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.”


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.

Syrian army shelling kills at least 11 civilians

Syrian army shelling kills at least 11 civilians
Updated 26 min 38 sec ago

Syrian army shelling kills at least 11 civilians

Syrian army shelling kills at least 11 civilians
  • Among the casualties were several school children

AMMAN: At least 11 civilians died on Wednesday in a Syrian army shelling of residential areas of rebel-held Ariha city, witnesses and rescue workers said.
The shelling from Syrian army outposts, which came shortly after a roadside bomb killed at least 13 military personnel in Damascus, fell on residential areas in the city in Idlib province.
Among the casualties were several school children, witnesses and medical workers in the opposition enclave said.

13 killed in Damascus army bus bombing: state media

13 killed in Damascus army bus bombing: state media
Updated 20 October 2021

13 killed in Damascus army bus bombing: state media

13 killed in Damascus army bus bombing: state media
  • Images released by SANA showed a burning bus

DAMASCUS: A bomb attack on an army bus in Damascus killed at least 13 people Wednesday in the bloodiest such attack in years, the SANA state news agency reported.
“A terrorist bombing using two explosive devices targeted a passing bus” on a key bridge in the capital, the news agency said, reporting an initial casualty toll of 13 dead and three wounded.
Images released by SANA showed a burning bus and what it said was a bomb squad defusing a third device that had been planted in the same area.
Damascus had been mostly spared such violence in recent years, especially since troops and allied militia retook the last significant rebel bastion near the capital in 2018.

Those who want to stop Beirut port blast probe are involved in the crime, say activists

Those who want to stop Beirut port blast probe are involved in the crime, say activists
Updated 20 October 2021

Those who want to stop Beirut port blast probe are involved in the crime, say activists

Those who want to stop Beirut port blast probe are involved in the crime, say activists
  • Civil society members stage a sit-in outside the Justice Palace to show ‘solidarity with the judiciary’

BEIRUT: Tarek Bitar, the judge leading the investigation into the August 2020 port explosion, resumed investigations on Tuesday after being notified by the Lebanese Civil Court of Cassation of its second decision to reject the request submitted by the defendant in the case of MP Ali Hassan Khalil.

Normal service resumed at the Justice Palace in Beirut after a long vacation. The Lebanese army guarding roads leading to the palace and Ain Remaneh, which was the arena of bloody events on Thursday, over protests to dismiss Bitar from the case. The repercussions of these events have affected the political scene, its parties and the people.

Civil society activists under the auspices of the “Lebanese Opposition Front” staged a sit-in outside the Justice Palace to show “solidarity with the Judiciary carrying out its national duties and support for Judge Bitar to face the threats.”

Speaking on behalf of the protestors, activist Dr. Ziad Abdel Samad said: “A free and sovereign state cannot exist without a legitimate authority, judiciary and justice.”

Abdel Samad urged “the defendants to appear before Judge Bitar, because the innocent normally show up and defend themselves instead of resorting to threats.”

“We have reached this low point today because of a ruling elite allied with the Hezbollah statelet, protected by illegal arms.

“They want to dismiss Judge Bitar in all arbitrary ways and threats because he has come so close to the truth after they managed to dismiss the former judge, hiding behind their immunities because they know they are involved in the crime.”

Abdel Samad claimed that “those making threats are involved in the crime.”

Regarding the Tayouneh events that took place last week, he said: “They took to the streets to demonstrate peacefully, as they claimed, but they almost got us into a new civil war as a result of the hatred and conspiracies against Lebanon.”

Lawyer May Al-Khansa, known for her affiliation with Hezbollah, submitted a report at the Lebanese Civil Court of Cassation against the leader of the Lebanese Forces party, Samir Geagea, Judge Bitar and “all those who appear in the investigation to be involved, accomplices or partners in crimes of terrorism and terrorism funding, undermining the state’s authority, inciting a strife, and other crimes against the law and the Lebanese Constitution.”

Hezbollah Leader Hassan Nasrallah on Monday night waged an unprecedented campaign of accusations and incitement against the Lebanese Forces party and its leader.    

