Mental health in Middle East conflict zones: How are people dealing with psychological fallout?

Zedan, a patient suffering from post-traumatic stress disorder (PTSD), is in medical consultation at the mental health centre of the Bajet Kandala camp for displaced Yazidis near Dohuk, northwest of the Iraqi capital. (File/AFP)
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Updated 15 July 2021
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Mental health in Middle East conflict zones: How are people dealing with psychological fallout?

  • Studies show high incidences of depression in Tunisia, Palestine, Jordan, Lebanon and Iraq
  • Almost 1 billion people worldwide live with a mental illness

ABU DHABI: Almost all 10 to 19-year-olds in the Gaza Strip are exhibiting symptoms of post-traumatic stress disorder (PTSD) due to their exposure to security threats and violence, according to clinical psychologist Dr. Thoraiya Kanafani.

And a 2020 Arab youth survey found that nearly a third of all young people living in 15 countries in the region know at least one person suffering some form of mental illness.




Palestinian children carry household items they recovered from the rubble of a building, destroyed by Israeli strikes, in Beit Hanun in the northern Gaza Strip on May 21, 2021. (File/AFP)

Kanafani told Arab News that studies show high incidences of depression in Tunisia, Palestine, Jordan, Lebanon and Iraq.

In the Gaza Strip, 97.5 percent of 10 to 19-year-olds have PTSD, a mental health condition that results from experiencing or witnessing a traumatic event.

The Palestinian crisis and other major events in the Middle East have caused an increase in mental illness.

Almost 1 billion people worldwide live with a mental illness, but more than 75 percent of those with psychological disorders fail to receive treatment, according to a 2021 World Bank report.




A Syrian man suffering from mental issues looks outside a window at al-Waalan special needs centre in northern town of Aldana near Syria's second largest city of Aleppo on February 14, 2019. (File/AFP)

“Every year, close to 3 million people die due to substance abuse. Every 40 seconds, a person dies by suicide. About 50 percent of mental health disorders start by the age of 14,” the organization said.

The World Health Organization (WHO) said in a 2019 report that one person in five (20 percent) living in a conflict zone is estimated to have depression, anxiety, PTSD, bipolar disorder or schizophrenia.

“Among people who have experienced war or other conflicts in the previous 10 years, one in 11 (9 percent) will have a moderate or severe mental disorder,” the WHO added.

In May, 11 Palestinian children, who were receiving trauma therapy, were killed in their homes by Israeli airstrikes.

Asked if seeking treatment while experiencing continued attacks in a conflict zone is still effective, Kanafani said: “Studies suggest that some type of intervention and treatment for children in war is effective to an extent, especially those that help children build coping skills.”




Palestinian children take part in a four-week summer activities programme organised by the United Nations Relief and Works Agency for Palestine Refugees (UNRWA) which include sports, games, music and crafts, in Rafah in the southern Gaza Strip, on July 08, 2021. (File/AFP)

She added that children living under continued attacks develop a constant fear of violence and suffer from long-lasting anxieties as well as physiological responses to stress. It is beneficial to support their existing coping strategies and educate them on other tools that may help, she said.

In Yemen, about one in five people suffers from mental illness due to the long-running conflict in the country, according to a 2017 study by the Family Counselling and Development Foundation.

“Mental health care remains scarce in Yemen. Mental illness is stigmatized, and the proportion of psychiatrists per population is insufficient. Some of the few existing mental health services have even closed as a result of the pandemic,” ReliefWeb, a humanitarian information service provided by the United Nations Office for the Coordination of Humanitarian Affairs, said in a statement.




People displaced by conflict receive food aid in the Khokha district of Yemen's war-ravaged western province of Hodeida, on April 20, 2021. (File/AFP)

Yemen has the added difficulties of damaged infrastructure as a result of the civil war, Dr. Kirin Hilliar, assistant professor of psychology at Heriot-Watt University Dubai, told Arab News.

“Reports suggest that only 51 percent of all healthcare facilities in the country are fully functional,” she added. Hilliar further said there are limited mental health services — a stigma that is also evident in many countries in the region. 

The Syrian crisis has led to about 207,000 civilian casualties since the beginning of the conflict in 2011. About 25,000 of these were children, according to a 2021 report by Statista.




