Select Committee on International Development Written Evidence

Memorandum submitted by the Palestinian Counseling Center


  Mental health is the balance between all aspects of life—social, physical, spiritual and emotional. It impacts on how we manage our surroundings and make choices in our lives—clearly it is an integral part of our overall health.

  Mental Health is far more than the absence of mental illness and has to do with many aspects of our lives including:

    —  How we feel about ourselves.

    —  How we feel about others.

    —  How we are able to meet the demands of life.

  Taking into consideration this definition of mental health, it becomes quite clear how it connects to all other concerns in the Palestinian life. Therefore in order to measure the effectiveness of aid it is crucial to understand the psyche of the people and what motivates or obstructs their productivity in addition to taking into account the general political and economic factors.

What is the problem?

  The main issue here is to integrate the human factor in any discussion of effective and sustainable work in Palestine. To take into consideration that any viable project has to be worked out mainly with human resources, so understanding the psyche is critical.

  So far we do not have any specific epidemiological studies of how the situation is affecting the people psychologically but there are data released by GCMHP in Gaza which states that 75% of the Palestinian children suffer from Post Traumatic Stress Disorder (PTSD) but with varying degrees. The Palestinian Counseling Center is conducting a quantitative research of the psychological effect of the building of the Apartheid Wall on the people in Qalqilya and environs. Preliminary findings indicate that that there is a high prevalence of depressive features apparent in sleeping and eating problems and psycho-somatic symptoms among the adults and children in the villages of Kufr Attiyeh, Al Dabaa' and Falamieh in the Qalqilya district. The children in the villages mentioned above have to cross a gate at the wall twice daily to go to their school. Needless to say that the gate and the wall is electrocuted and children can get killed if they touch it by mistake.

  Another assessment (a behavioural checklist) carried out by PCC in Jenin refugee camp revealed that 47% of children between the ages of 8-12 have anxiety related behaviours like bedwetting, lack of concentration, and attention.



  The Palestinian people's right to freedom and self-determination are recognized by the international community through a number of resolutions passed by the United Nations. The fourth Geneva Convention of 1949 one of the main pillars of international humanitarian law call for the protection of civil persons in time of war, the applicability of the convention to the OCT has been reaffirmed by UN security council resolution 1322 (2000). The International Covenant on Economic, Social and Cultural rights, in Article 12.1 states: "the right of everyone to the enjoyment of the highest attainable standard of physical and mental health". Israel consistently breaches every clause in the International resolutions, like article 33 , of the fourth Geneva Convention by imposing collective punishments on the people by shelling residential areas and indiscriminately terrorising and killing civilians, imposing prolonged curfews, closing off villages and towns. Article 55-56 was also breached by undermining public health and attacking hospitals, ambulances and medical staff. In addition to attacking schools, mosques, undermining the right to education and freedom of religion. In our view, it is the failure of the international community to force Israel to comply with these resolutions and to uphold customary international law that is the major cause of the ongoing conflict and the consequential impoverished environment for mental and physical well being in Palestine today.


  Violence is defined (Amir, 1982) as a premeditated offensive act of one party using power to inflict hurt or damage on another party. Political violence is a term used to describe practices committed by a state, political regime, or political organisations against individuals and groups in order to inflict hurt and damage and guarantee domination. Political violence is the illegal and unnecessary abuse of force in order to dominate others. The violence of Israel as an occupying power is a combination of physical force with psychological terror and fear (GCMHP, 2002). The systematic and organised Israeli violence against the Palestinians takes two forms: a direct one and an indirect one.

Direct Violence

  For the past 36 years, and intensively since September 2000 (Al Quds, 2002), Palestinians have been living as though in a large prison with a continuous threat and fear for their lives. Basic human rights are being violated on a daily basis. The following are statistics (PCBS, 2003) of the casualties of the recent Intifada, as of the date of writing (September 19, 2003):

    —  Total number of Palestinians killed by Israeli security forces and Jewish settlers are: 2,618 deaths.

    —  Political figures assassinated/extrajudicial killings by Israeli death squads: 275.

