As Gaza's children endure relentless bombardment and overcrowded UN-run shelters, parents and psychiatrists report the emergence of severe trauma symptoms, including convulsions, bed-wetting, and fear
Reuters Gaza Published 22.10.23,
Palestinians, who fled their houses amid Israeli strikes, take shelter in a United Nations-run school, after Israel's call for more than 1 million civilians in northern Gaza to move south, in Khan Younis in the southern Gaza StripReuters
Gaza’s children are showing ever more signs of trauma two weeks into Israel’s intense bombardment, parents and psychiatrists in the tiny, crowded enclave say, with no safe place to hide from the falling bombs and little prospect of respite.
Children make up about half of Gaza’s 2.3 million population, living under near constant bombardment with many packed into temporary shelters in UN-run schools after fleeing their homes with little food or clean water.
Israel is expected to launch a ground attack on Gaza shortly in response to a cross-border assault by Hamas fighters on southern Israel on October 7 that killed more than 1,400 people, with a further 210 taken hostage.
“Children ... have started to develop serious trauma symptoms such as convulsions, bed-wetting, fear, aggressive behaviour, nervousness, and not leaving their parents’ sides,” said Gaza psychiatrist Fadel Abu Heen.
Over 4,100 Palestinians have been killed in Gaza so far, including more than 1,500 children, according to the Palestinian health ministry.
Conditions in makeshift shelters in United Nations schools, where more than 380,000 people are camped out in hope of escaping the bombardment, only compound the problem. There are sometimes 100 people sleeping in each classroom, which all require continuous cleaning. There is little electricity and water so bathrooms and toilets are very dirty.
“Our children suffer a lot at night. They cry all night, they pee themselves without meaning to and I don’t have time to clean up after them, one after the other,” said Tahreer Tabash, a mother of six children sheltering in a school.
Even there, they are not safe. Such schools have been hit several times, the United Nations has said, and Tabash has seen strikes hitting nearby buildings. When her children hear so much as a chair being moved, they jump in fear, she said. “That lack of any safe place has created a general sense of fear and horror among the entire population and children are most impacted,” said Abu Heen.
“Some of them reacted directly and expressed their fears. Although they may need immediate intervention, they may be in a better state than the other kids who kept the horror and trauma inside them,” he said.
One house in Khan Younis, in the south of the enclave, is sheltering about 90 people including 30 under the age of 18, where they have to sleep in shifts for lack of space. “When there’s an explosion or any target getting hit nearby they are always screaming, always frightened,” said Ibrahim al-Agha, an engineer sheltering in the house.
How Many Children Must Die? – OpEd
October 22, 2023
By Andy Worthington
Like all sensitive people everywhere, I’ve been aware that a rift has opened up in the world — a dangerous tear in the very fabric of human decency, of fundamental morality, through which supposed justifications are loudly being made to excuse the killing, in the Gaza Strip, of children, of women, of the elderly and the ill, and of unarmed men “of military age” who have not engaged in any kind of military conflict at all.
It’s an age-old story, sadly. Throughout human history, men — it’s almost always only men — have slaughtered civilians in their quest, or their leaders’ quest for land, power and control. You could be forgiven for thinking that what drives most wars is actually an excuse to unleash these darkest impulses, and that everything else is secondary.
Gideon Levy’s ‘A Brief History of Killing Children’
It’s nearly two years since the great Israeli journalist Gideon Levy wrote an article for Haaretz, Israel’s oldest newspaper, entitled ‘A Brief History of Killing Children’, in which he chronicled the moral decline of the Israeli government from the 1990s to the time of writing through the ways in which Palestinian children have been treated.
“First we were ashamed, then we were shocked, and we even investigated”, Levy wrote. “Then we denied it and lied. After that we ignored and repressed it, yawned and lost interest. Now is the worst phase of all: We’ve started to extol the killers of children.
That’s how far we’ve gone.”
Levy recalled the shock he felt in 1996, when a new-born baby, whose mother, Faiza Abu Dahuk, gave birth to him at an Israeli checkpoint, died after Israeli soldiers turned her away from three checkpoints. When she finally arrived at a hospital, after carrying him “all through a cold and rainy night”, he “was already dead.”
At the time, Levy noted, “The matter came up at a cabinet meeting. An officer was dismissed and a mini-storm ensued. This was in April 1996, during the year of hope and illusions.”
