A child in Gaza

Jun 26, 2024
Injured Palestinians, Including children are brought to Al-Aqsa Martyrs Hospital in Dair El-Balah Injured Palestinians, Includ Children are brought to Al-Aqsa Martyrs Hospital in Dair El-Balah for treatment following the Israeli attacks in Khan Yunis, Gaza on March 02, 2024. Photo by Omar Ashtawy apaimages Dair EL-Balah Gaza Strip Palestinian Territory 020324_Dair_EL-Balah_OSH_005 Copyright: Alamy/xapaimagesxOmarxAshtawyxxapaimagesx

A silent consequence of the horrifying hostilities taking place in Gaza is the long-term behavioural impairments for the children who, the United Nations estimate, make up 40% of the casualties.

The Save the Children organisation estimates, as of June 2024, that 14,000 have been killed and 21,000 are missing, disappeared, detained or buried in the rubble or in mass graves. There are 17,000 believe to be unaccompanied or separated effectively orphaned with no adult care in a war zone.

It is very likely these horrific numbers are an under estimation. The constant bombardment, military invasions, the lack of shelter, water and food describes the perfect conditions for inflicting early childhood post traumatic-stress disorder (PTSD) on these children. In fact, a 2022 study, reported in the Lancet showed that 53.5% of children in this region had PTSD before this conflict, this figure would be approaching 100%!

These are the tragic results of Israel’s policy towards their Palestine neighbours and there are real consequences for this strategy.

To kill a child is to exterminate a miracle, a single life, one that is unique amongst the 8.1 billion individuals alive today. Recently I sat with my mother at the moment she passed away. In an instant life left her, every physical thing about her was still there but she was immediately different, that life force was gone and there was nothing I could do could get it back. My mother had lived a long, satisfying life and we had much to remember. Each one of these 14,550 children had the right to experience the world, to contribute with a potential that has been terminated.

Israel has to live with the reaction by the families of these dead children. Don’t they understand what drives the members of Hamas, so many of what they call terrorists are adults understandably determined to get revenge; to the families of the children Hamas are freedom-fighters.

There is another hidden, long-term consequence of this assault on these children. They are constantly assaulted resulting in highly elevated levels of stress. They also live in poverty without the basics like food and water. They don’t go to school, safely play with friends, there are no schools and many of their friends are dead. The consequences of this combination of abuse and neglect is well known at an individualised level. The illustration below is from Bruce Perry’s work on childhood abuse. This compares an MRI of a child in Nicolae Ceausescu’s Romanian Orphanages with that of a normal child, the damage is evident.

Image: [Three Year Old] Child supplied
The structural changes to the brain are:

  • Broad scale reduction in the neural density caused by the lack of appropriate stimulation at the pertinent times, the persistent presence of cortisol which erode the tissue and the corresponding, excess pruning.
  • The amygdala is increased in size which heightens fear responses making the individual hyper-aroused and emotionally over-active.
  • The hippocampus is critical for learning and memory and is reported to have a 12% size reduction. This causes difficulties in memory formation and retrieval
  • The prefrontal lobes are responsible for decision-making, impulse control, and executive functioning. They are 20% smaller and have lesions on the surface. This leads to problems with self-regulation, attention, and problem-solving.

There are other functional changes; the hypothalamic-pituitary-adrenal (HPA) axis become deregulated resulting in an overactive stress response which adds to the impact of the enlarged amygdala. The suitable levels of neurotransmitters like serotonin and dopamine, which play roles in mood regulation and reward processing change making the regular responses to situations dysfunctional, that they are inappropriate. These chemical changes lead to mental health disorders such as depression and anxiety.

Victims will be permanently plagued by intrusive thoughts, unwanted recall of events or the feelings surrounding those events. These are uncontrollable and their presence makes the individual feel like they are back in the war zone again. The inability to stop these thoughts can leave them feeling guilty and/or ashamed that they can’t even stop the abuse in their mind and if it becomes too obsessive suicide becomes a big risk.

As far as future interactions with the outside world are concerned, these changes decrease their ability to trust, particularly those who resemble their early abusers. They also become hypervigilant within their immediate environment, constantly looking for threats. Because of this exaggerated focus on protecting themselves they can misinterpret genuine efforts to engage in trusting relationships.

This hypervigilance effects their interpretation of the emotional content of other’s communications. They are super sensitive to facial expressions, body language and tone of voice; the non-verbal cues in any conversation. Unfortunately, they read too much into situations and become highly suspicious of others.

These cognitive alterations to the brain, imposed through the torturous living conditions experienced by the children, significantly impact their future behaviour. This early abuse can disrupt the development of secure attachment patterns, leading to difficulties in forming and maintaining healthy relationships and social inclusion. However, they become attracted to those who have the same temperament, they form organisations that reflect a common goal, revenge.

The changes in the frontal lobe are closely related to impulse control and decision-making. The damage to this area can lead to increased risk-taking behaviours and difficulties remaining calm when they feel threatened. When they fear they might be attacked, they ‘get in first’!

Israel’s stated goal for this current invasion is the elimination of Hamas and other militant groups that threaten the current configuration of their expanded borders. They want to ensure the safety and security of their citizens living near the ever-expanding Gaza border. This endeavour is destined to fail in the long-term. Their acts of terror are creating a population that will be impossible to engage in any honest dialogue, will be willing to take high level risks, a population of individuals whose sense of hopelessness makes them primed for terrorist activities with little care of their own life.

Abuse of any child is evil and the children of Gaza are being raised in an abusive situation. When a country deliberately goes to war with another, children are abused. Those who order the invasion, those who facilitate it, those who drop the bombs, shoot the rifles, those who support these actions and even those who are indifferent must share that malevolence.


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