Syrian patients sit in a yard at a mental health clinic -- the sole such facility in the rebel-held north of Syria -- in the town of Azaz, near the border with Turkey, on July 6, 2017. (File/AFP)

Another 2017 report by the International Review of the Red Cross said over 2.4 million homes have been damaged, 67 percent of the industrial capacity has been destroyed, 45 percent of health centers are no longer functioning, and 30 percent of educational institutions have been demolished.

This has plunged 89 percent of Syrians into extreme poverty. This critical situation in the country has left those living through the crisis at high risk of psychological damage.

“In 2018, it was reported that only 80 psychiatrists were working in Syrian territories, and psychologists were not trained or licensed in the country. However, the WHO and other NGOs have helped in providing training to health professionals, so they feel more capable to provide psychiatric and psychological services to those in their communities,” Hilliar said.

Wars and extremist attacks in the region have affected not only those witnessing them, but also social media users who are being exposed to negative news every day.




 In this file illustration photo taken on April 7, 2021, a smart phone screen displays the logo of Facebook on a Facebook website background, in Arlington, Virginia. (File/AFP)

Reports of killings, torture and bombings are taking over social media. Users might not even notice how much negative information they consume daily and the effects of that on their mental health.

Referring to Palestine, Kanafani said social media has been an important tool for spreading awareness about the truth of what is happening there.

“The negative consequence for many individuals who are viewing all the content is survivor’s guilt as well as emotional fatigue. Viewers who do not live in Palestine are experiencing strong feelings of helplessness, injustice and frustration. The consistent nature of these feelings may lead to emotional burnout,” she added.

Hilliar said that it can be hard for many people to read and watch details of negative events happening around the world. This type of content can make people feel helpless after witnessing the suffering of others, she added.




A woman uses her mobile phone to check Facebook and other mobile apps in Yangon on February 4,2021. (File/AFP)

A 2020 report by Cleveland Clinic, a US academic medical center, said that social media “doom scrolling” can cause negative thoughts and mindset which can affect a person’s mental health.

“Consuming negative news has been linked in research with greater fear, stress, anxiety and sadness,” the report said.

Kanafani said that the Middle East lacks mental health funding, resources and workforce, while stigmatization and lack of proper awareness also leaves people reluctant to seek treatment.

The highest number of psychiatrists in the region, according to Kanafani, are found in Qatar, Bahrain, Kuwait and Lebanon, with Saudi Arabia and the UAE following with less than five psychiatrists per 100,000 population.

“Positively, we are certainly seeing an increase in the provision of mental health facilities in the Middle East, though the rate of growth varies widely across different countries,” Hilliard said.

She added that the UAE, for example, is seeing an increase in mental health services.


UK signs deals with Iraq aimed at curbing irregular immigration

Britain’s Home Secretary Yvette Cooper and Iraq’s Minister of Interior Abdul Amir Al-Shimmari, front right, shake hands.
Updated 26 min 51 sec ago
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UK signs deals with Iraq aimed at curbing irregular immigration

  • “Organized criminals operate across borders, so law enforcement needs to operate across borders too,” Cooper said
  • Pacts include a joint UK-Iraq “statement on border security” committing both countries to work more closely in tackling people smuggling and border security

LONDON: The UK government said Thursday it had struck a “world-first security agreement” and other cooperation deals with Iraq to target people-smuggling gangs and strengthen its border security.
Interior minister Yvette Cooper said the pacts sent “a clear signal to the criminal smuggling gangs that we are determined to work across the globe to go after them.”
They follow a visit this week by Cooper to Iraq and its autonomous Kurdistan region, when she met federal and regional government officials.
“Organized criminals operate across borders, so law enforcement needs to operate across borders too,” she said in a statement.
Cooper noted people-smuggling gangs’ operations “stretch back through Northern France, Germany, across Europe, to the Kurdistan Region of Iraq and beyond.”
“The increasingly global nature of organized immigration crime means that even countries that are thousands of miles apart must work more closely together,” she added.
The pacts include a joint UK-Iraq “statement on border security” committing both countries to work more closely in tackling people smuggling and border security.
The two countries signed another statement on migration to speed up the returns of people who have no right to be in the UK and help reintegration programs to support returnees.
As part of the agreements, London will also provide up to £300,000 ($380,000) for Iraqi law enforcement training in border security.
It will be focused on countering organized immigration crime and narcotics, and increasing the capacity and capability of Iraq’s border enforcement.
The UK has pledged another £200,000 to support projects in the Kurdistan region, “which will enhance capabilities concerning irregular migration and border security, including a new taskforce.”
Other measures within the agreements include a communications campaign “to counter the misinformation and myths that people-smugglers post online.”
Cooper’s interior ministry said collectively they were “the biggest operational package to tackle serious organized crime and people smuggling between the two countries ever.”


