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.


15 killed in Darfur camp as battle for last army-held city intensifies

Updated 10 April 2025
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15 killed in Darfur camp as battle for last army-held city intensifies

  • Earlier in the day, the paramilitary Rapid Support Forces (RSF) announced they had captured Um Kadadah, a key town on the road to El-Fasher

KHARTOUM: Shelling by Sudanese paramilitaries killed at least 15 civilians in a Darfur displaced persons’ camp Thursday, a medical source told AFP, as fighting for the only part of the region still under regular army control intensified.
Earlier in the day, the paramilitary Rapid Support Forces (RSF) announced they had captured Um Kadadah, a key town on the road to El-Fasher, the last city in Darfur still in the hands of their regular army foes.
“The Abu Shouk camp was shelled by the RSF with 120mm and 82mm cannons fired inside the camp and the Nifasha market, killing at least 15 people and wounding 25,” the camp’s volunteer emergency department said in a statement.
The densely populated camps for the displaced around the besieged city of El-Fasher have suffered heavily during nearly two years of fighting between Sudan’s warring generals.
The Zamzam camp was the first part of Sudan where famine was declared.
The RSF has stepped up its efforts to complete its conquest of Darfur since losing control of the capital Khartoum last month.
On Thursday, it said it had captured Um Kadadah.
“Our forces took full control of the strategic town of Um Kadadah,” an RSF spokesman said in a statement, adding that hundreds of members of its garrison had been killed.
There was no immediate comment from the regular army.
The paramilitaries’ advance came after their shelling of besieged El-Fasher killed 12 people on Wednesday, the army and activists said.
The conflict in Sudan has killed tens of thousands of people and uprooted more than 12 million since a struggle for power between rival generals erupted into full-blown war in April 2023.
Famine has been declared in parts of the country, including displacement camps around El-Fasher, and is likely to spread, according to a UN-backed assessment.
On Wednesday the United Nations humanitarian office OCHA said conditions in Darfur are rapidly deteriorating.
“In North Darfur state, more than 4,000 people have been newly displaced in the past week alone due to escalating violence in El-Fasher, as well as in Zamzam displacement camp south of the city and other areas,” OCHA said on its website.
The RSF also controls parts of the south.
The army retook the capital Khartoum in late March. It holds sway in the east and north, leaving Africa’s third-largest country divided in two.


South Sudan replaces foreign minister

Updated 10 April 2025
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South Sudan replaces foreign minister

  • No explanation was given for the sacking of Foreign Minister Ramadan Mohammed, which was announced on the state radio station late on Wednesday

JUBA: South Sudan’s President Salva Kiir has replaced its foreign minister with his deputy, Monday Semaya Kumba, state media reported, following a migration dispute with the United States.

No explanation was given for the sacking of Foreign Minister Ramadan Mohammed, which was announced on the state radio station late on Wednesday.

The move follows a row with Washington over Juba’s refusal to admit a Congolese man deported from the US, which led to the Trump administration threatening to revoke all US visas held by South Sudanese citizens.

South Sudan yielded to Washington’s demands on Tuesday and allowed the man to enter the country.

Separately, a faction of South Sudan’s main opposition party said on Wednesday it had replaced its chairman, First Vice President Riek Machar, with an interim leader, Peacebuilding Minister Stephen Par Kuol, until Machar was released from house arrest.

Analysts said the move, which other party members criticized, could allow Kiir to sack longstanding rival Machar and consolidate his power over the government by appointing Kuol.

“President Kiir (would) want people who would agree with him ... so that now the government’s legitimacy will be created,” said Kuol Abraham Nyuon, professor of political science at the University of Juba.

Machar, who has served in a power-sharing administration with Kiir since a 2018 peace deal ended a civil war between fighters loyal to the two men, was accused of trying to stir up rebellion and detained at his home last month.

Machar’s party denies government accusations that it backs the White Army. 

This ethnic militia clashed with the army in the northeastern town of Nasir last month, triggering the latest political crisis.

African Union mediators arrived in Juba last week to try to rescue the peace deal but did not appear to have made any immediate progress.

On Thursday, embassies based in Juba, including France, Germany, Netherlands, Norway, the UK, US, and the EU, reiterated their call for the immediate release of all political detainees.

