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Resilience in the Palestinian Occupied Territories (1)

Contributed by Toine Van Teeffelen on 03.09.2006:


Toine van Teeffelen, Hania Bitar and Saleem Habash

A focus on resilience is an extremely useful angle for looking at the mental health situation in the Occupied Palestinian Territories (OPT: the West Bank, Gaza and East-Jerusalem). On the one hand, Palestinians there are dealing with a broad range of adversities and psychological stressors which especially during the latest Intifada have tested them and their health to the limit; on the other hand, they dispose of individual, social and national assets which help at least the majority of them to continue life against the odds, and to develop and maintain basic sources of resilience. In this contribution, we will detail the adversities, the consequences for the mental health situation, and the resilience of Palestinian youth in the OPT through the consideration of a specific development organization: the Palestinian Youth Association for Leadership and Rights Activation (Pyalara), a Palestinian youth NGO in the West Bank.

Palestinians in the West Bank, Gaza, and East-Jerusalem presently find themselves in a crisis of dramatic proportions. Due to the strict closures and a system of Israeli checkpoints and roadblocks which was already initiated in the first half of the 1990s but reached an unprecedented level during the second Intifada (from September 2000 on), traveling has become full of obstacles and hazards; not only traveling from the OPT into Israel, but also between Palestinian cities or districts inside the West Bank and Gaza. A survey conducted by the Palestinian Bureau of Statistics in September 2003 found that over half of the population of the West Bank reported difficulties in trying to reach their place of work or agricultural fields (PBS 2003). As a result, there has been a steep decline in employment opportunities, trade movements and the provision of services. According to World Bank estimates, the unemployment in the OPT has reached levels of 30-70%, while in 2003 the percentage of persons living below the poverty line of 2 dollars per person per day was over 60%, from some 20% before 2000 (World Bank 2003).

The majority of Palestinians in the OPT – over three million – are young, below 24 years, and are confronted with a prospect of deficits. They can barely meet others outside their community, so important for adolescents who want to enjoy life, engage in social experimentation and adventuring, or test their competencies. They also know that they will face difficulty in finding appropriate vocational or academic study opportunities after school, and a suitable job later on. Given the stagnation in the search for political solutions to the Palestinian-Israeli conflict, we observe present-day Palestinian youths to be generally pessimistic about the duration of the occupation; whether a viable Palestinian state will ever emerge, and how the political situation will affect their life. The recent Israeli policy of building the Separation Wall/Fence, the political-military measure that attracted a great deal of international attention in 2003-4, is generally perceived as an instrument of annexation and of making the establishment of a viable Palestinian state impossible. Basically, many Palestinians, including the youths, relay in their daily life talks that they confront a policy of national fragmentation and “silent transfer” (from the OPT to countries abroad, as a result of the various obstacles to a normal life). Gradually, Israel is trying to test Palestinian resolve to its limits, it is felt, in order to induce the Palestinians to give up on the national project.

While youths experience their individual opportunities to be very limited, and the political track to be blocked, they also face a great many, often recurrent, crisis situations in daily life. In the three years since the beginning of the Intifada in September 2000, Palestinians were killed at a rate of almost three per day. From 28 September 2000 – 24 March, 2004, 2,936 Palestinians were killed as a result of the violence. From that total 541 were children (age 17 and under) [Palestine Monitor 2004]. The number of unarmed people killed so far in the West Bank and Gaza is over 2,000.

Thousands of Palestinian youths have become handicapped as a result of clashes with the army. In a study conducted among 10- to 19-year-olds in the OPT last year, Iyad Sarraj, the president of the Gaza Community Mental Health Program, discovered that 94.6 percent had experienced a funeral, 83.2 percent had witnessed shooting incidents, and 61.6 percent had seen a relative being hurt. A psychosocial assessment of Palestinian children (Arafat and Boothby, 2003) showed 93% of a sample of children in August 2002 “not feeling safe and exposed to attack,” while almost half of the children “personally experienced violence owing to the ongoing Palestinian-Israeli conflict or … witnessed an incident of such violence befalling on an immediate family member” (idem). “One out of five children (21%) … had to move out of their homes, temporarily or permanently, overwhelmingly for conflict related reasons” (idem). Witnessing relatives or friends being imprisoned, especially when they are older and carry authority, is an additional stressor. During the direct occupation of the Palestinian cities by the Israeli army, from Spring 2002 on, tens of thousands of arrests have been made, and Palestinian youths have been imprisoned or saw their fathers or brothers being imprisoned.

