How Gaza’s Largest Mental-Health Organization Works Through War

For more than two decades, Dr. Yasser Abu-Jamei has worked at the Gaza Community Mental Health Programme, the largest mental-health organization in the Gaza Strip, which he has been running since 2014. Gazans have long faced an array of mental-health challenges brought on by Israel’s blockade of the territory, which began in 2007, and its frequent bombings and raids. Since October 7th, the Israeli government has prosecuted a military campaign that has displaced most of the population of Gaza and killed more than thirty-three thousand people.

I recently spoke by phone with Abu-Jamei, who left Gaza for Egypt, where he arrived about a week ago. We discussed how he has managed to continue his work in the past six months and how he has approached treating children specifically. Our conversation, edited for length and clarity, is below.

Can you tell me a little bit about the history of the work you do?

The Gaza Community Mental Health Programme is a non-governmental organization that was established in Gaza, in 1990. It was founded by the late Eyad el-Sarraj, who was a human-rights activist and psychiatrist. This was around the time of the first intifada, when he was still working at a psychiatric hospital, the only mental-health facility on the Gaza Strip. And he noticed that many of the people were coming to the hospital talking about the difficulties that their children faced. These were not mental illnesses that required hospitalization but, rather, symptoms of the hard conditions that people were under in the eighties.

He was thinking all the time about what he could do to help children and their families and the community at large cope with difficulties, and how he could alleviate the implications of the living conditions, the occupation. He was introduced to the concept of community mental health. And that’s basically when a multidisciplinary team that is composed of a psychiatrist and psychologist, social worker, and maybe a psychiatric nurse simply works together to offer what we now call social psychiatry or community psychiatry.

El-Sarraj began with a handful of technical people, professionals who joined him to establish the first community center. One of his main goals was to help children and their family members who were victims of torture or ill treatment, or ex-detainees who were in Israeli prisons. He also tried to provide some counselling and awareness-raising sessions to the community in order to combat stigma associated with mental-health issues.

When did you get involved with this work?

I joined in 2002.

Can you describe the political context of the work you all did in Gaza before October 7th?

The first intifada ended with the peace process that led to the Oslo Accords. That’s how the Palestinian Authority was established, how we as Palestinians started to be able to have some source of autonomy in the Gaza Strip and parts of the West Bank. But time was moving without any improvement. And, in 2000, the second intifada began. Then, in 2006, elections yielded a victory for Hamas over Fatah. There were a lot of disputes between Hamas and Fatah that ended with Hamas taking power in Gaza and starting its own ruling system that was not accepted by the Palestinian Authority or by the international community.

That led to putting the Gaza Strip under a blockade. And, in addition to the blockade, Gaza was exposed to many Israeli military operations. There were thousands of people who were killed, thousands who were injured, and, as professionals working in mental health, we knew that this put a continuous strain on the community. We were living in a pressure cooker. And, since October 7th, you can imagine the level and span of trauma that the population has been exposed to. Let’s keep in mind that more than 1.3 million people within Gaza are now internally displaced and living in very dire conditions.

Where are your clinics situated, and are they still there?

We have three locations. One is in Gaza City itself, where we have our headquarters. The second one is in Deir al-Balah. The third is in Khan Younis. What we know is that our Gaza community center used to be a six-story building, and only one floor is still there. Our Deir al-Balah center is still up, but it was affected by the destruction of the neighboring buildings. Our rented place in Khan Younis was burned, and we’re not sure if the building is still up there or not, but it’s also not usable.

That’s why we have rented a couple of places. One’s in the middle of Gaza, and the other one is in Rafah, in the south. Through both places, we have been able to provide some services. This is not the optimal means of offering what we really want to provide, but the circumstances, again, are getting worse and worse. A lot of my colleagues are wondering about their safety. So we are doing our best, given the current conditions.

Were you living in Gaza City?

My house is situated on the eastern side of Khan Younis. I worked in Gaza City in the main building. I was displaced from Day One. And, since December, I was staying in Rafah. I stayed for a couple of weeks in a shelter, which was a school. Then I moved to a tent where I stayed for about three months.

Were you able to do your work at all during that time, or were you mostly just moving from place to place? What was that like for you?

Well, we tried to keep the services running despite all the difficulties. We are a big organization that has about a hundred staff members, and we wanted to make sure that at all times there was someone who could, for example, give medication to patients or receive someone who is in need of emergency intervention.

At the same time, we have a toll-free line that we tried to continue to operate. We were also connecting or forwarding the calls to our partner organizations in the West Bank. For example, the counselling service was available, and we were opening the clinics whenever there was a chance—not the one in Gaza City, unfortunately, but the one in Deir al-Balah and the one in Khan Younis, until the situation got worse in Khan Younis. And since January we have stopped working from Khan Younis, but we started to work in Rafah in February.

The other difficulty was the availability of medicine, because we used to procure medications from pharmaceutical warehouses, and those warehouses were not capable of bringing in any medication for the past six months. We tried to ask international organizations to help. We received other medications from the W.H.O. last week. We are still lacking different types that we hope we’ll be able to receive in the coming months.

One of the difficulties was to continue making the drugs available for mental-health patients or psychiatric patients who are in need of them. It’s lifesaving if you keep the medications available for many of those patients. We tried to do that, and we managed to with some success, but it was not an easy job at all. Most of our staff members are internally displaced. Some of them live in tents, some of them live in shelters, but we are trying one way or another to manage. About a month ago, we also started to visit the shelters to provide psychological first aid and to try to meet children to give them some little gifts. Encourage them to draw, encourage them to have some fun. We are trying. We are successful to some extent, but, again, the conditions we’re working under are not the best.

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