Some Lebanon hospitals look set to restart quickly after ceasefire, WHO says

Updated 28 November 2024
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Some Lebanon hospitals look set to restart quickly after ceasefire, WHO says

  • “Probably some of our hospitals will take some time,” Abdinasir Abubakar, WHO representative in Lebanon said

GENEVA: A World Health Organization official voiced optimism on Thursday that some of the health facilities in Lebanon shuttered during more than a year of conflict would soon be operational again, if the ceasefire holds.
“Probably some of our hospitals will take some time, but some hospitals probably will be able to restart very quickly,” Abdinasir Abubakar, WHO representative in Lebanon, told an online press conference after a damage assessment this week.
“So we are very hopeful,” he added, saying four hospitals in and around Beirut were among those that could restart quickly.


Lebanon says 2 hurt as Israeli troops fire on people returning south after truce with Hezbollah

Updated 28 November 2024
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Lebanon says 2 hurt as Israeli troops fire on people returning south after truce with Hezbollah

  • Lebanon’s state-run National News Agency said two people were wounded by Israeli fire in Markaba, close to the border, without providing further details
  • It said Israel fired artillery in three other locations near the border

BEIRUT: At least two people were wounded by Israeli fire in southern Lebanon on Thursday, according to state media. The Israeli military said it had fired at people trying to return to certain areas on the second day of a ceasefire with the Hezbollah militant group.
The agreement, brokered by the United States and France, includes an initial two-month ceasefire in which Hezbollah militants are to withdraw north of the Litani River and Israeli forces are to return to their side of the border. The buffer zone would be patrolled by Lebanese troops and UN peacekeepers.
Lebanon’s state-run National News Agency said two people were wounded by Israeli fire in Markaba, close to the border, without providing further details. It said Israel fired artillery in three other locations near the border. There were no immediate reports of casualties.
An Associated Press reporter in northern Israel near the border heard Israeli drones buzzing overhead and the sound of artillery strikes from the Lebanese side.
The Israeli military said in a statement that “several suspects were identified arriving with vehicles to a number of areas in southern Lebanon, breaching the conditions of the ceasefire.” It said troops “opened fire toward them” and would “actively enforce violations of the ceasefire agreement.”
Israeli officials have said forces will be withdrawn gradually as it ensures that the agreement is being enforced. Israel has warned people not to return to areas where troops are deployed, and says it reserves the right to strike Hezbollah if it violates the terms of the truce.
A Lebanese military official said Lebanese troops would gradually deploy in the south as Israeli troops withdraw. The official spoke on condition of anonymity because they were not authorized to brief media.
The ceasefire agreement announced late Tuesday ended 14 months of conflict between Israel and Hezbollah that began a day after Hamas’ Oct. 7, 2023 attack out of Gaza, when the Lebanese militant group began firing rockets, drones and missiles in solidarity.
Israel retaliated with airstrikes, and the conflict steadily intensified for nearly a year before boiling over into all-out war in mid-September. The war in Gaza is still raging with no end in sight.
More than 3,760 people were killed by Israeli fire in Lebanon during the conflict, many of them civilians, according to Lebanese health officials. The fighting killed more than 70 people in Israel — over half of them civilians — as well as dozens of Israeli soldiers fighting in southern Lebanon.
Some 1.2 million people were displaced in Lebanon, and thousands began streaming back to their homes on Wednesday despite warnings from the Lebanese military and the Israeli army to stay out of certain areas. Some 50,000 people were displaced on the Israeli side, but few have returned and the communities near the northern border are still largely deserted.
In Menara, an Israeli community on the border with views into Lebanon, around three quarters of homes are damaged, some with collapsed roofs and burnt-out interiors. A few residents could be seen gathering their belongings on Thursday before leaving again.


