Page last updated at 10:33 GMT, Wednesday, 7 January 2009

Children hit hard as Gaza toll rises

A Palestinian man carries an injured child in Gaza
Injuries could have a lasting effect on Palestinian children, doctors say

By Heather Sharp
BBC News, Jerusalem

The pictures keep coming. The blood-spattered young faces, the glazed eyes, the limp small bodies.

The latest figures from Palestinian health officials say 205 children are among some 600 people who have died in the Gaza war. In the chaos, there are no statistics for how many are among the at least 2,900 injured.

As medics work flat out to save as many young lives as they can, child psychiatrists in both Gaza and southern Israel fear some children will never recover from the psychological damage done as the bombs, shells and rockets fall.

Dr Iyad Sarraj, director of the Gaza Community Mental Health Programme, says "so many people" are telephoning his workers - although the organisation's headquarters lies abandoned with shattered windows and broken furniture after it was damaged in an Israeli air strike.

"It's really terrible for children here now," he says. "I have been through so many of these kinds of things and this is the worst."

Long-term impact

He talks of a boy he treated five years ago. Grappling in the dark after his house was hit in an air strike on a Hamas militant next door, he felt something wet.

"He realised it was the flesh of his sister who was blown into pieces. He was in such a state. He couldn't eat or smell meat for three years after that. I am sure he will suffer some kind of long-term psychological impact," Dr Sarraj says.

"This sort of thing must be happening right now as we speak."

He can barely leave his home for fear of the fighting, and has been unable to visit the hospitals where he has watched television pictures of traumatised, badly injured children arriving.

"These children need help more than anyone. They look frightened, horrified, bewildered. They need a lot of attention but they can't receive it because their families are so terrified," he says.

WARNING: This image contains graphic content

But the effects of the war are plain even among his own family.

His stepdaughter Nour Kharma, 14, barely spoke in the days immediately after she heard her school friend and basketball partner, Christina, 15 had been killed in an Israeli airstrike.

"She was in such turmoil, in a depressive mood, in really bad shape. She was always in tears," he says. "In the end I asked her to write about it."

"[When I heard,] I threw the phone and started crying…" Nour reads, in crisp English. "Her parents did the best they can do. But it wasn't enough, so the result was dying. What if my parents can't protect me…? Will I die too?"

She weeps quietly on the other end of the phone. "I feel very sad. I keep remembering her. I really miss her," she says simply.

Children in Gaza venture outside to play during the three hour ceasefire

Salwi Tibi of Save the Children, who lives in the north of Gaza City close to some of the most intense ground clashes, has also been monitoring the impact on children.

She talks of a two-and-a-half year old boy from Beit Lahiya, scene of heavy fighting, who was taken lifeless to the local hospital.

"He was not injured, his health was OK. The doctors told me the child died because of the shock from the sound of the shelling," she said.

And she thinks her own daughter, Malak, 7, is typical of many children affected by the war.

Palestinian children have lived with a fear of sirens for months
Palestinian children have lived with a fear of sirens for months
She began wetting her bed on the first day of the airstrikes.

"Wherever I go she follows me - even to the bathroom. As soon as she hears the shelling she puts her fingers in her ears, closes her eyes and shouts "stop them, stop them," says Ms Tibi.

"She can't sleep alone, she wants to sleep close to me and she puts her arms around my neck."

"If I had a computer I would let her listen to music and play games so she would forget, but there is no electricity, everything is silent, so all she can hear is shelling and bombing."

It is exactly these symptoms that are also prevalent among the children of Sderot.

The Israeli town close to Gaza has been hit by many of the 10,000 Palestinian rockets fired into southern Israel over the past eight years.

Four people have been killed and 100 people injured in the region since the start of the air campaign. No figures are available for the number of children, although one victim was a baby injured in the face.

Dalia Yosef, a psychotherapist and Director of the Resilience Centre, says her workload has increased with the rocket fire in the run-up to and during the war.

Any child under eight in the town has only known a life with just 15 seconds to reach shelter whenever the warning siren sounds.

"He has experienced the world as not safe - his house is not safe, his yard, his daycare centre is not safe… it influences the whole circle of the child's life," she says.

Yossi Haimov, 10, had gone out to play after school with his eight-year-old sister when he was hit by a qassam rocket in February 2008.

"It splintered his hand and now he can't use it," his father, Tashkent, said. "The bone was completely destroyed from the shoulder down. Only half of his shoulder is still there."

"He is definitely still traumatised," says Mr Haimov.

Previously a keen footballer, Yossi is no longer always outside with his friends.

"Now he's scared all the time… he's afraid to get hurt or get knocked over. Sometimes he gets very upset and nervous and he has panic attacks."

Research from Sderot says about 30% of children there show signs of Post Traumatic Stress Disorder; Mr Sarraj says about a third of Gazan children are suffering from psychological symptoms that needed intervention.

"Your mind doesn't ask from where the stress is coming. It doesn't matter if you live in Sderot, Gaza or in New York. This is the reaction of the human," says Ms Yosef.

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