    —  Bystanders killed during Israeli assassination operations: 133.

    —  Total disabilities (both partial and permanent) in the West Bank and Gaza Strip: 3,000.

    —  Physical injuries: 41,000+.

    —  Houses demolished during Israeli incursion: West Bank: 9,750, Gaza Strip: 2,349 (numbers reflect end of 2002).

    —  Ambulances damaged and/or destroyed: 222.

  This is in addition to the closure of schools, the damage to school buildings, the people who die from lack of access to medical care and the infants who die at Israeli military checkpoints because of inaccessibility to clinics for immunisation.

Indirect Violence:

    —  People are living under siege, terrorised, subjected to daily systematic humiliation at army checkpoints and within their neighbourhoods.

    There are limited social relations, as people are confined to their homes: every town and village is cut off from the others and completely isolated. There is disintegration of family and social relationships.

    —  A large section of the population is starving and lacking basic needs for their survival. The economic situation is dire, and people are barely surviving. According to the World Bank's recent report, the National Domestic Product declined by 40%, unemployment reached 50% in the Gaza Strip and 63.3% in the West Bank, and thus people living under the poverty line increased by 65% since September 2000. The poverty line defined by the World Bank is an income of $2.00 per person per day (in third world countries). The inability of workers to reach their place of work because of the closure of all the towns and many villages in the West Bank and Gaza Strip (Al Quds, April 2002), the difficulties associated with the marketing of products, and the inability to obtain raw materials have resulted in the dwindling of the economy.

    —  Arbitrary measures of closing areas, shooting at people sporadically as they cross checkpoints, invading towns and arresting people in the middle of the night leaves the subjugated people confused and not knowing what to expect and therefore living in continuous fear.

    —  The Israeli military practices do not end with the military, psychological, and economic siege imposed on the Palestinian people, but include the daily humiliation of individuals and groups of Palestinians. (


  It is a well-known fact that there exists a high correlation between life stressors and a prevalence of psychological problems in a community (Sebastian, 2002). For Palestinians, the increase in life threatening situations and the fear of losing one's life have caused grief and trauma and have affected all sectors of the community. It is usually thought that 25% of any community directly living in a conflict area or war zone is affected psychologically on a long-term basis. The PCC believes that the number in the OPT (Occupied Palestinian Territories) has reached 30-35% who will, be affected on a long-term basis Halileh (2002). This is primarily due to the sporadic shelling and shooting that leads to unpredictability— a situation of extreme uncertainty. Bombing and shelling are more traumatising than other violent measures because they are more sporadic and constitute a drastic threat to people's sense of existence and security. For Palestinians, the lack of control over one's environment is the main cause of psychological problems. This ghetto-like life not only restricts psychological development, but also denies individuals the chance to reclaim the psychological and social advancements they had once achieved as people. Psychologists who are themselves Jewish, as well as others (Glabach, D) have written a great deal about the Ghetto mentality, about how people who are put in a situation of captivity act, and how they respond physically, cognitively and emotionally. They also describe the way in which people can become aggressive, paranoid and ruthless, ie active in trying to release themselves from captivity, or passive with feelings of hopelessness and helplessness.

  In our work and day-to-day lives, we have increasingly witnessed signs of psychological and physical fatigue amongst the Palestinian people. If we take Maslow's hierarchy of needs (Gilliland, James & Bowman, 1989) as a way to comprehend the situation, we can conclude that the Palestinians are placed somewhere near the bottom of the hierarchy in pursuit of basic needs for food and safety. The natural development of people towards realizing self-actualization and growth is not possible under these circumstances.

  The ability to love and have a sense of belonging is affected when people are physically separated from families and loved ones and denied the social support that results from this interaction. This separation affects the sense of self, as well as the relationship to others. According to Maslow, people who are at the lower levels of the pyramid will have low self-esteem. And consequently are not able to develop and advance socially, psychologically and professionally, as self-esteem is an important element in human growth and development (Gilliland et el 1989). They also tend to resort to primitive process thinking, ie reacting emotionally and instinctively instead of applying more sophisticated secondary process thinking, ie being proactive, capable of analyzing, reasoning and thinking logically (Mitchel, 1995). In relation to others, it is expected that if a person does not think highly of him/herself then that person cannot think highly of others. If he/she does not respect his/her own life, he/she will not respect the life of others.