Nasrallah accused them of being “the biggest threat for the presence of Christians in Lebanon” and said they were “forming alliances with Daesh.”

In a clear threat to Geagea and his party, Nasrallah bragged in his speech of having “100,000 trained fighters,” calling on Christians to “stand against this murderer.”

Nasrallah accused Bitar of “carrying out a foreign agenda targeting Hezbollah in the Beirut port crime” and of “being supported by embassies and authorities, turning him into a dictator.”

During the parliamentary session on Tuesday, no contact was made between Hezbollah and the Lebanese Forces. However, a handshake was spotted between the Lebanese Forces’ MP Pierre Abu Assi and the Amal Movement’s MP Hani Kobeissi.

Minister of Culture Mohammed Mortada, who represents Hezbollah, said “Hezbollah’s ministers will attend the ministerial session if Prime Minister Najib Mikati calls for one, but the justice minister and the judiciary must find a solution to the issue of lack of trust in Bitar.”

Several calls were made on Monday night between different political groups to prevent escalation and calm the situation.

Efforts are being made to reach a settlement that allows Bitar to keep his position and for defendants in the Beirut port case — who are former ministers and MPs — to be referred to the Supreme Judicial Council for prosecution.

Elsewhere, parliament dropped the proposal of a women’s quota ensuring female participation through  a minimum of 26 seats.

It passed a move to allow expats to vote for the 128 MPs and dropped the decision to allocate six additional seats representing them.

The parliament’s decision angered Gebran Bassil, who heads the Strong Lebanon parliamentary bloc. Following the parliamentary session, Bassil referred to “a political game in the matter of expats’ right to vote, which we will not allow to happen.”

European court raps Turkey over presidential ‘insults’ law

European court raps Turkey over presidential ‘insults’ law
Updated 20 October 2021

European court raps Turkey over presidential ‘insults’ law

European court raps Turkey over presidential ‘insults’ law
  • Thousands have been charged and sentenced over the crime of insulting President Erdogan in 7 years

STRASBOURG, France: Europe’s top human rights court on Tuesday called on Turkey to change a law regarding insulting the president under which tens of thousands have been prosecuted, after ruling that a man’s detention under the law violated his freedom of expression.

Vedat Sorli was given a suspended 11-month jail sentence in 2017 over a caricature and a photograph of President Tayyip Erdogan that he shared on Facebook, along with satirical and critical comments.

There was no justification for Sorli’s detention and pre-trial arrest or the imposition of a criminal sanction, the European Court of Human Rights court said.

“Such a sanction, by its very nature, inevitably had a chilling effect on the willingness of the person concerned to express his or her views on matters of public interest,” it said.

The criminal proceedings against Sorli were “incompatible with freedom of expression,” the court added.

Thousands have been charged and sentenced over the crime of insulting Erdogan in the seven years since he moved from being prime minister to president.

In 2020, 31,297 investigations were launched in relation to the charge, 7,790 cases were filed and 3,325 resulted in convictions, according to Justice Ministry data. Those numbers were slightly lower than the previous year.

Since 2014, the year Erdogan became president, 160,169 investigations were launched over insulting the president, 35,507 cases were filed and there were 12,881 convictions.

In a prominent case earlier this year, a court sentenced pro-Kurdish politician Selahattin Demirtas to 3-1/2 years for insulting Erdogan, one of the longest sentences over the crime, according to Demirtas’ lawyer.

The court said Turkey’s law on insulting the president affords the head of state a privileged status over conveying information and opinion about them.

It said the law should be changed to ensure people have the freedom to hold opinions and impart ideas without interference by authorities in order to put an end to the violation it found in Sorli’s case.

10 diplomat summoned

Separately, Turkey’s Foreign Ministry summoned the ambassadors of the US and nine other countries to protest a statement they issued that called for the release of imprisoned philanthropist and civil rights activist Osman Kavala.

Kavala, 64, has been kept behind bars for four years, accused of attempting to overthrow the Turkish government through the 2013 nationwide demonstrations that started at Istanbul’s Gezi Park. He has also been charged with espionage and attempting to overthrow the government in connection with a failed military coup in 2016.