“South Sudan’s leaders must meet their obligations and demonstrate that their priority is peace,” they said in a joint statement.

The SPLM-IO said Machar’s detention had effectively voided the agreement that ended the five-year civil war in which hundreds of thousands of people were killed. The party later said they were committed to upholding the deal.

The SPLM-IO’s military wing remained loyal to Machar and was “not part and parcel of the betrayers in Juba,” its spokesperson, Lam Paul Gabriel, said in a statement on Wednesday.


UN food agency warns that tens of thousands could die during third year of war in Sudan

Updated 10 April 2025
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UN food agency warns that tens of thousands could die during third year of war in Sudan

  • Shaun Hughes of the World Food Programme says 10 areas of the country are affected by famine and it could spread to another 17
  • His agency faces a $650m shortfall in its funding needs for Sudan over the next 6 months alone

LONDON: Tens of thousands of people will die in Sudan if the country’s civil war continues for another year, with the UN facing a vast food-aid funding gap and unable to reach those most vulnerable to famine, a senior official warned on Thursday.

The conflict, which began two years ago, has caused what is, “by any metric,” the largest humanitarian crisis in the world, Shaun Hughes, the World Food Programme’s emergency coordinator for the Sudan crisis, told a UN briefing.

He said famine had spread to 10 areas in the Darfur and Kordofan regions, and threatens to engulf another 17. Unless the WFP can bridge a $650 million gap in funding for its operations over the next six months, which amounts to an 80 percent shortfall, and gain better access on the ground to those in need, he said the crisis will continue to spiral out of control.

“This war is having devastating consequences for the people of Sudan and the entire region,” Hughes said during a video call.

“Tens of thousands more people will die in Sudan during a third year of war unless WFP and other humanitarian agencies have the access and the resources to reach those in need.”

The civil war began on April 15, 2023, amid a power struggle between the Sudanese army and the leader of a powerful rival militia called the Rapid Support Forces. The fighting has killed thousands of people and forced 12 million to flee their homes.

The army finally regained control of all of Khartoum last month, having been driven out of the capital at the start of the conflict. But the RSF continues to control vast areas in western and southern Sudan, including much of Darfur region.

Fighting has raged around the city of El-Fasher in Darfur, just south of which is located the Zamzam displacement camp that hosts 400,000 people. Famine was first reported in the camp in August last year and people continue to die from starvation and malnutrition there, Hughes said.

“It’s obviously a horrific situation,” he added. “El-Fasher, Zamzam and other camps have been at the center of famine and the epicenter of conflict in the Darfurs for several months now, and under an effective siege on a daily basis.

“People are unable to access services, and humanitarian agencies have, essentially, had to withdraw from the camp.”

He said the last delivery of food aid was in October but the WFP had managed to digitally transfer cash aid to help residents of the camp buy food wherever they can.

But unless aid efforts can be reestablished on the ground in Sudan’s worst-effected areas, Hughes fears the famine could spread, with nearly half of the country’s 50 million people facing the prospect of extreme hunger.

“We need to be able to quickly move humanitarian assistance to where it is needed, including through front lines, across borders within contested areas, and without lengthy bureaucratic processes,” he said.

The WFP has managed to increase the number of people it is reaching to 3 million per month, he added, but hopes to increase the figure to 7 million in the coming months. The focus will be on those areas already suffering from famine or most at risk of falling into it, Hughes said.

Many aid operations in Sudan have been affected by the US government’s slashing of foreign aid budgets since President Donald Trump took office, but Hughes said funding for his agency’s work in the country had not been affected by this.

Meanwhile, the International Committee of the Red Cross on Thursday released a report detailing the “catastrophic humanitarian situation” in Sudan.

It said attacks on hospitals and other civilian infrastructure have severely compromised access to essential services.


Migrant killed in clash at makeshift camp in Tunisia

Updated 10 April 2025
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Migrant killed in clash at makeshift camp in Tunisia

Tunis: A man from Guinea died after migrants clashed at a makeshift camp in northern Tunisia, a parliamentarian who visited the site and the National Guard said on Thursday.