Violent happenings are loaded with fear and anxiety. During Intifada clashes a great many children and youths were forced to lay on the ground for several hours or to hide in the kitchen or under the stairwells. They saw bullets coming into the house, family members escaping death, or soldiers entering and sometimes occupying their homes for the purpose of using them as look-out posts. Young people witnessed the demolition of their house after it was considered illegally built, or in the case of a family member being involved in violent action, or for the purposes of Israeli construction projects (i.e. the building of settlement roads or the Separation Wall/Fence).

Less dramatically, but also significantly affecting people’s mood, are the humiliations people routinely witness or experience at, mainly, checkpoints. People aimlessly waiting at checkpoints is commonplace, and in each community countless stories have been circulating about soldiers behaving mockingly or asking people to perform irrelevant and humiliating tasks. A stressor which usually goes unobserved but which has a pervasive influence is the continuous uncertainty in organizing daily life. Whole communities often do not know in the early morning what the day will bring, whether the children and youths can go to school, which route to take to work, or whether there will be work tomorrow. During the months of December 2002-February 2003, it appeared to be a purposeful policy of the military to keep the inhabitants of Palestinian cities such as Bethlehem up until the course of the morning uncertain about whether a curfew would be installed that day or lifted. This uncertainty led to stressful situations inside families who did not know whether to work or send their children to school [personal observation TvT]. “You cannot plan for tomorrow,” is the traditional complaint in the OPT.

These obstacles should be viewed in a more general context of personal and collective vulnerability. Due to the violence, there is a basic lack of safety in public life, and many parents do not allow the children to leave home in the evening. The lack of safety is also keenly felt at the economic level. The OPT do not have an institutional safety net as associated with welfare states, such as unemployment or retirement allowances. What many experience in such a risky situation is an accumulation of adversities in daily life, such as when children have a handicap, a father is unemployed, and family members cannot reach other places, including facilities, due to the traveling hazards. Characteristic for Palestinian life in the OPT thus is an accumulation of interlocking obstacles which make nearly all aspects of daily life an uphill struggle, a continuing experience of “exponential risks” as a result of “multiple stressors” (Small and Memmo 2004).

Obviously, some people have to struggle more than others. Everybody is at risk, but there are especially severe cases in the refugee camps, in the peripheries of the West Bank, in the Gaza Strip as a whole (with its large refugee camps), near the settlements (where clashes with settlers may be frequent), and near the Separation Wall/Fence. Groups at special risk include the disabled, who often are already secluded from public life, but are now further affected by financial constraints and traveling obstacles. Further, girls and young women in general cannot easily leave home alone due to the lack of safety on the street and traditional conventions, especially not in the late afternoon and in the evening, and so they are even more affected by the political and military circumstances than boys and young men.


How does this situation of interlocking adversities affect the mental health and the behavior of especially young people in the OPT?

First, it has been documented by mental health organizations and psychologists that the emotional behavior of individual youths display many direct symptoms of trauma and anxiety, such as nightmares and bedwetting, increased aggressiveness and hyperactivity and a decrease in attention span and concentration capacity (Arafat and Boothby 2003: 6). World Vision, a leading foreign organization working in the Occupied Palestinians territories, mentioned in a report about the psychosocial syndromes and trauma Palestinian children are facing (Albina 2002) that a recent unpublished study by Tamar Lavi from Tel Aviv University showed a 70% prevalence of Post Traumatic Stress Syndrome (PTSD) among Palestinian children from the West Bank and Gaza Strip, compared to a 20-60% prevalence of such syndromes in international studies on children in war-zones. In Sarraj’s study 97% of the participants revealed PTSD symptoms of varying severity. But perhaps the term PTDS is not felicitous in the case of the OPT, Palestinian spokesperson Hanan Ashrawi recently informally said, since Palestinians do not just face post-traumatic stress disorders but rather ongoing trauma disorders (personal communication TvT, March 2004)..

Pyalara’s own experiences as a development youth NGO in the OPT point to how the reality of risk and vulnerability negatively impacts upon the youth’s sense of self-efficacy, especially for the estimated 95% of youth who are not actively involved in the Intifada. They do not feel control, we hear in our workshops, over the general political developments nor the events at the community and family level. It is very common to hear youth implicitly or explicitly talking about their lack of power; for instance, they feel subject to political “conspiracies,” or they say that “it doesn’t really matter what we are doing, the Israelis do what they want anyway,” or that the Palestinian National Authority is “not doing anything.” Moreover, while they often see democracy at work in other societies, including Israel, they don’t see many opportunities to let their voice heard in their own society.