The ministry said the ambassadors were told that “the impertinent statement via social media regarding a legal proceeding conducted by independent judiciary was unacceptable.” Turkey rejects the attempt to “politicize judicial proceedings and put pressure on (the) Turkish judiciary,” it continued.

“Turkey is a democratic country governed by the rule of law that respects human rights, and it was reminded that the Turkish judiciary will not be influenced by such irresponsible statements,” the ministry added.

Israel violates international law ‘because it can,’ UN Security Council told

Israel violates international law ‘because it can,’ UN Security Council told
Updated 20 October 2021

Israel violates international law ‘because it can,’ UN Security Council told

Israel violates international law ‘because it can,’ UN Security Council told
  • US/Middle East Project called for the Palestinian leadership to stop repressing ‘their own people’
  • Israel PR slammed the security council meetings on the Middle East and said the focus should be on Iran instead

NEW YORK: Israel pursues policies in violation of international law and of UN resolutions “Because it can — no tangible cost or consequence is attached,” the UN Security Council heard on Tuesday. 

Daniel Levy, president of US/Middle East Project, told council members of the need to address what he called “an accountability deficit when it comes to Israel’s action” as it is one of the core understandings that should guide the peace process forward.

“If the unlawful and peace negating politics of Israel continue to be met with impunity, there should be no expectation of positive change.

Also to be considered is “a legitimacy deficit in Palestinian politics,” Levy said.

“The Palestinian Liberation Organization must become fully representative, inclusive and by extension better able to demonstrate strategic agency and to negotiate. 

“Palestinians have a right to elect representatives to their national institutions. That requires a Palestinian leadership decision, as well as supportive, not preventive, steps by Israel and the International community.

Israeli activists of the Rabbis for Human Rights organization help Palestinian farmers harvest their olive trees in Burin village in the occupied West Bank, on Oct.19 2021. (Photo by Menahem Kahana / AFP) 

“We also cannot ignore or condone when existing Palestinian self-governing authorities on the ground with their limited mandate repress their own people.”

Palestinian politician, activist, and scholar Hanan Ashrawi told the ambassadors that everything must be viewed in the context of occupation. 

The security council’s inability to assert its authority, Ashrawi said, has allowed “this injustice to become a perpetual tragic, human modern political and legal travesty.”

She discounted talk of confidence-building between Israel and the Palestinians as “there can be very little confidence under occupation. 

“The policy of confidence-building measures is misguided because occupation brings only contempt, distrust, resentment, and resistance. The oppressed cannot be brought to trust or accept handouts from their oppressor as an alternative to their right to freedom.”

Another attempt at spreading misconception is the constant call for “balance in an unbalanced situation,” Ashrawi said. 

“The mindless refrain that Israel has a right to defend itself while the Palestinian people are denied such a right is perverse, and that the occupier’s violence is justified as self-defense while the occupied are stigmatized as a terrorist. 

“Peace is not achieved by normalizing the occupation, sidelining the Palestinian question, or rewarding it by repositioning Israel as a regional superpower. 

“Such an approach maintains in place the causes of regional instability while enabling Israel as a colonial apartheid to superimpose greater Israel on all of historic Palestine.” 

Israel’s permanent representative to the UN Gilad Erdan strongly criticized Ashrawi’s presence at the security council meeting.

“A spokesperson for Palestinian leadership was invited to represent civil society,” giving a platform to what he called “Palestinian rejectionism.”

Erdan slammed security council meetings on the Middle East for what he called disregarding “the real threat to regional and global security: Iran. 

“Iran has assembled six armies of terrorist proxies in the region and by allowing the Ayatollah regime to continue with the severe violation of their international commitments, these six terror armies will soon have an Iranian nuclear umbrella.”

Before the meeting began, Erdan told reporters in New York that such meetings have the sole aim to “bash Israel” and are a “waste of everyone’s time.

“The security council members help dig the ditch of conflict deeper,” he said.

Erdan called on council members to “stand up to Iran and demand that Palestinian leadership abandon their culture of hate. This is the only way to transform the region into a paradise of progress, prosperity, and peace.”