, and a solid constitutional basis “that appropriately sequences presidential and legislative elections in line with the broader road map to complete (the) transition effectively,” he said.

Addressing the UN Security Council on Monday during its regular meeting about developments in Libya, Saudi said that when these steps are implemented, elections will naturally follow and will be “far easier to manage, protect and successfully deliver.”

Stephanie Williams, UN Secretary-General Antonio Guterres’s special adviser on Libya, recently reiterated the importance of holding elections “in the shortest possible time frame.” She said this month that “it is possible, and needed, to have elections before the end of June.”

However, Saudi said that “focusing on the dates for the elections instead of a clear process to facilitate them risks once again compromising due process for the sake of perceived political expediency.”

Growing polarization among political powers in the country and disputes over key aspects of the electoral process — including shortcomings in the legal framework for the elections, contradictory court rulings on candidacies, and political and security concerns as cited by the High National commission for Elections — resulted in the postponement of the elections, which had been scheduled to take place on Dec. 24 last year.

Saudi reminded members of the Security Council that “accountability is a prerequisite to political progress. Poorly defined and fundamentally weak vetting criteria applied to candidates applying for elections resulted in individuals implicated in corruption or crimes against humanity and human rights violations, including persons who have been indicted by the ICC (International Criminal Court), being accepted as candidates.”

Following the postponement of polling in December, Libya’s House of Representatives established a “road map committee” to develop a new path toward national elections. The committee will present its first report for debate on Tuesday in Tripoli.

Rosemary DiCarlo, the UN’s under-secretary-general for political and peacebuilding affairs, welcomed what she described as renewed efforts by Libya’s Presidency Council to advance national reconciliation but lamented the political uncertainty in the run-up to the elections. which she said has “negatively impacted the overall security situation, including in Tripoli, resulting in shifting alliances among armed groups affiliated with certain presidential candidates.”

She expressed concern about the human rights situation in Libya, citing “incidents of elections-related violence and attacks based on political affiliation, as well as threats and violence against members of the judiciary involved in proceedings on eligibility of electoral candidates, and against journalists, activists and individuals expressing political views.”

DiCarlo added: “Such incidents are an obstacle to creating a conducive environment for free, fair, peaceful and credible elections.”

Taher El-Sonni, Libya’s permanent representative to the UN, told the Security Council that while some people had been surprised by the postponement of elections, it had been widely expected.

“In light of the crisis of trust and the absence of a constitution for the country, or a consensual constitutional rule as advocated by most political forces now, it will be very difficult to conduct these elections successfully because the elections are supposed to be a means of political participation and not a means of predominance and exclusion, and a means to support stability and not an end in itself that may open the way for a new conflict,” he said.

El-Sonni called on the UN to offer more “serious and effective” support to the electoral process and send teams to assess the requirements on the ground.

“This would be a clear message to all about the seriousness of the international community in achieving elections that everyone aspires to, without questioning it or its results,” he said.

The Libyan envoy invited the council to “actively contribute” to the processes of national reconciliation and transitional justice, “two concomitant and essential tracks that have unfortunately been lost during the past years, although they are the main basis for the success of any political solution that leads to the stability of the country.”

He also once again called on the African Union to support his country’s efforts in this area.

Ambassador Jeffrey DeLaurentis, senior advisor for special political affairs to the US mission at the UN, said it is time for the wishes of the millions of Libyans who have registered to vote to be respected.

“It is time to move beyond backroom deals between a small circle of powerful individuals backed by armed groups, carving up spoils and protecting their positions,” he said “The Libyan people are ready to decide their own future.

“Those vying to lead Libya must see that the Libyan people will only accept leadership empowered by elections and that they will only tolerate so much delay.”

Like many other ambassadors at the meeting, DeLaurentis also addressed the migrant crisis and reports of violence and abuses directed at migrants, asylum seekers and refugees in Libya.

“Libyan authorities must close illicit detention centers, end arbitrary detention practices and permit unhindered humanitarian access to affected populations,” he said.


Coalition in Yemen begins military operations in Sanaa

Coalition in Yemen begins military operations in Sanaa
Updated 25 January 2022

Coalition in Yemen begins military operations in Sanaa

Coalition in Yemen begins military operations in Sanaa
  • More than 50 Houthis killed in operations targeting Marib and Al-Bayda

RIYADH: The Coalition to Restore Legitimacy in Yemen said on Monday that it had began “military operations” against “legitimate targets” in the capital, Sanaa, Saudi state TV reported.
The coalition said the operation is in response to threats and out of military necessity to protect civilians from hostile attacks.
The Iran-backed Houthi militia launched missiles toward Saudi Arabia and the UAE earlier on Monday, sparking widespread condemnation from the international community.
Meanwhile, the coalition said it carried out 14 operations targeting the Houthi militia in Marib and Al-Bayda during the past 24 hours, killing more than 50 fighters and destroying nine military vehicles.


