The Impact of Post-War Trauma on the Girls and Women of Gaza

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WOMENSENEWS — One year after the Israeli offensive in Gaza, the reconstruction has not started; neither for the buildings or lives shattered, said Dr. Seita Akihiro, director of the health department at the United Nations Relief and Works Agency for Palestinian Refugees.

“War does not only destroy the buildings; what war destroys is the lives of the people,” Akihiro told Women’s eNews in a phone interview from Amman.

His colleague, Dr. Ghada Al-Jabda, chief of the field of health program in Gaza for the refugee agency, echoed that sentiment, saying the crisis in Gaza is leading to a “social degradation.”

Women and children, Al-Jabda said, have always been the first to pay the price during and after the successive wars in Gaza.

The 50 days of conflict during July and August 2014 resulted in heavy casualities in Gaza: 2104 Palestinians killed, included 1,462 civilians, of whom 495 children and 253 women. In addition, more than 100,000 refugee homes or dwellings were damaged or destroyed, according to the U.N. The consequences of the conflict are now affecting families at several levels, with women and children being heavily impacted, whether it’s early marriage, increased violence or complications in pregnancy.

Along with the successive wars and the political instability, the Palestinian territory has undergone a blockade imposed by Israel since 2006. As a result, Gaza residents can barely leave the enclave.

One result of that isolation, Al-Jabda said, is, among other consequences, a high rate of early marriage (at 33 percent) and a 24 percent divorce rate among young couples only one year after their marriage.

Although there could be some cultural factors, Al-Jabda explained that economic strains and an uncertain future have mostly contributed to the rise of early marriage.

Early Marriage Consequences

Early marriage can have health and social repercussions, particularly for girls. Since it takes place during adolescence, it can negatively impact a girl’s sense of identity and confidence. Pregnancy during this time can also be more risky for the infant and mother, leading to death. In addition to the risks of getting pregnant during adolescence, the stress brought on by war can cause pre-term labor, miscarriages and stillbirths.

Two months ago, Al-Jabda saw an 18-year-old die after her second pregnancy. “She was probably married when she was 15,” she said in a phone interview. “It is a social crime. She is one the victims of this difficult situation that affects families, making them very poor.”

Gaza has the highest maternal mortality rate — 26.4 deaths for 100,000 live births — out of the five fields covered by the refugee agency, which also includes Lebanon, Syria, West Bank and Jordan, according to the organization’s annual health report. Yet the report does not specify if the deaths occurred pre- or post-war.

Another aspect of the suffering of women and girls as a result of the continuous instability and the blockade in Gaza is a rise in gender-based violence. Al-Jabda said the number of cases of this type of violence after the war has increased dramatically compared with numbers before the war.

There were 795 cases registered among the refugee population after the war–between September 2014 and April 2015–up from 500 cases during the same period in 2014, Al-Jabda said. Yet, these numbers could be lower than the reality as gender-based violence is often under-reported.

The continuous blockade, Akihiro said, is also affecting the quality of neonatal care. “Mothers don’t have access to the most advanced care services, which could save several premature babies,” Akihiro said, adding that the closest most advanced units of neonatal care are either in Israel or East Jerusalem but nearly impossible to access for Gaza residents who are hardly granted exit. However, Akihiro could not say how many newborns’ lives could have been saved if they had had access to highly specialized care.

Schools Turned Into Shelters

During last summer’s war, the refugee agency turned 92 schools into shelters across the Gaza Strip and each location hosted more than 3,000 internally displaced persons. The agency also recorded a total of 344 newborns in their shelters during the 50 days.

Yet, in the early days of the conflict, emergency shelters were not yet ready to accommodate pregnant women and new mothers. Privacy was unthinkable in the classrooms, each crammed with about 40 people.

Al-Jabda said their U.N. agency didn’t expect such a high number. “About 300,000 internally displaced persons fled to U.N. shelters during the last war. We were prepared to receive only 50,000 like in the previous wars.”

Al-Jabda still remembers a pregnant Palestinian woman who arrived at one of the schools in the early days of the conflict. That same evening, the pregnant woman went into labor but kept quiet and didn’t alert her husband due to fear of being transported to the hospital during the night and possibly being targeted by Israeli soldiers. She was eventually rushed to the hospital in the morning and discharged two hours after giving birth. She returned to the shelter with her newborn.

“She was lying on cardboard with her baby on the floor,” said Al-Jabda. “She was very pale. For 24 hours after the delivery, she couldn’t use the bathroom since no accommodation was made yet for pregnant women and new mothers.” The discomfort of the new mother didn’t end there. During her stay at the shelter, Al-Jabda said, the woman showered only once when she was offered to go to a health center.

The refugee agency has a total of 21 health centers across the Gaza Strip, seven of which were closed during the war due to their location in heavily-shelled areas. Out of a total population of 1.8 million, more than 1.2 million Gaza residents currently access the agency’s services.

The continuous blockade and successive war is also taking a toll on the mental health of Gaza residents, especially teens who have witnessed three or four wars–from June 2006 through August 2014. “It is traumatic for the adolescents. Every two or three years they have a war. That has a serious effect on them,” said Akihiro, adding that teens can struggle with psychological trauma as the war ends.

When Akihiro visited a family whose house was half destroyed, he asked a 16-year-old girl how she is envisioning her future. “If the situation stays like this in Gaza, I want to leave Gaza,” replied the teen.

Hajer Naili is a New York-based reporter for Women’s eNews. She has worked for several radio stations and publications in France and North Africa and specializes in Middle East and North Africa. Follow her on Twitter @H_NAILI.

Image by Gustave Deghilage