Against this background of powerlessness and frustration, one problematic health response is withdrawal from reality. Many youths are inactivated, stay at home, watch TV (several music video satellites have lately sprung up in the Arab world, with huge audiences), and are left without a role or voice. The result is a kind of generalized frustration turning inwards – not an explosion but an implosion. Withdrawal is sometimes a reaction to the gravity of events. After prolonged periods of curfew in the Palestinian cities it was not uncommon to observe people being confused, not concentrating and rather forgetful, overcome by an overall loss of orientation.

Another specific response to the political situation is a compensatory identification with suicide bombers, as documented especially by the Gaza Community Mental Health program (2003). This identification takes place due to the shortage or absence of powerful and inspiring persons in the youths’ social environment. As Arab society and culture pay special importance to a strong father figure, the children and youth are deeply affected by the diminishing authority of the father after seeing him becoming unemployed, humiliated at checkpoints by young Israeli soldiers, or put into custody. At the national level, Arafat – a national “father” considered the leader who initiated and controlled the Palestinian national movement over five decades – is observed as being actually imprisoned in his headquarters in Ramallah, a leader without the physical opportunity to lead. The Palestinian police, part of the Palestinian Authority, has become a symbol of powerlessness as well, since they are usually perceived to comply to the Israeli army’s commands. So the suicide bomber takes on the role of a substitute, seemingly powerful figure, expressing in a single, spectacular and deadly act the frustration and rage of victimized persons. In Arafat and Boothby’s study (2003: 6), a minority of parents (5-8%) are said to report that “their children have become fixated on thoughts of death and revenge.”

Withdrawal, anger and feelings of revenge go hand in hand with a pervasive despair about both the larger political context and the daily life situation. The feeling of hopelessness has deepened nowadays and in the streets it is common to hear expressions like “for Palestinians yesterday is always better than today.” Informally, many youth are ambiguous about the official Palestinian “story” of a progressive struggle leading to independence. Even though people in general subscribe to the legitimate Palestinian national rights and regard Palestinian spokespersons as expressing legitimate positions in the conflict with Israel, it is also often said that the struggle goes from one “debacle” to another. What such pronouncements betray are a lack of orientation and a sense of being abandoned by leaders or relevant others who could provide such orientation, including guiding social institutions.

The overall mental health situation is, all in all, characterized by a pervasive obstacle rather than opportunity thinking grounded in a reality which is indeed visually and effectively full of obstacles. “Nothing is easy here,” is sometimes said as the concluding point of a frustrating story from daily life. Many Palestinians are likely to identify with the painting of the Palestinian artist Suleiman Mansour which depicts the Palestinian people’s identity in an old man carrying the globe on his back. Daily talk is full of images of being “closed up,” or about how one is living in a “coffin,” “cage” or “prison.” The visibility of a highly protected Wall/Fence adds to a sense, buttressed by such metaphors rooted in real life, that one cannot move. “Traveling [from the southern or middle West Bank to the northern part] to a city like Jenin, is in people’s experience almost like traveling to the moon,” a development worker recently commented.

A continuous awareness of not being able to move, and a sense of waiting without knowing the future, does not just add to frustration and obstacle thinking, but also generates a feeling of boredom among youths, especially during outside school hours, like holidays. Diaries written by older school students in the OPT [see the compilation by Atallah and Van Teeffelen 2004) display a remarkable swing between on the one hand a basic level of nervousness, vulnerability and uncertainty due to the hazards of daily life, and on the other hand the routine boredom of living in a closed-up environment that lacks the presence of spatial and temporal ‘horizons’.


Given this gloomy picture, we have to emphasize that Palestinians dispose of a range of significant resources of resilience which should also be elaborated not only to balance the mental health picture but also to show ways out of the situation. After all, the academic and developmental interest in concepts such as resilience has precisely sprung from a need to correct the pervasive image of helpless, traumatized victims that is putting responsibility for changing the situation on psychosocial professionals or policy makers, with little role for the affected persons themselves (Newman and Fellow 2004). To their own misfortune, Palestinians themselves have long been confronting, in the media and politics, the bipolar stereotypes of victimized refugees and victimizing terrorists disconnected from any normal daily life (Van Teeffelen 2004).

Resources for resilience in the Palestinian case especially include social opportunities, supportive networks, and spiritual, cultural or value-based resources.

