December 11, 2013

OCCUPIED MINDS  © Juan Carlos Tomasi

Occupied minds is a series of stories about MSF patients affected by the Israeli-Palestinian conflict, and being assisted by the mental health teams in Hebron and in East Jerusalem. They are short stories, published periodically, and collected by the MSF teams. Their aim is to reflect the reality of daily life, that of our teams and their patients: lives lived under occupation.


Hussein and Ziad, 15 and 14 years old, are cousins and live in Silwan, a conflictive neighborhood in East Jerusalem, adjacent to the Old City and the revered Al-Aqsa Mosque. Its Palestinian population of more than 30,000 people faces the constant threat of house demolitions, Jewish settlers’ encroachment and a plan from the municipality to convert part of the neighborhood (Al-Bustan) into a national park, ‘King David’s Garden’.

There is no other place to talk to Hussein and Ziad than at Hussein’s house. He can’t go out. Otherwise, there will be more problems. He is under home detention. Hussein and Ziad were arrested, with four other youngsters a couple of years ago, and charged with not minor offences: attempting to stab a settler, throwing Molotov cocktails, and the classic stone-throwing, among others. “You name it, it was a long list,” says Ziad, “taking into account that we did nothing of the sort.”

After their arrest, they were sent to prison. Ziad, for four days. Hussein, for two weeks. When released, Hussein was condemned to a period of six months of home detention. For a while he was forced to live at an aunt’s house. That was, according to his own account, the worst period. He couldn’t go to school or see his friends. “I was just sitting in the house, browsing the internet, watching TV. Nothing else,” says Hussein, a tall boy who nonchalantly keeps a constant eye on his cellphone to check his Facebook for updates. Shy and cocky at the same time, a difficult combination that only teenagers know how to perfect, Hussein explains that now he is back with his parents the situation has improved, and he has been allowed to go back to school. “I’ve missed too many classes and I can’t catch up. I mainly stare at the blackboard. But after all, I don’t want to go to school, I just want to work.” Ziad, shorter and burlier, looks at his cousin and nods, with a “me too, and the sooner the better” expression on his face. Kids playing adults.

According to MSF’s psychologists, many of the children arrested, imprisoned or being kept under home detention end up dropping out of school just, if they’re lucky, to do menial jobs for a very low salary, without any future.

Hussein’s mum sits with the translator and the journalist in their modest living room after serving the customary tea and cool drinks for the visitors. Silent and preoccupied, she smiles vaguely at her son’s remarks and often looks at the picture that dominates the room: her first-born son, Ziad’s brother, is still in prison.

After his release, Hussein has been receiving care from the mental health project that MSF has recently opened up in East Jerusalem. According to the psychologist, he was hyperactive, aggressive and he had flashbacks recalling his detention by the police. The treatment, combined with going back to his parents’ house (where he feels much safer), has meant a definite improvement in his condition. He boasts about school, “Our schoolmates told us yesterday that they missed us a lot, that we are good friends, that we have become better.” Prison, a rite of passage, means instant status upgrade. Asked if the rest of the students see them as heroes, the answer is sharp, immediate: “Not at all, on the contrary, many of our classmates have already gone to prison, nothing new there.” And then he adds: “Prison was not bad. My brother was there, the prisoners took good care of me. It was very crowded, but later they put us in a cell for eight people. We got up at five in the morning for counting and searching. If you were not up and ready they hit you. We did have some classes. Maths and also painting. We only painted about how we love Silwan, how we love Palestine.”

Playing football is their thing. But if asked what object they value the most, both kids do not hesitate for a second and they raise their arms: on their wrists, two thin bracelets, braided threads. “The prisoners made them for us. They gave them to us when we were about to be released. They make them with frayed towels.” Are they afraid of going back to prison? Of facing the judge? “No,” they say, “we didn’t do anything wrong. Besides, here it’s normal.”

MSF have detected a substantial increase in the number of minors treated at their programs in Hebron (half the patients) and in East Jerusalem. Children are direct or indirect witnesses of the conflict: family members being detained or even they themselves (from twelve years old they can go to prison and from sixteen they are treated as adults); settler confrontations; movement restrictions by the army, and internal fighting amongst the Palestinian groups. It all takes its toll. Many children suffer from isolation, night terrors, being constantly on alert and aggressive behavior. They may wet their beds or their language or behavior may change. The constant tension can also cause physical problems like fatigue, aches and pains, sleeping difficulties and loss of appetite. These natural reactions may feel overwhelming to the children and their families and, if not treated in time, may have an irreversible impact on the child’s development.


In the winter of 2013 during a freezing night, Ibrahim's house was subjected to a very violent raid by Israeli soldiers. “There were many, many soldiers surrounding the house. They broke the windows and the main door. They entered in a very savage way, they didn't allow anyone to talk, and they didn't care if there were old people or children. We were all forced to get out in the cold”, says Ibrahim. The family lives in a small community, of about 400 people, north of Hebron.

The soldiers arrested Youssef, Ibrahim son's (26 years old), tied his hands and blindfolded him. And they took him away. During the arrest, according to Youssef, he was brutally kicked in his testicles, severely beaten, and humiliated and mocked by the soldiers. But that was only the beginning. He asked to be seen by a doctor who gave him a couple of painkillers and refused to further examine him. In prison he was isolated, kept in a tiny room without ventilation where he couldn't even stretch his legs. Youssef explained to the MSF teams that for 59 days he was subjected to continuous interrogations, with only a one-hour break each day. He was repeatedly beaten up and afterwards moved to another cell with a bird (slang for a collaborator) who also tried to get information from him. A friend of his, according to Youssef, died while being tortured in prison. He was finally transferred to another prison where he spent seven months.

