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Trauma and Time

Trauma and Time

Gaza City

Overview

Humanitarian protection has increasingly involved interventions in the field of Mental Health. Much of this work follows a PTSD-informed approach, or is undergirded by the assumption that Mental Health is impacted by the experience of a time-limited and single catastrophic event; whether this is war, the COVID-19 pandemic, an assault, or natural disaster. Almost always, Mental Health interventions presume that after the intervention the individual or community would ideally get ‘back to normal.’ While this approach has been criticized widely from the Global South, less work has been done to build or understand alternative approaches. This Case Study works with the Palestine Trauma Centre in Gaza City (PTC-UK), and looks at their locally-developed programming.

 

Aims

The aim is to better understand how a grassroots approach defines trauma and the role of Mental Health work in addressing it when harm is not time-limited, and the catastrophic is ‘normal’ (but certainly not normalized).

The project seeks to understand the role and possibilities of Mental Health intervention in a context of ongoing harm.

The Palestine Trauma Centre is a small NGO operating in Nuzierat, an area in the Middle Area of the Gaza Strip. Its founding director Dr Mohamed Altawil, along with the governing board, are based in the UK, which is where the center does most of its fundraising operations and is registered as a charity. Altawil had come to the UK to carry out PhD work at the University of Hertfordshire in 2004. Based on Altawil’s findings (2008), a group of professionals was brought together in Gaza in 2007 and in 2010 was formalized as the Palestine Trauma Centre. The centre was supported by what became its governing board. The organization has faced multiple challenges and is built on a model meant to weather the challenges that life in Gaza entails (recognizing need, developing to scale, first come first served, free to access, reducing stigma).

When Case Study funds stalled during UK Government cuts, a 5,000 GBP UKRI-IAA COVID Urgency grant was sourced through the University of Birmingham to collect data on the rapid change in operations at PTC in response to the first wave of COVID-19 cases were reported in the Gaza Strip. Analysis of this data is currently undergoing peer review.  When Case Study funding was restored, investigators teamed up with the Community Practitioner Research Programme to train PTC staff in qualitative data collection and analysis. Staff developed interview questions, carried out interviews, and initial analysis on two groups. First, they interviewed practitioners at the centre who delivered grassroots programming and helped to develop programs in response to the many different harms that the community endures.

Findings

The community of Nusseirat engaged in the Tarkiz program because it defined mental healthcare in a way that was recognized as valid and useful by the individuals it served. Reading the relationship between the themes, we can say that PTC defines mental healthcare as a community issue and locates the harm that it redresses at the level of community. In other words, Tarkiz understands that psychological harm is being experienced by the community and sees individuals as agents of that community. Ultimately, it sees that the harm experienced by the individual is not about the individual, but indeed takes place in the context of settler colonialism and occupation, where the legacies of harm and the ongoing harms specifically target the community. We see this most painfully at the present moment, where international courts are considering charges of genocide against Israel, a crime that specifically targets a group–Palestinians–en masse. Tarkiz’ definition of harm and approach to redress can be evidenced in some way across all the themes.

This is part of a multi-phase and ongoing project :