By 2000, however, and the time of the Second Intifada, the killing of 12-year old Mohammed al-Dura, who was shot by Israeli forces as he sought shelter with his father behind a concrete cylinder, marked the start of what Levy described as Israel’s “phase of denials and lies.” Although the Israel Defense Forces initially accepted responsibility for the killing, they then retracted their admission, claiming that “the whole episode was staged and that Mohammed al-Dura was not killed at all — or was murdered in cold blood by the Palestinians — to discredit and ‘delegitimize’ Israel”, as Levy’s fellow journalist Khaled Diab described it in 2013.
After that, as Levy described it, “20 years of indifference and complacence” began, as a result of which, as he further explained, “Soldiers and pilots have killed 2,171 children and teenagers, and not one of these cases shocked anyone here, or sparked a real investigation or led to a trial. More than 2,000 children in 20 years — 100 children, three classrooms a year.”
Crucially, he added that “all of them, down to the last, were found guilty of their own death”, because of the prevailing opinion in Israel that “they were terrorists and the soldiers or the police had no choice but to execute them.”
Levy’s 2021 article was prompted by what he called “the next phase” in this dehumanisation, in which Israel now “praises the killers of children; they are the new heroes.” He added, “This never happened before. They were Palestinians, terrorists, but still they were children.”
The specific example Levy focused on was that of 16-year old Omar Abu Sab, who “went out with a knife to stab a Border Police officer.” As he explained, “A video clip released by the police shows him approaching two officers from behind and attacking them. He was smaller and thinner than them, they could have stopped him, they didn’t have to shoot him, and they certainly didn’t have to kill him, like they needlessly killed children with knives before him and after him.”
Instead of being condemned or even criticised, however, the border guard who shot Omar Abu Sab to death at point-blank range was feted in the press, with the officer described as “The hero from the Old City”, who “took out a terrorist and prevented a major disaster” — and with no mention made of Omar Abu Sab’s age. As Levy concluded, “to turn the shooting of a 16-year-old with a knife into a big story is the crossing of a moral red line. It will encourage the needless killing of more children, if any such encouragement was needed.”
Children’s deaths amidst increasing violations of international humanitarian law
Gideon Levy’s analysis of Israel’s increasing dehumanisation of Palestinian children is significant, in part because it highlights Israel’s refusal to accept that, as stated in Article 6 of the UN Convention on the Rights of the Child (which was agreed in 1989, and was ratified by Israel in 1991), States Parties “must recognize that every child has the inherent right to life”, and “shall ensure to the maximum extent possible the survival and development of the child”, but also because, in the case of Omar Abu Sab and other children summarily executed by Israeli soldiers, it so flagrantly violates the Optional Protocol on the Involvement of Children in Armed Conflict, which was adopted by the UN General Assembly in May 2000, and which has also been ratified by Israel, in which Article 6.3 calls on States Parties to provide juveniles recruited into armed conflict with “all appropriate assistance for their physical and psychological recovery and their social reintegration.”
In addition, of course, Levy’s assessment also condemns Israel for its increasing contempt not just for the rights of children, but also for the entire apparatus of international humanitarian law, which, as the ICRC (International Committee of the Red Cross) explains, “protects those who do not take part in the fighting, such as civilians and medical and religious military personnel”, who “are entitled to respect for their lives and for their physical and mental integrity”, who “also enjoy legal guarantees”, and who “must be protected and treated humanely in all circumstances, with no adverse distinction.”
This is hugely important, of course, because the 2,171 children and teenagers killed by Israel from 2000 to 2021 weren’t all shot at checkpoints; many were, instead, killed in the indiscriminate bombing raids on the Gaza Strip that have been taking place with alarming regularity ever since the 2.3 million inhabitants of that tiny densely populated area (roughly the size of east London) were first imprisoned in 2007, when Israel imposed a complete land, air and naval blockade of such severity that Human Rights Watch has accurately described the Gaza Strip as “an open air prison.”
Major assaults on the Gaza Strip took place in 2008-09, in 2012, in 2014 and again in 2021, with B’Tselem, the Jerusalem-based NGO, which documents human rights violations in the Israeli-occupied Palestinian territories, compiling reports demonstrating that, from September 29, 2000 (the start of the Second Intifada) to December 26, 2008 (the start of Operation Cast Lead, the first of Israel’s major attacks on Gaza), 961 Palestinian children were killed, 345 children were killed in the 23 days of Operation Cast Lead, which lasted until January 18, 2009, and 877 more children were killed between January 19, 2009 and January 18, 2022.
This is a total of 2,183 Palestinian children killed, while over the same period 139 Israeli children were killed — a ratio of 15.7:1. UN figures from January 1, 2008 to September 19, 2023 provide further context, with 6,407 Palestinians in total killed throughout that period compared to 308 Israelis — a ratio of 20.8:1.