The national-cultural level is the most general one. Palestinians have a cultural trait of a stubbornness and enduring capacity which is perhaps related to the traditional mentality of peasants – the large majority of Palestinians before the 1948 war used to be peasants – who are strongly attached to their lands. In part rooted in a centuries’ old history of collective resilience during confrontations with rulers and landlords, and of not being subjugated after successive military or political setbacks, the talk of despair is somehow neutralized by a spoken or unspoken collective will not to have the spirit broken: “While we suffer more, the Israelis suffer too, and this will in the end break their spirit rather than our’s.” It is important to notice that Palestinian talk in daily life is not one-dimensional, not expressing one or two types of emotions (anger and despair, for instance) but rather a range of interpretative and emotional repertoires helpful for coping with the uncertainties of the situation, many of them in fact resting upon not just a willingness to take in suffering but also on a human spirit, warmth and a certain “lightness” characteristic for Mediterranean culture. So many visitors have been struck by the ability of Palestinians to even under the present circumstances somehow laugh and enjoy the environment and weather, and a quiet rhythm of life interrupted by impatient but friendly bursts of social interaction.

Much of Palestinian cultural resilience is a way of coping with suffering, a survival strategy of ‘hanging on’. In local discourse, this daily life strategy is sometimes called sumud or steadfastness, a concept close to but not exactly the same as resilience. Stretching a period of three decennia, the Palestinian lawyer Raja Shehadeh has written a series of diaries (1981, 1991, 2002) in which he gave personal meaning to sumud, or, what he initially called, ‘the third way’ – neither allowing oneself to be subjugated by the occupation (by withdraw or inactivation) nor making a choice for armed struggle. The third way was to stay put, not to leave the country or to resign in the occupation, yet at the same time not fully giving up on normal life either. As a concept, sumud has not been unproblematic. It initially was employed as a rather top-down concept by Arab and Palestinian leadership to politically express a desired steadfastness in the national struggle. But staying put became a sometimes impossibly rigid demand, not linked to the demands of daily life, when for instance youths were advised to stay in the country while study or work possibilities elsewhere were much better; possibilities that would in fact allow them later on to provide a greater contribution to the national cause. Also, the sumud concept – sometimes metaphorically likened in Palestinian Arts and popular culture to the ineradicable desert cactus or the long-living olive tree with its roots deep in the soil – was criticized for not being flexible enough to meet the challenges of modern life and identity. This life is after all characterized by mobility, by “routes” rather than by “roots” (Woodward 2002). Perhaps the term resilience has more ‘flexible’ connotations than sumud can provide for. Yet somehow sumud captures this element of endurance and refusal to give up without which no account or analysis of Palestinian society can be valid.

A factor relevant to the cultural sumud of Palestinians is the importance of religion as a source of faith, spiritual commitment, guidance and consolation. Observers during the Intifada have often equated the increase in Islamic religious observance with an increase in political radicalism and despair, and in support for Hamas and Islamic Jihad. Yet such statements, although satisfying media frames of Islam, give reductive meaning to a complex phenomenon. During uncertain and seemingly hopeless times many persons and families consider faith as a beacon for spiritual orientation in a world lacking leadership and values. For instance, in the diaries quoted above (Atallah and Van Teeffelen 2003), several of the Christian and Moslem girls at a private school in Bethlehem mentioned as their main inner source of strength the inspiring example of religious, Palestinian and non-Palestinian, personalities who devoted themselves to the improvement of the world. In that sense, religion may well contribute to an inner, spiritual resilience. At the same time it is also true that religion can contribute to a crippled form of resilience when it incorporates the youths into hierarchical relations that block initiative and independence, and when religion feeds into fanaticism. To what extent religion contributes to mental health is therefore a complex and contradictory subject that certainly in the Palestinian context awaits study and research.

Resilience is further supported by educational opportunities, especially so in the Palestinian case. In the study of Arafat and Boothby, education was felt to be the single most important resource for resilience. Despite the odds with respect to availability of and access to education, the majority of Palestinian children (70%) felt that they could improve their own lives educationally by “developing academically first and foremost, but also personally and socially,” while 96% saw education as their main means to improve their situation” (2003: 6). Commitment to education is very strong among Palestinian families, for historical reasons. After loosing much of their land in 1948, Palestinian families inculcated values of education into their children as education was perceived as opening horizons for alternative routes in life. It helped to develop a resilience understood as a concept that not only reflects psychic strength and the capacity to endure adversities across a prolonged time – “steeling,” as appropriately called in the resilience literature [quoted in Small and Memmo 2004: 6) – but also tactical inventiveness, problem solving capacities and survival techniques comparable to the requirements of an adventurous journey in which the resilient person should not only be steadfast but also make “long sideways and complicated detours in order to find the right way back” (Cyrulnik 2002).