Algeria facing growing calls to release French-Algerian author Boualem Sansal

Updated 28 November 2024
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Algeria facing growing calls to release French-Algerian author Boualem Sansal

  • “The detention without serious grounds of a writer of French nationality is unacceptable,” France’s Foreign Minister Jean-Noël Barrot said
  • The European Parliament discussed Algeria’s repression of freedom of speech on Wednesday and called for “his immediate and unconditional release”

PARIS: Politicians, writers and activists have called for the release of French-Algerian writer Boualem Sansal, whose arrest in Algeria is seen as the latest instance of the stifling of creative expression in the military-dominated North African country.
The 75-year-old author, who is an outspoken critic of Islamism and the Algerian regime, has not been heard from by friends, family or his French publisher since leaving Paris for Algiers earlier this month. He has not been seen near his home in his small town, Boumerdes, his neighbors told The Associated Press.
“The detention without serious grounds of a writer of French nationality is unacceptable,” France’s Foreign Minister Jean-Noël Barrot said on Wednesday.
He added Sansal’s work “does honor to both his countries and to the values we cherish.”
The European Parliament discussed Algeria’s repression of freedom of speech on Wednesday and called for “his immediate and unconditional release.”
Algerian authorities have not publicly announced charges against Sansal, but the APS state news service said he was arrested at the airport.
Though no longer censored, Sansal’s novels have in the past faced bans in Algeria. A professed admirer of French culture, his writings on Islam’s role in society, authoritarianism, freedom of expression and the civil war that ravaged Algeria throughout the 1990s have won him fans across the ideological spectrum in France, from far-right leader Marine Le Pen to President Emmanuel Macron, who attended his French naturalization ceremony in 2023.
But his work has provoked ire in Algeria, from both authorities and Islamists, who have issued death threats against him in the 1990s and afterward.
Though few garner such international attention, Sansal is among a long list of political prisoners incarcerated in Algeria, where the hopes of a protest movement that led to the ouster of the country’s then-82 year old president have been crushed under President Abdelmadjid Tebboune.
Human rights groups have decried the ongoing repression facing journalists, activists and writers. Amnesty International in September called it a “brutal crackdown on human rights including the rights to freedom of expression, peaceful assembly and association.”
Algerian authorities have in recent months disrupted a book fair in Bejaia and excluded prominent authors from the country’s largest book fair in Algeria has in recent months, including this year’s Goncourt Prize winner Kamel Daoud,
“This tragic news reflects an alarming reality in Algeria, where freedom of expression is no more than a memory in the face of repression, imprisonment and the surveillance of the entire society,” French-Algerian author Kamel Daoud wrote in an editorial signed by more than a dozen authors in Le Point this week.
Sansal has been a polarizing figure in Algeria for holding some pro-Israel views and for likening political Islam to Nazism and totalitarianism in his novels, including “The Oath of the Barbarians” and “2084: The End of the World.”
Despite the controversial subject matter, Sansal had never faced detention. His arrest comes as relations between France and Algeria face newfound strains. France in July backed Morocco’s sovereignty over the disputed Western Sahara, angering Algeria, which has long backed the independence Polisario Front and pushed for a referendum to determine the future of the coastal northwest African territory.
“A regime that thinks it has to stop its writers, whatever they think, is certainly a weak regime,” French-Algerian academic Ali Bensaad wrote in a statement posted on Facebook.


Iranian Revolutionary Guards officer killed in Syria, SNN reports

Updated 28 November 2024
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Iranian Revolutionary Guards officer killed in Syria, SNN reports

DUBAI: Iranian Revolutionary Guards Brig. Gen. Kioumars Pourhashemi was killed in the Syrian province of Aleppo by “terrorists” linked to Israel, Iran’s SNN news agency reported on Thursday without giving further details.
Rebels led by Islamist militant group Hayat Tahrir Al-Sham on Wednesday launched an incursion into a dozen towns and villages in northwest Aleppo province controlled by Syrian President Bashar Assad.