The death toll in Gaza is spiralling out of control
Now, however, with Israel having launched an incomparably savage attack on the Gaza Strip in retaliation for the brutal and unforgivable attacks during incursions into Israeli territory by Hamas militants on October 7, in which at least 1,400 Israelis were killed (attacks that have been rightly condemned as war crimes by international legal experts), the death toll in Gaza is spiralling out of control.
According to the latest reports, around 3,000 people have now been killed in the Gaza Strip in Israeli bombing raids over the last week and a half (almost half of the total from the long years of bloodshed from 2000 to last month), with at least 1,000 of those killed being children (again, nearly half of the total from 2000 to last month).
Moreover, a further 1,200 Palestinians, including 500 children, are unaccounted for, with many — if not most — buried beneath the rubble of Gaza’s devastated buildings, and, even more alarmingly, untold numbers of people will soon die of thirst, hunger, their wounds, pre-existing medical conditions and disease if Israel refuses to lift the “complete siege” of Gaza that was imposed on October 8, when defense minister Yoav Gallant stated, in stark and blood-curdlingly chilling terms, “There will be no electricity, no food, no fuel, everything is closed. We are fighting human animals and we will act accordingly.”
It may sound rather alarmist for me to suggest that the Israel government is well aware of the statistics over the last 22 years — and, specifically, the ratio of 20 Palestinian deaths to one Israeli death over that time — but I’m sure that some officials are aware of it, and are calculating accordingly that, at a minimum, 30,000 Palestinians in the Gaza Strip will be required to die to pay for Hamas’s attacks on October 7.
Behind closed doors, I’m sure that some Israeli officials have been discussing even more alarming proposals — very specifically, genocide — and I also note that, just a few days ago, the US journalist Seymour Hersh spoke to a “veteran Israeli spy” who told him that the big debate within the Israeli government was “whether to starve Hamas out or kill as many as 100,000” civilians.
Western leaders’ complicity in war crimes, and the urgent need for a humanitarian ceasefire
Disgracefully, as I noted in my article last week, My Shame at the West’s Uncritical Support for Israeli War Crimes in Gaza, Western leaders initially responded to the start of Israel’s unprecedented assault on Gaza — in which 6,000 bombs were dropped, almost as many as the US dropped on Afghanistan in an entire year — by unconditionally endorsing Israel’s “right to defend itself.”
Many, if not most have subsequently rowed back from this position — in many cases, I have no doubt, because human rights lawyers have pointed out to them that they may, as a result, be complicit in war crimes — but although the West’s position is now broadly in accord with President Biden’s statement on October 15, when he belatedly acknowledged that “[w]e must not lose sight of the fact that the overwhelming majority of Palestinians had nothing to do with Hamas’s appalling attacks, and are suffering as a result of them”, the humanitarian crisis will not be addressed through standing at a podium and finally saying the right thing.
While the West vacillates and pontificates — and, far too often, still defends Israel unconditionally — the Israeli government’s unrelenting blizzard of violations of international humanitarian law — of war crimes — continues as though they only apply to lesser beings.
As well as imposing the most extraordinarily violent and cruel collective punishment on the people of Gaza, via its indiscriminate bombing raids, and by withholding water, food and medical supplies (all of which are quite startling war crimes), the Israeli government has recently added ethnic cleansing to its growing list of violations, via the evacuation order for half of the population to move to the south of the Gaza Strip, with the apparent intention of persuading Egypt to open the Rafah Crossing so that they can be exiled to the Sinai Desert, never to return.
As Jan Egeland, the secretary-general of the Norwegian Refugee Council, told the Associated Press, this is “not an evacuation opportunity, it’s an order to relocate. Under humanitarian law, it’s called forcible transfer of populations, and it’s a war crime.”
What is needed now, clearly, is nothing short of an immediate ceasefire followed by the provision of urgent humanitarian relief and supplies to the Gaza Strip. Anything less means that those in positions of power around the world continue to be complicit in war crimes, and, as more Palestinian children die, will have these children’s blood on their hands.
Andy Worthington is an investigative journalist, author, campaigner, commentator and public speaker. Recognized as an authority on Guantánamo and the “war on terror.” Co-founder, Close Guantánamo and We Stand With Shaker. Also, photo-journalist (The State of London), and singer and songwriter (The Four Fathers). Worthington is the author of "The Guantánamo Files: The Stories of the 774 Detainees in America’s Illegal Prison"
Little Light, No Beds, Not Enough Anesthesia: Gaza's Hospitals a 'Nightmare'
October 21, 2023
Associated Press
October 21, 2023
Associated Press
A Palestinian girl, wounded in an Israeli bombardment on the Gaza Strip, cries in a hospital in Deir al-Balah, south of the Gaza Strip, Oct. 21, 2023.
