Palestinian militants in the Gaza Strip frequently fire rockets into southern Israel, while Israeli forces carry out air strikes against Gaza. Week-long exchanges in March killed 25 Palestinians and wounded four people in Israel. Such confrontations cause high incidences of trauma among children on both sides of the border.
A birthday party at a school in Gaza's Beach refugee camp. It is part of the effort to make the lives of these children as normal as possible.
They are growing up under a threat of military strikes by Israel, which says it is defending its people from rocket attacks by Palestinian militants in Gaza.
Psychologists say many of these children suffer from trauma. Aida Kassab, of the Gaza Community Mental Health Program, trains parents and teachers to spot symptoms of its more severe form, Post Traumatic Stress Disorder. “The signs [of PTSD] are hyperactivity, regressive behavior, stuttering, stealing, lying, bed wetting and poor academic performance. All these problems are linked to trauma," she said.
Sami Owaida is the only child psychologist in Gaza. He says severe cases of trauma may require therapy but most children show signs of recovery over time. “But the problem is that the relapse is high, usually because with PTSD, if the shelling comes back, the child can develop a very fearful situation," he said.
A few kilometers away, across a fence and a shoot-to-kill zone two kilometers wide, children in Israel suffer similar trauma. About 12,000 rockets from Gaza have hit the area in the past 10 years.
The Israeli Psychotrauma Center has created a special place for parents and their children. Psychologist Naomi Baum says trauma can affect the entire family. “When families are under long-term stress, they forget some basic activities, like play. Parents forgot how to play with their kids. They were so worried about keeping them safe that they forgot how important play was," she said.
In Hamas-ruled Gaza the situation is aggravated by an Israeli blockade that has degraded living conditions. Israel considers Hamas to be a terrorist group.
The head of the Gaza Mental Health Center, Dr. Hasan Shaban Zeyada, says there is a strong connection between the political situation and the mental health of the people. “One political decision will help the people here a lot and will solve a lot of the difficulties. And the mental health will be better," he said.
He says trauma causes feelings of powerlessness and, as the conflict drags on, hopelessness which poses one of the biggest obstacles to recovery.