Trauma and Time

Trauma and Time

Gaza City

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 Center in Gaza City (PTC-UK), and looks at their locally-developed programming. 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 Center 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 Center. The center 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 center who delivered grassroots programming and helped to develop programs in response to the many different harms that the community endures. The aim here was to trace and understand how interventions change and adapt in a context of complex, overlapping, and ongoing harm. In parallel, staff interviewed clients, enquiring as to the acceptability and perceived effectiveness of programs.

The final phase of the Case Study will be the analysis of the data, determining not only what makes programs effective in the eyes of community, but how this perceived effectiveness intersects with the ability of a program to adapt to the complex circumstances within which the community lives.

PTC successfully applied for one of Rights for Time’s small grants, and will be running an RCT-feasibility study  to further understand and verify the success of local programs.