DEIR AL-BALAH, GAZA STRIP —
The only thing worse than the screams of a patient undergoing surgery without enough anesthesia are the terror-stricken faces of those awaiting their turn, a 51-year-old orthopedic surgeon says.
When the Israeli bombing intensifies and the wounded swamp the Gaza City hospitals where Dr. Nidal Abed works, he treats patients wherever he can — on the floor, in the corridors, in rooms crammed with 10 patients instead of two. Without enough medical supplies, Abed makes do with whatever he can find – clothes for bandages, vinegar for antiseptic, sewing needles for surgical ones.
Hospitals in the Gaza Strip are nearing collapse under the Israeli blockade that cut power and deliveries of food and other necessities to the territory. They lack clean water. They are running out of basic items for easing pain and preventing infections. Fuel for their generators is dwindling.
Israel began its bombing campaign after Hamas militants surged across the border on Oct. 7 and killed more than 1,400 people, mostly civilians, and abducted more than 200 others. Israel's offensive has devastated neighborhoods, shuttered five hospitals, killed thousands and wounded more people than its remaining health facilities can handle.
DEIR AL-BALAH, GAZA STRIP —
The only thing worse than the screams of a patient undergoing surgery without enough anesthesia are the terror-stricken faces of those awaiting their turn, a 51-year-old orthopedic surgeon says.
When the Israeli bombing intensifies and the wounded swamp the Gaza City hospitals where Dr. Nidal Abed works, he treats patients wherever he can — on the floor, in the corridors, in rooms crammed with 10 patients instead of two. Without enough medical supplies, Abed makes do with whatever he can find – clothes for bandages, vinegar for antiseptic, sewing needles for surgical ones.
Hospitals in the Gaza Strip are nearing collapse under the Israeli blockade that cut power and deliveries of food and other necessities to the territory. They lack clean water. They are running out of basic items for easing pain and preventing infections. Fuel for their generators is dwindling.
Israel began its bombing campaign after Hamas militants surged across the border on Oct. 7 and killed more than 1,400 people, mostly civilians, and abducted more than 200 others. Israel's offensive has devastated neighborhoods, shuttered five hospitals, killed thousands and wounded more people than its remaining health facilities can handle.
Palestinian wounded in the Israeli bombardment of the Gaza Strip are brought to Al Asa Hospital in Deir el-Balah on Oct. 21, 2023.
"We have a shortage of everything, and we are dealing with very complex surgeries," Abed, who works with Doctors Without Borders, told The Associated Press from Al Quds Hospital. The medical center is still treating hundreds of patients in defiance of an evacuation order the Israeli military gave Friday. Some 10,000 Palestinians displaced by the bombing have also taken refuge in the hospital compound.
"These people are all terrified, and so am I," the surgeon said. "But there is no way we'll evacuate."
The first food, water and medicine trickled into Gaza from Egypt Saturday after being stalled on the border for days. Four trucks in the 20-truck aid convoy were carrying drugs and medical supplies, the World Health Organization said. Aid workers and doctors warned it was not nearly enough to address Gaza's spiraling humanitarian crisis.
"It's a nightmare. If more aid doesn't come in, I fear we'll get to the point where going to a hospital will do more harm than good," Mehdat Abbas, an official in the Hamas-run Health Ministry, said.
Across the territory's hospitals, ingenuity is being put to the test. Abed used household vinegar from the corner store as disinfectant until the stores ran out, he said. Too many doctors had the same idea. Now, he cleans wounds with a mixture of saline and the polluted water that trickles from taps because Israel cut off the water.
A shortage of surgical supplies forced some staff to use sewing needles to stitch wounds, which Abed said can damage tissue. A shortage of bandages forced medics to wrap clothes around large burns, which he said can cause infections. A shortage of orthopedic implants forced Abed to use screws that don't fit his patients' bones. There are not enough antibiotics, so he gives single pills rather than multiple courses to patients suffering terrible bacterial infections.
"We are doing what we can to stabilize the patients, to control the situation," he said. "People are dying because of this."
"We have a shortage of everything, and we are dealing with very complex surgeries," Abed, who works with Doctors Without Borders, told The Associated Press from Al Quds Hospital. The medical center is still treating hundreds of patients in defiance of an evacuation order the Israeli military gave Friday. Some 10,000 Palestinians displaced by the bombing have also taken refuge in the hospital compound.
