لخّصلي

The findings of our assessment of the mental health of children in Beit Hanoun and the Gaza Strip generally are in accordance with the predictions. In a survey in central Gaza, less than a week after the first ceasefire in the war, almost all (99%) of 13-17-year-olds could provide precise descriptions of events occurring during the war, and two-thirds had high levels of post-traumatic stress disorder (PTSD) symptoms. This is comparable with older teenagers from Chechnya two weeks after a period of heavy bombardment. Analysis of symptom scale scores shows that Gaza children distributed their clinical characteristics into 4 clusters: re-experiencing the war, emotional numbing, arousal, and avoidance. During the war, 7.3% of children developed positive PCR for acute stress disorder, and in our Beit Hanoun cluster sample, PTSD prevalence at the detection phase was 30.3%. Such new onset disorders are particularly indicative of persistent war stress. Our qualitative data from younger children with PTSD provides an account of specific types of war stress, including a case of a 6-year-old child caught in crossfire while walking up the stairs to his rooftop, and a case of a 9-year-old girl who witnessed the bombing of a building adjacent to her home. These children describe a pervasive sense of fear for both themselves and their families. Detailed awareness of the war around them increases the risk of children's war stress because it encourages attempts to grasp the reasoning behind frightening experiences. This cognitive endeavor is often fruitless and results in unnecessary guilt or feelings of anxiety and depression. Children with PTSD in Gaza also describe constant rumbling of tanks, shooting, and helicopter activity as major sleep disturbances. This reporting of detailed trauma recalls accounts of PTSD in Bosnian adolescents exposed to heavy mortar shelling.
When the war in Gaza began, one of the health outcomes that was predicted was on Gaza's children. The prediction was based on findings from analogous settings in the region, and it centered on the subjective state of their mental health. All children are believed to be at risk in any war environment, but the nature of war can change greatly for different communities and groups of children. The war in Gaza was expected to be peculiarly unforgiving for the young. The setting in which Gazan children experience their war is a key determinant of its immediate and long-term effect. The use of artillery, rockets, and helicopter gunships in a highly urbanized environment imposes psychological threats on children and their families.
In 2005, The Lancet published a series on the health of Palestinians. This series reported that "Israeli military attacks in the Gaza Strip have caused loss of life, injury, and mental distress. Children have been killed, and those who have witnessed killings or have been injured themselves have significant psychiatric morbidity." For the purpose of this paper, the emotional issues will be the primary focus