In the Middle East, Palestinian and Israeli children have witnessed unprecedented violence for the past three years. Often overlooked is the mental trauma suffered by these children on both sides of the conflict. In the first of a two-part series, Ross Dunn visits Gaza City and looks at how Palestinian children have been affected.
She is only 13, but Riam Abu Shaloub is undergoing psychiatric treatment. Riam is suffering from what doctors call post-traumatic stress disorder.
The National Institute of Mental Health in Washington defines this illness as "an anxiety disorder that can develop after exposure to a terrifying event or ordeal, in which grave physical harm occurred or was threatened."
Riam's condition is a by-product of the violence that has raged around her home in the Jabalya refugee camp in the Gaza Strip for the past three years.
Her mother, Noura, 32, is alarmed at the changes in her daughter.
"As a result of the Israeli incursions to the Jabalya camp, the bombardment, my daughter has changed completely," she said.
Riam is not alone.
The Gaza Community Mental Health Program has estimated that nearly 55 percent of Palestinian children living in areas that were bombarded or shelled by Israeli troops started to develop Post-traumatic Stress Disorder (PTSD) symptoms.
In the case of Riam, the symptoms include memory loss, little appetite and lack of ability to concentrate at school. She is also restless at bedtime, sometimes waking in fright, after imagining Israeli soldiers in action.
She believes that there is at least one way to vanquish her demons. To the shock and dismay of her mother, Riam admits that she is considering volunteering for a suicide bombing mission.
"This is the only way, this is the only thing we can do," said Riam.
One of her physicians is not surprised by her statement. He is Dr. Khaled Dahlan, a psychiatrist in the Gaza Community Mental Health program.
Dr. Dahlan says that the Israeli army's operations in Gaza are preparing a fertile ground, in which Islamic militant groups can encourage more young Palestinians to become suicide bombers.
"When the Israeli army attacks the home at night and beat the father, beat the mother, so the child sees and begins to think 'I must do something," said Dr. Dahlan. "I see my father and my grandfather unable to protect themselves in my home, so I must do something,' and they prepared the climate for the fanatic idea."
Dr. Dahlan says that he once attended the funeral of a Palestinian killed by Israeli forces, and was shocked to see the reaction of one child.
"One time I found a small child, who [was] 10 years old, pick up the photograph of the martyr and put his photograph in place of the martyr," he said. "What does this mean as psychiatrist? It is very dangerous. This child in his unconscious would like to be a martyr, would like to make a suicide explosion."
The head of the Gaza Community Mental Health Program, Eyad Sarraj, has observed the same phenomenon.
"Out of the despair, the despair of how can we combat Israel with all these Phantoms [jet fighters], and all these Apaches [helicopter gun-ships], and all these tanks, how can we defeat such an army, a superpower, what can we do? And we are tribal, and we want to take revenge," said Eyad Sarraj. "As one of my clients told me, the only way is that each one of us should kill himself and kill an Israeli."
His staff at the health center works hard to prevent this from happening. They hold workshops with children. The therapy includes having the patients relive their experiences through story-telling, free drawing, and explanations of their dreams and nightmares.
Dr. Dahlan sees such techniques as helpful, but there is always a risk that children will suffer more traumas. He says the best medicine is prevention of violence, and adds that a real cure will only be found when Israel and the Palestinians finally make peace.
This report part of VOA's World Health series