Incidentally, when referring to such flexible problem-solving skills and tactical resilience, we should not only think about the influence of formal organizations for youths like the educational system, but also informal daily survival techniques like supportive sociality, e.g. talking about the many tricks at crossing checkpoints; the informal impromptu release sessions between family members or youths at the morning break, and the pervasive black humor which helps anybody, including youths, to raise above their situation and look at it in a lighter way. In our experience, mutually supportive discourse at the small moments of daily life is a major factor in explaining Palestinian resilience, combining and valorizing the influence of cultural values and social networks.

Crucial supportive network for social resilience are the extended family and the community. The family is considered a moral pillar in Palestinian society, and it takes a central place in Palestinian popular culture. Traditionally, especially the refugee camps have been examples of the Palestinian families’ ability to endure, to successfully recover from wars, and to re-organize the social fabric afterwards (Sayigh 1976). In Palestinian society it is still common – even though to a somewhat lesser extent than in the past, due to globalization and the influence of the media – to take care of each other, also financially; to create a feeling of togetherness during feasts and celebrations, and to lend each other support during times of crisis like curfews or illnesses in the family. Hospitality, generosity and sociability – clearly linked to the aforementioned Mediterranean type of culture – are values which underpin social life to an extent unknown in the West. A friend of us once said that after she had a car accident she was so warmly and promptly surrounded by families and friends that for some moments she completely forgot about the accident! Social occasions on the balcony and in the garden or joint strolls in the street in good weather are common and form natural resting points in Palestinian life, providing relaxation as well as moments of re-energizing the spirit and experiencing a gay, uplifting friendliness. During the opening hours of the long curfews in the Palestinian cities, when people had to rush to buy their amenities in a few hours, it was common to see people supporting each other by giving walkers a ride or doing purchases for the elderly. In addition, it has to be noticed that it is highly uncommon to see persons begging on Palestinian streets. The effective welfare safety net is not created by formal institutions but by extended families. Based on values and practices of mutuality, there is an informal involvement in neighborhood or community voluntary work, the last being a traditional custom among Palestinians, perhaps rooted in ancient practices of cooperative work among the peasantry.

In addition, a great many Palestinian NGOs have contributed these years to enhancing the resilience of youths. The history of Palestinian NGOs in relation to the Palestinian National Authority cannot be fully dealt with here, due to lack of space. Just briefly: Prior to the signing of the Oslo agreement , the role of NGOs in the OPT was more focused on relief and aid for crisis-affected Palestinian citizens, in addition to acting as referral organization substituting for the lack of a ruling government. After a new future was envisioned with the semi-resolution of the Palestinian-Israeli conflict (proven a failure after almost seven years), the role of the non-governmental organizations started to evolve around the development of Palestinian society into a proto-state. After the collapse of the peace process, and the re-escalation of violence and conflict in the second Intifada, the NGOs had to change course once again. The NGOs started to provide opportunities for dealing with the emergency situation as a result of the violence. With regard to the youths’ role, they mainly facilitated or organized leisure activities, training and workshops, non-violent action, and community work:

Activation and awareness-raising

 Summer camps

 Discussion meetings

 Club activities

 Local journeys

 International journeys

Skills related

 Skill enhancing courses or workshops for youth (arts, computer etc.)

Expressive, ‘voice’ activities

 Diary writing

 International computer exchanges

 Counseling workshops

 Youth media

 Theater and film

 Participation in international meetings

Community actions

 Voluntary community work, e.g. rebuilding demolished houses or supporting patients

 Advocacy campaigns for e.g. right/access to education

 Support to victims of violence

 Non-violent direct or indirect actions in protest against the occupation or the Separation Wall/Fence.

After the onset of the last Intifada, it was a major task of youth development NGOs in Palestine to look for ways which could help to bring out, discuss or heal traumas, counter despair and obstacle thinking, and show ways for strengthening sumud coupled with the flexibility and creativity of a resilience that would look for alternative pathways. In the following section we will describe how Pyalara developed a new working model in which media, counseling techniques, and the establishment of new social relationships amongst youth were strategically combined to create a deeper and broader health effect.

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