Researcher Rita Giacaman works to understand the impact that conflict and continued exposure to violence have on the health of the Palestinian population.
Since the beginning of the 20th century, the history of Palestine has been marked by conflict and violence. The uninterrupted Israeli occupation of the West Bank, the blockade of Gaza and the systematic denial of rights to the local population have generated a chronic and complex crisis that has seriously affected the health of the Palestinians, leaving multiple wounds in the form of psychological and emotional problems.
In this context, different investigations have addressed the impact that the political and social conditions to which the Palestinians are subjected have on their psychological well-being. One of them – The Burden of Mental Disorders in the Eastern Mediterranean Region 1990-2013 – highlights that there has been an increase in mental health disorders in Palestine and that more than 40% of the population suffers from clinical anxiety and depression, which makes it the highest rate in the world.
For researcher Rita Giacaman, the reasons for this extraordinary figure are not based on reality, but on the way in which these types of disorders are categorised: through the DSM, a classification system developed in the United States with the aim of treating the different mental disorders. According to Giacaman, the measures contained in this diagnostic code, in addition to being “alien to Arab culture and the Palestinian context, are intended for clinics and patients, and not for the general population.”
In the opinion of the expert, who is also the founder of the Institute of Public and Community Health at Birzeit University in Ramallah (West Bank), there is the main problem in the classification of mental disorders, since most of the scientific literature defends a biomedical model. “It stigmatises us as mentally ill when, in reality, our problems are social and political.”
Both Giacaman and different researchers from the Arab world question the western biomedical framework and have developed an alternative approach that links mental health with environmental circumstances and with indicators of social well-being.
“Most of the Palestinians live in a situation of chronic warlike conditions and violence, so many feel anguish or stress, fluctuating between well-being and illness. Depending on the resources we have, we can reduce our suffering or we will end up suffering psychological consequences for the rest of our lives, ”explains Giacaman.
In the eyes of the researcher, the problem cannot be tackled solely with pills and individual therapy: “Although some mental health disorders need therapeutic support of this type, the best therapy for Palestinians are support groups with which to share experiences. traumatic events and go to the bottom of what happens to them ”.
Health and justice
After the partition of Palestine by the UN in 1947 and the massive expulsion of its Arab inhabitants by the Israeli armed forces, Palestinians were presented in the scientific literature as victims, terrorists or refugees, but, in any case, without any recognition. that the circumstances they suffered affected their mental health.
However, with the outbreak of the First Intifada in 1987 and the interest of the media, it began to be documented that the Palestinians were really traumatised, that they had injuries and not only on their bodies. This research development led to counterproductive results.
On the one hand, the idea that Palestinians could be traumatised by oppression and political violence was consolidated. On the other, the emphasis on the discourse of “trauma” led to the adoption of programs exclusively focused on depression and post-traumatic stress disorder as a central treatment model in the Occupied Palestinian Territory.
Faced with the narrow biomedical paradigm, the Birzeit Institute of Public and Community Health (IPHC) links justice and health, concentrating on the latter being a force for change in the living conditions of Palestinians.
“Living through the Israeli military occupation of our land every day we begin to realise that health is a social construction and that the psychological damage suffered by Palestinians is caused by an unjust social and political reality. In this way, we began to see that we needed to develop research that could help transform the living conditions of our people ”, says Giacaman.
One such investigation was the study Mental Suffering in a Protracted Political Conflict: Feeling Broken or Destroyed, in which Giacaman and other researchers interviewed 68 politically active Palestinians during the First Intifada.
During the meetings, the participants described a more existential form of suffering that, according to them, was the result of the political and economic context in which they live: feeling that one’s spirit, morals and / or future are broken or destroyed.
“Many people who have been very active in politics and now see what is happening in Palestine say they feel ‘destroyed’ or ‘broken’. Those of us who do not feel that way, are either crazy – jokes the researcher – or we maintain hope by training young people and creating institutions that may be useful in the future ”.
The triple captivity of women
Since its creation in the late 1970s, the IPHC has played an important role in the development of various projects aimed at meeting the needs of Palestinian women and improving their health.
“We were the first to develop comprehensive projects focused on the well-being of women of all ages and not just those of reproductive age,” says Giacaman.
In a 2013 study titled Our Life is Prison: The Triple Captivity of Wives and Mothers of Palestinian Political Prisoners, Giacaman and American scholar Penny Johnson analysed the impact of the incarceration of Palestinian men on their wives and children. “Until that moment, all the studies dealt with the prisoners, but they did not talk about their families and, even less, about their wives,” she says.
During interviews with the wives and mothers of Palestinian political prisoners, the researchers found descriptions of triple captivity: “Within the Israeli colonial system, they are held captive because they cannot see their husband and because they must mediate between prison and family life. On the other hand, they are also conditioned by their community, given that the machismo that prevails in Palestinian society implies that many of these women have to stay isolated in their homes for fear of ‘what will they say’ and to maintain their reputation ”, argues the expert.
Resilience in the face of adversity
The stalemate in the Israeli-Palestinian conflict is growing, and as a result, the political, social and economic situation in the Occupied Territories worsens year after year. However, despite the high levels of suffering experienced by the population, defeatism is not something that is heard among the Palestinians.
Giacaman attributes part of that attitude to the strong social and family cohesion that exists in Palestine: “We are very connected to the community and we receive a lot of support, which helps us to move forward. Furthermore, when there are problems we are not alone or isolated: we resist together because we are all going through the same thing, ”he declares.
For Palestinians hope, often combined with the ability to endure and resist, is a form of political and personal struggle that enables them to survive with dignity and decency under occupation. “We continue to resist in the face of adversity because we have no choice and because we understand that the moral imperative is ours: we know that we are busy and that the Israelis are the occupiers,” she says with conviction.