"These people are all terrified, and so am I," the surgeon said. "But there is no way we'll evacuate."
The first food, water and medicine trickled into Gaza from Egypt Saturday after being stalled on the border for days. Four trucks in the 20-truck aid convoy were carrying drugs and medical supplies, the World Health Organization said. Aid workers and doctors warned it was not nearly enough to address Gaza's spiraling humanitarian crisis.
"It's a nightmare. If more aid doesn't come in, I fear we'll get to the point where going to a hospital will do more harm than good," Mehdat Abbas, an official in the Hamas-run Health Ministry, said.
Across the territory's hospitals, ingenuity is being put to the test. Abed used household vinegar from the corner store as disinfectant until the stores ran out, he said. Too many doctors had the same idea. Now, he cleans wounds with a mixture of saline and the polluted water that trickles from taps because Israel cut off the water.
A shortage of surgical supplies forced some staff to use sewing needles to stitch wounds, which Abed said can damage tissue. A shortage of bandages forced medics to wrap clothes around large burns, which he said can cause infections. A shortage of orthopedic implants forced Abed to use screws that don't fit his patients' bones. There are not enough antibiotics, so he gives single pills rather than multiple courses to patients suffering terrible bacterial infections.
"We are doing what we can to stabilize the patients, to control the situation," he said. "People are dying because of this."
A Palestinian boy wounded in Israeli bombardment on Gaza Stripcries in a hospital in Deir al-Balah, south of the Gaza Strip, Oct. 21, 2023.
When Israel cut fuel to the territory's sole power plant two weeks ago, Gaza's rumbling generators kicked in to keep life-support equipment running in hospitals.
Authorities are desperately scrounging up diesel to keep them going. United Nations agencies are distributing their remaining stocks. Motorists are emptying their gas tanks.
In some hospitals, the lights have already switched off. At Nasser Hospital in the southern city of Khan Younis this week, nurses and surgical assistants held their iPhones over the operating table, guiding the surgeons with the flashlights as they snipped.
At Shifa Hospital, Gaza's biggest, where Abed also worked this week, the intensive care unit runs on generators, but most other wards are without power. Air conditioning is a bygone luxury. Abed catches beads of sweat dripping from his patients' foreheads as he operates.
People wounded in the airstrikes are overwhelming the facilities. Hospitals don't have enough beds for them.
"Even a normal hospital with equipment would not be able to deal with what we're facing," Abed said. "It would collapse."
Shifa Hospital — with a maximum capacity of 700 people — is treating 5,000 people, general director Mohammed Abu Selmia says. Lines of patients, some in critical condition, snake out of operating rooms. The wounded lie on floors or on gurneys, sometimes stained with the blood of previous patients. Doctors operate in crowded corridors filled with moans.
The scenes — infants arriving alone to intensive care because no one else in their family survived, patients awake and grimacing in pain during surgeries — have traumatized Abed into numbness.
But what still pains him is having to choose which patients to prioritize.
"You have to decide," he said. "Because you know that many will not make it."
When Israel cut fuel to the territory's sole power plant two weeks ago, Gaza's rumbling generators kicked in to keep life-support equipment running in hospitals.
Authorities are desperately scrounging up diesel to keep them going. United Nations agencies are distributing their remaining stocks. Motorists are emptying their gas tanks.
In some hospitals, the lights have already switched off. At Nasser Hospital in the southern city of Khan Younis this week, nurses and surgical assistants held their iPhones over the operating table, guiding the surgeons with the flashlights as they snipped.
At Shifa Hospital, Gaza's biggest, where Abed also worked this week, the intensive care unit runs on generators, but most other wards are without power. Air conditioning is a bygone luxury. Abed catches beads of sweat dripping from his patients' foreheads as he operates.
People wounded in the airstrikes are overwhelming the facilities. Hospitals don't have enough beds for them.
"Even a normal hospital with equipment would not be able to deal with what we're facing," Abed said. "It would collapse."
Shifa Hospital — with a maximum capacity of 700 people — is treating 5,000 people, general director Mohammed Abu Selmia says. Lines of patients, some in critical condition, snake out of operating rooms. The wounded lie on floors or on gurneys, sometimes stained with the blood of previous patients. Doctors operate in crowded corridors filled with moans.
The scenes — infants arriving alone to intensive care because no one else in their family survived, patients awake and grimacing in pain during surgeries — have traumatized Abed into numbness.
But what still pains him is having to choose which patients to prioritize.
"You have to decide," he said. "Because you know that many will not make it."
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