US ‘prepared to meet directly’ and ‘urgently’ with Iran on nuclear issue

US ‘prepared to meet directly’ and ‘urgently’ with Iran on nuclear issue
Updated 25 January 2022

US ‘prepared to meet directly’ and ‘urgently’ with Iran on nuclear issue

US ‘prepared to meet directly’ and ‘urgently’ with Iran on nuclear issue
  • The comments came after Iran said it will consider direct talks with the US during ongoing negotiations in Vienna

WASHINGTON: The US State Department on Monday repeated that it remains open to meeting with Iranian officials directly to discuss the nuclear deal and other issues after Iran’s foreign minister said Tehran would consider this but had made no decisions.
Speaking at a briefing, State Department spokesman Ned Price also said the US had not made Iran’s releasing four Americans a condition of reaching an agreement for both nations to resume compliance with the nuclear deal, saying that achieving such an agreement was an uncertain proposition.
Earlier on Monday, the State Department said the US was prepared to hold direct talks with Iran after Tehran said it would consider such an option.
“We are prepared to meet directly,” a State Department spokesperson said.
“We have long held the position that it would be more productive to engage with Iran directly, on both JCPOA negotiations and other issues,” the spokesperson said, referring to the nuclear deal between Iran and major powers.
The spokesperson said that meeting directly would allow “more efficient communication” needed to reach an understanding on what is needed to resuscitate the 2015 deal.
“Given the pace of Iran’s nuclear advances, we are almost out of time to reach an understanding on mutual return to full implementation of the JCPOA,” the official said.
The comments came after Iran said Monday it will consider direct talks with the United States during ongoing negotiations in Vienna aimed at restoring the deal.
“Iran is not currently talking with the US directly,” Hossein Amir-Abdollahian said in televised remarks.
“But, if during the negotiation process we get to a point that reaching a good agreement with solid guarantees requires a level of talks with the US, we will not ignore that in our work schedule,” he added.
(With AFP and Reuters)


‘Horror scenes’ in Syrian refugee camps amid ‘extremely cold winter’: UN official

‘Horror scenes’ in Syrian refugee camps amid ‘extremely cold winter’: UN official
Updated 24 January 2022

‘Horror scenes’ in Syrian refugee camps amid ‘extremely cold winter’: UN official

‘Horror scenes’ in Syrian refugee camps amid ‘extremely cold winter’: UN official
  • ‘No one should have to live in these conditions,’ Mark Cutts tells briefing attended by Arab News
  • Nearly 3m people internally displaced in northern Syria, most of them women and children

LONDON: Brutal winter conditions in northern Syria have ushered in mass-scale suffering for 2.8 million internally displaced persons, a top UN humanitarian official warned on Monday.

“We’re extremely concerned about the situation there,” Mark Cutts, the UN’s deputy regional humanitarian coordinator for Syria, said in a briefing attended by Arab News.

The IDPs, he added, are “some of the most vulnerable people in the world,” the majority of them living in temporary camps and tents.

“During this extremely cold weather, we’ve seen some real horror scenes in the last few days — about 1,000 tents have either collapsed completely or been very badly damaged as a result of heavy snow,” said Cutts, adding that temperatures have dropped to as low as -7 degrees centigrade.

About 100,000 people have been affected by the heavy snow, while 150,000 more have been affected by freezing conditions and heavy rain.

“These are people who’ve been through a lot in the past few years. They’ve fled from one place to another. The bombs have followed them. Many of the hospitals and schools in northwest Syria have been destroyed in the 10 years of war,” said Cutts, adding that what he and his team are seeing in camps now is a “real disaster zone.”

He said: “Our humanitarian workers have been pulling people out from under their collapsed tents … They’ve been clearing snow from tents with their bare hands.”

Children, the elderly and the disabled are suffering the most from the conditions, added Cutts, who appealed to the international community to “do more, to recognize the scale of the crisis, to help us get these people out of tents and into safer, more dignified temporary shelter.”

In a final plea, he said: “It’s absolutely unacceptable that you’ve got 1.7 million people living in camps in these appalling conditions — most of them are women and children and elderly people.

“These civilians are stranded in a warzone, and now, on top of that, they’re dealing with temperatures below zero. No one should have to live in these conditions.”


Iran: ‘Possible’ to agree on prisoners, nuclear deal

Iran: ‘Possible’ to agree on prisoners, nuclear deal
Updated 24 January 2022

Iran: ‘Possible’ to agree on prisoners, nuclear deal

Iran: ‘Possible’ to agree on prisoners, nuclear deal

TEHRAN: Tehran on Monday said it is “possible” to reach an agreement on the two issues of Iran-US prisoners’ release and the Vienna talks to restore the 2015 nuclear deal.

“They are two different paths, but if the other party (the US) has the determination, there is the possibility that we reach a reliable and lasting agreement in both of them in the shortest time,” Foreign Ministry spokesman Saeed Khatibzadeh said during his weekly press conference.

Khatibzadeh’s comments came in reaction to remarks made by the US envoy for Iran, Robert Malley, who on Sunday said it is unlikely that Washington would strike an agreement unless Tehran releases four US citizens.

BACKGROUND

The four US citizens held in Iran are Iranian-American businessman Siamak Namazi, 50, and his father Baquer, 85, as well as environmentalist Morad Tahbaz, 66, and businessman Emad Sharqi, 57.

“Iran has not accepted any precondition from day one of the negotiations,” Khatibzadeh said.

He added that “the negotiations are complicated enough, and should not get more complex with complicated remarks.”