Later that afternoon, I met with Gazal’s mother, Ridana Zukhara, who is twenty-four with a childlike face, in the white-tiled living room of their pristine two-bedroom apartment. Ridana’s husband, Bilal, and her three-year-old son, Yusef, are trapped in a refugee camp in Rafah. To keep herself from constant worry, Ridana, who rarely leaves the apartment, scrubs the brand-new appliances in the modern kitchen. She is still devastated by the choice she made to evacuate with Gazal and her newborn daughter, Aileen, while her son remained in danger. “Yusef can’t understand why I took Gazal and left him behind,” she said. She tipped the dining-room chairs on top of the farm table to sweep underneath and made up the platform beds topped with fluffy white duvets.

Gazal played on the apartment’s immaculate floor with Aileen, now three months old, looking on from a car seat. Chubby and about the size of a loaf of bread, Aileen squawked good-naturedly from under a pink Hello Kitty blanket while Gazal jabbered to a wild-haired imitation Barbie doll dressed as a bride. She folded the doll’s plastic left leg behind her and marched her around the floor on her right. “This is Gazal when she gets married,” she announced. Ridana tut-tutted. She didn’t want Gazal fashioning the doll as an amputee. She reminded Gazal that soon she would have a new leg, although that seemed nearly impossible for the four-year-old to comprehend.

Sometimes, when Gazal got out of bed, she tried to use her missing left leg and fell. Such moments were hard, Ridana said, but Gazal cried less about her leg than about her father and brother. She asked her mother incessantly when they were coming to Doha. “They told us they could come when there’s a ceasefire,” Ridana said, of Qatari officials. “But when will that be?”

In Rafah, Bilal and Yusef are living in a tent near the Egyptian border. “They are freezing,” Ridana said. They have no phone signal in the camp, so, most days, Bilal walks for hours to send his wife a video of Yusef. In one that Ridana showed me, Yusef is filling his pockets with rocks, pretending they are money. In another, he lies on a muddy sleeping mat, unresponsive. “He has lost so much weight, and his face is yellow,” Ridana murmured. While we were watching, a message arrived on WhatsApp from her sister, who’d just given birth in the Rafah refugee camp. “Habibi, my sister I hope to God you guys are good. Please send me pictures of the girls. I miss them so much. Are you in touch with your husband?” Rafah is dangerous, but the family is most worried about the toll that separation from Yusef is taking on Ridana. When she brings black plastic trays of hummus and pita back from the food stalls, she leaves hers untouched. “How can I eat when my son doesn’t have food?” she asked me.

For separated families, as well as for those trapped in Gaza, the mental-health toll of the crisis continues to mount. During the first several months of the conflict, the Gaza Community Mental Health Programme (G.C.M.H.P.), the leading mental-health organization in the Strip, ceased operations. Two weeks ago, in Rafah, they re-started some of their programs. “We can’t wait any longer for a ceasefire to take place to deal with mental health,” Yasser Abu-Jamei, a psychiatrist and the head of the G.C.M.H.P., told me by phone from Rafah recently. Abu-Jamei is also displaced and living in a tent in Rafah. He and a team of mental-health providers go into camps to speak to families and perform psychological first aid. They work with traumatized children, trying to help them identify somewhere nearby that’s safe. “If we can’t find an actual place, we help children imagine somewhere safe,” he said. They also work with parents who are baffled by their children’s misbehavior, and, with the help of the World Health Organization, they provide psychotropic medications to adults—though such drugs, like most others, are scarce.

In addition to offering treatment, the Gaza Community Mental Health Programme has conducted clinical studies of trauma among children. Samir Qouta, a psychologist who founded the research department of the G.C.M.H.P., in 1990, and now teaches at the Doha Institute, has researched subjects such as children’s dreams and the relationship between trauma and maternal attachment, as well as the core aspects of building resilience. “Traumatic experiences don’t necessarily wound children,” Qouta told me one afternoon at his office in Doha. “There are so many factors that mitigate trauma—creativity, storytelling, and, most of all, a child’s strong bond with her mother.”

Although many of the compound’s residents remain glued to their smartphones and to the large flat-screen TVs that Qatar has furnished in their apartments, following news reports from Gaza to ascertain the fate of their families, Ridana keeps their television set turned off for Gazal’s sake. “She has already seen so many traumatic things,” Ridana told me. “I try to limit how much she hears and sees.”

Gazal rarely speaks of her experiences in Gaza. Ridana doesn’t encourage it. Yet her daughter does show signs of specific anxieties and aversions. She stays away from anyone dressed in white because they remind her of hospital staff. She demands that Ridana sleep in her bed, and, even in sleep, she won’t let go of her mother. “I can’t even go to the bathroom,” Ridana said.

For children who’ve experienced extreme loss, such hypervigilance is common, Salsabeel Zaeid, a psychologist working with children and families at the compound, told me. Many of the child amputees in Doha suffer from “depression, anxiety, trouble concentrating, restlessness, nausea, trouble sleeping, anxiety attacks, hopelessness,” she said. “They’re really tearful and guilt-ridden,” she added. The children suffer from a form of survivor’s guilt, because, unlike friends and family members, “they’ve walked into another country and their basic needs are being met.”

Ridana had taken Gazal to the compound’s mental-health clinic to see whether Gazal might benefit from speaking with a therapist. But, at the appointment, Gazal broke down, crying the whole time and telling her mom to answer the questions. “It caused her more pain,” Ridana said. She recalled what the therapist told her about attachment: that maternal bonding was integral to Gazal’s ability to heal. Ridana said, “For now, what she needs is her mom by her side.” ♦



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