  Some people who survive and are surviving organised violence such as war, occupation, torture or imprisonment, may have already moved out of their bodies (Crosbie-Wheatley) as a survival mechanism. The goal of torture and organised and systematic violence is to take away a person's power of being a subject and turn him or her into an object. We as a people have noticed recently that death, which is a spiritual concern, preoccupies us less and less. The news of yet another death or another injury has become part of our "normal" daily lives. To ignore death, treat it indifferently, and not allow ourselves to be affected by it, these are not only linked to an overwhelming sense of grief and frustration, but are also the result of our perception of the self as an object, the acceptance of the notion that an object's life is not valuable. If life, in our eyes, is considered so diminished then preserving it is no longer a holy task.


  In conclusion it is important to note here that any consideration of the viability of projects and effectiveness has to take into consideration the mental health of the Palestinian people. The Israeli systematic policies of humiliation and psychological torture have a debilitating effect that is affecting productivity and organisation.

  It is known worldwide that unemployment and restricted mobility constitute a main stressor that harm the mental well being of the individuals and community.

Background on the Palestinian Counseling Center

  The PCC was established in 1983 by a group of professionals from the social sciences field in Jerusalem. The aim of the Center since its establishment has been to promote the mental health and well-being of the Palestinian people.

  The PCC is an important capacity building center for students from the Universities and professionals from the mental health field who are trained in clinical work at the Center, and who also receive support to further their education in other institutions locally and abroad in the same field. The Center has also been able to make an impact on progress in the mental health field by starting projects, which have been adopted nationally. One of these projects is the training and placement of counselors in the public schools. In addition, the Center has worked to integrate mental health care into primary health care settings. The Palestinian Ministry of Health and the Palestinian Red Crescent Societies have adopted this work.

  Most importantly, the PCC has been a strong advocate in emphasising the importance of responding to individual needs in the community, ensuring that the individual and his/her needs are not forgotten in the midst of collective needs. This is very important in light of the fact that individual counseling and personal growth might be considered a luxury for a developing community like ours. In spite of this, the insistence on providing quality mental health services to the community and providing further training for the professional staff in the field are a priority of the PCC. As a Counselling Center we deal with people with a wide range of presenting difficulties, some of which are directly or indirectly related to exposure to political violence (occupation and military force). Others are victims of domestic abuse, while yet others have physical conditions, possibly aggravated by the political situation.

September 2003


  1.  Intifada statistics are taken from the database compiled by the Gaza Community Mental Health Program ( Updated regularly.

  2.  Intifada statistics are taken from the database compiled by Miftah—the Palestinian Initiative for the Promotion of Global Dialogue and Democracy ( And the Palestinian Bureau of Statistics (PCBS) Updated regularly.

  3.  Dates and news are quoted from the website of Al-Quds daily newspaper


  1.  Amir, M (1982). "Basic Concept and Terminologies Related to Violence", Improving The School Environment, The Ministry of Education, Jerusalem. pp 15-18.

  2.  Crosbie-Wheatley, J Attachment Trauma and Somatization in Adults: When Time Does not Heal. view as html

  3.  Giacaman, R & Johnson P (2002). Who lives in Jenin Refuge Camp?

  4.  Gilliland, B James, R & Bowman, J (1989) Theories and Strategies in Counseling and Psychotherapy. Needham Heights, MA: Allyn and Bacon Press.

  6.  Glabach, D An Evolutionary Psychological Perspective on Natural Rights as an Inherent Aspect of Human nature.—rights.htm

  7.  Halileh, S (2002) The effect of Israel's operation Defensive Shield on Palestinian children living in the West Bank. %202002.doc

  8.  Mitchell, Stephen A, Black, Margaret J, Freud and Beyond: A History of Modern Psychoanalytic Thought. New York, N.Y. Basic Books (1995).

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