MSF teams worked with the family immediately after the raid and Youssef's arrest. Three weeks after his imprisonment, three members of the family were in need of psychological help (Ibrahim, Youssef's mother and his sister) while Ibrahim also needed to be referred to the hospital due to respiratory problems. Since then Ibrahim stutters, something that never happened to him before the raid and the detention of his son. Incursions in the area by Israeli forces are conducted regularly causing the family to live in fear and constant worry.

After Youssef's release, seven months later, MSF was asked by the family to visit him. The detention had dire consequences for him and his family. He couldn't work anymore, as he was still under medical care, which caused financial strain on the whole family as he was a plumber and the family breadwinner. He couldn't sleep and he didn't trust people anymore, so he had few friends left. He still owed money that he had to borrow while in prison.

He started getting help from a psychologist, a doctor and a psychosocial worker. He managed to attend regular therapy sessions (and still does), even if having to travel for more than one hour through different checkpoints. While he is recovering from his injuries at the local hospital he is getting more training as a plumber. He is now starting to see some hope and thinks that soon he will finally be able to move on with his life despite all the difficulties that he is facing.


Yaqub is 17 years old. He lives with his family in Al Fawwar refugee camp, a camp that was established in 1950 for refugees after what is known to Palestinians as Al Nakba (the catastrophe) in 1948. The refugee camp now houses 7,000 people and is known as a hotspot for clashes with the Israeli forces. At the beginning there were 14,000 people, but half of them moved to Jordan. They come from the Palestinian villages of Iraq Al-Manshiyyah, Beit Jibreen, Tal As-Safi, Samu’el, Falujah, Deir Adubbn, Aker, Al-Masmiyyah,Deir Nakhass, Beit Mahseer, Ajoor and Qbeibah.

Next to the camp lies an Israeli military base, just two kilometers away. Its watchtower is a reminder to all who live in the camp that it's there, though it's difficult to forget, as the population of the camp is subjected to flying checkpoints almost constantly. Beside the base and only 4 kilometers away, is the Israeli settlement of Hagai, which occupies 400 km2.

But these were none of the concerns of Yaqub on 9 January four years ago. He was actually quite relieved as he had just finished an Arabic exam and he was getting ready to play football with his colleagues. Like most of his friends he was crazy about football. But there were four or five soldiers near the school and some children started throwing stones at them. The soldiers responded by shooting. With live ammunition.

Yaqub doesn't remember much as he lost consciousness. He woke up at the hospital. The bullet went through his abdomen, impacted his back and affected the spinal cord. He wouldn’t be able to walk anymore, although nobody told him. Not then, because the doctors explained to him that he was critical and needed to be referred for further treatment to Jordan, where he spent 75 days.

It was his mum who had to break the bad news to Yaqub, as soon as he was home. He would need to use a wheelchair from now on. Yaqub couldn't stomach it, wouldn't recognize it. His anger was then directed to his mum, he beat her, threw tantrums, breaking things around him in the house. He wasn't sleeping; he shouted and cried a lot, many times, for many days.

In June, Yaqub's desperate mother asked MSF for advice. “I remember the psychologist and the translator that came to see me. They helped me with the anger,” he now says. He was also placed in the care of an MSF doctor.

Yaqub spends plenty of time at his uncle's garage, watching how his uncle and cousins mend cars. And since MSF finished with his treatment, he has found a new occupation, a plan for his future. He likes to take care of birds. He has two injured birds in a cage, and he spends much of his time with them. “I sometimes feel that I am like the birds in the cage, not able to fly. But then, I hope that I will soon have an electric wheelchair that will allow me to fly, to fly without wings all over OPT”


Adel was on hunger strike for 105 days in protest for being kept in prison without an official sentence and therefore not knowing when was he going to be allowed out. After six months of prison, he was again subjected to a new six month period in jail. But Adel has been in and out of Israeli prisons for ten years and as a result he has accumulated many health problems. And his family has also paid a price.

An MSF psychologist visited the family after he started the hunger strike. Both his wife, Rania (32 years old) and his mother Yousra (62), were sad and depressed, and had sleeping problems. Adel and Rania have four children, aged from 6 months to 13 years old. All but one have been born with their father in prison. One of their children has a medical condition which has been a cause of even greater distress in the family. Rania's pregnancy was even used as a way to put pressure on her husband. “They came and detained me, asking many questions. I was pregnant and I tried to be strong for the sake of my children,” she remembers. Sometimes there came a rumour that Adel was agonizing, or dead. “That was horrible for everybody, the worst, but especially for the children,” says Rania. “And my mother-in-law, Yousra, who is very strong, started to experience all-over body spasms, and she couldn't stop crying, she didn't go out anymore, she didn't talk to anybody anymore. We weren't sleeping at all.”

MSF teams started working with the two women, getting them to express their feelings and fears and also to make sure that the news and rumours about Adel's health were coming from the correct sources. The psychologists also gave them tools to talk to the children and help them cope with their father's situation.

While they started to see some improvement in their sleeping patterns and were managing the stress a bit better, this improvement varied mainly because of the news of Adel's health (quickly deteriorating) and also due to external factors such as new incursions and detentions in the area. One of the worst episodes was a raid on the house of one of Adel's brothers. Pictures of the children sleeping were taken by the soldiers. When the news reached Rasnia's family, again the children were the most affected, filled with feelings of threat and anguish.

So it was only after Adel decided to stop his hunger strike (he reached an agreement and he was administratively sentenced) that an improvement was evident in each member of the family, who started to see some hope in the future, establishing old relationships with neighbours and family and getting ready for Adel's release.

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