Tarak Mahdi, the MP for Sfax, around 30 km from camps set up in olive groves, said the violence began on Tuesday and that “dozens were wounded” by “machetes and knives.”

Mahdi said the violence erupted between two groups, one from Guinea and the other from the Ivory Coast, after a Champions League football match.

National Guard spokesman Houcem Eddine Jebabli said the dead man had been hit in the head by a stone and that six people have been arrested.

The clashes followed a significant security sweep last week to clear olive groves around El Amra, a town south of Tunis, where thousands of migrants from sub-Saharan Africa had set up home a few kilometers from the coast.

Tensions between residents and migrants have been rising in Tunisia.

Tempers flared in 2023 after President Kais Saied said that “hordes of sub-Saharan migrants” threatened to change the North African country’s demographics.

On March 25, Saied called on the International Organization for Migration to accelerate voluntary returns for irregular migrants to their home countries.

Tunisia has, in recent years, become a key departure point for migrants making the perilous Mediterranean Sea crossing in hopes of reaching Europe.

People staged two protest rallies on Wednesday against what they say is the authoritarian rule of President Kais Saied and demanded the release of political prisoners, while six detained opposition figures held a hunger strike.

The rallies highlight the opposition’s growing concerns about what it sees as Saied’s muzzling of dissent and efforts to establish one-man rule, accusations he denies.


Amputees in Gaza face life in war zone with little hope

Updated 10 April 2025
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Amputees in Gaza face life in war zone with little hope

  • Prosthetics and other aid hard to get into blockaded Palestinian territory

CAIRO/GAZA: Farah Abu Qainas hoped to become a teacher, but an Israeli airstrike last year injured her so severely she lost her left leg, throwing all her plans into doubt and adding the 21-year-old to a list of thousands of new amputees in devastated Gaza.

Still living in a temporary shelter, Abu Qainas attends physiotherapy sessions at a prosthetics center in the territory where she waits in a wheelchair for an artificial limb that could allow her some freedom again.

“That day, I lost more than just my leg. My dreams vanished,” she said. 

“I longed to attend university and teach children. But this injury has stolen that future.”

The war began on Oct. 7, 2023, when militants carried out a cross-border attack on Israeli communities.

Israel’s military campaign has since killed more than 50,000 Palestinians in Gaza, local health authorities say, and left most of the tiny, crowded coastal territory in ruins and nearly all its people homeless.

Many thousands more have suffered injuries that will change their lives for decades to come. 

However, amid a conflict that has left the medical system barely able to function, estimates for how many Palestinians have lost limbs vary.

“Across Gaza, it is estimated that 4,500 new amputees require prosthetics, in addition to the 2,000 existing cases requiring maintenance and follow-up care,” the UN humanitarian agency OCHA reported last month.

Ahmed Mousa, who runs the physical rehabilitation program in Gaza for the International Committee of the Red Cross, said at least 3,000 people had been registered in their program, of whom 1,800 have amputations.

Many thousands more Palestinians have suffered spinal injuries or lost their sight or hearing, according to OCHA and the ICRC.

The large number of injuries has slowed and complicated efforts to provide treatment. 

ICRC officials said that getting artificial limbs into the Gaza Strip has been challenging.

“Accessing proper prosthetics or mobility aids is increasingly challenging in Gaza right now, and unfortunately, there is no clear timeline for many,” said Mousa.

Israel suspended all humanitarian aid to Gaza after the collapse of a two-month-old ceasefire last month.

Abu Qainas, who attends Mousa’s therapy program, said she does not know when she might get an artificial leg or treatment abroad. 

“They told me to wait, but I don’t know if it’s going to happen anytime soon,” she said.

Israel’s military has said its bombardment of Gaza is necessary to crush Hamas, which it accuses of hiding among the general Palestinian population. Hamas denies this. Israel says it tries to reduce harm to civilians.

Children have not escaped the carnage.

An April study by the Palestinian Bureau of Statistics said at least 7,000 children have been injured since October 2023, with hundreds losing limbs, sight, or hearing.

She said seven-year-old Shaza Hamdan had wanted to learn to ride a bike.

“My father asked (me) to join him for a walk, before shells began falling on us like rain. One hit my leg and cut it off, and another hit my father’s arm,” she said.