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Why The Palestinian State of Mind Matters

Politics is inextricably bound up with everyday life in Palestine. This sentence at first sounds so obvious that it seems trite. Why bring it up now? The answer is simple: to highlight a largely ignored issue, Palestinian mental health, an issue that cannot be separated from the fact of Israeli military occupation and colonization.

For, among all the ink spilled on the Middle East and the Israeli-Palestinian conflict, academics and journalists have largely ignored the crucial topic of Palestinian mental health. There are many probable reasons for this sidestepping, not least that to highlight this problem would be to spotlight Israel’s negative treatment of Palestinians: a subject that the US government, for one, would prefer to ignore.

Here’s a Guardian article from July on the subject that cites a recent UNRWA report on health in the occupied territories, mental health disorders are increasing in the Gaza Strip. Even UNRWA, presumably overwhelmed by the litany of health problems facing Palestinians, gives the subject short shrift in its admittedly brief report.

Let’s examine this avoidance a bit more closely before turning to the question that may already foremost in your mind: why does mental health matter?

There are three common stories about the Middle East and politics.

The first, the one major news outlets would have us believe, is that “the Middle East” is political by its very essence: that this vast and complex area is somehow synonymous with war, violence, and radicalism. This common argument is most frequently identified with “conservative” news outlets such as FOX and their ilk, but it’s worth noting that bastions of the “liberal” media, such as CNN and the New York Times, are just as likely to fall prey to it.

This story is relatively easy to combat and complexify, and many authors have done just that (to take an example, Lisa Anderson in the article “A critique of the political culture approach” in the book Political Liberalization and Democratization in the Arab World. So we’ll pass over it for now.

There is a second, equally vast, though less influential, story about the Middle East and politics, which would erase them completely in favor of happy tales about development and empowerment. The bestseller Three Cups of Tea is a good example of the popular side of this approach. However, it doesn’t take much work to learn to spot this insidious line of argument: just be on the lookout for photos of grinning foreign children, often side by side with beaming volunteers and women working on looms.

It’s the third story that I want to focus on. In some ways this third story is the most subtle and yet also the most dangerous. It is the story of meticulous academics who don’t take their conclusions far enough.

Let’s take your average report of youth mental health in Palestine. These stories spring from great and thorough research. They collect data painstakingly and you can’t fault their lack of dedication to their crucial subject matter. They can’t avoid the easy elision of suffering into statistics, but can any of us? However, they do not squarely address the moral questions that their conclusions raise.

What does it mean when S. Qouta and J. Odeb estimate that 97.6-99% of their young Palestinian study subjects have PTSD? What do such high rates show about the pain of an entire people? And when a whole population of children is traumatized, how can you ignore politics in suggesting how to treat those children? Can one honestly state that they can be “cured” without some political recourse – without an end to the occupation?

Rita Giacaman, the director and founder of the Institute of Community and Public Health at Birzeit University, looks these dilemmas in the face. When I asked her if politics was a factor in Palestinian mental health outcomes, her reply was unequivocal. “Of course this is true. If you lived here, you would clearly realize that political violence—occupation and colonization—are the ultimate determinants of the health status of the population (the dependent variable).” Not just factors worthy of consideration. Not just a sidebar in the midst of an article or a footnote suggesting further research. No, political violence is the central factor, the propelling force that drives all else before it and leaves nothing in its wake untouched. How could the minds of youth or their parents resist such a psychic onslaught?

When writing a letter to the Lancet, contributors are typically asked to state, “I have no conflict of interest.” Giacaman bravely stated, “I declare that I have a conflict of interest. Israel is occupying my land and threatening my society with destruction.” Let us stand with Giacaman. Let us, too, have a conflict of interest, if by sacrificing some measure of objectivity we help to fight injustice in Palestine and everywhere we see it.

This content is provided courtesy of Palestine Note

Jacqueline Outka is a recent Yale graduate interested in health and the Middle East. She is currently assisting with a report on Muslim mental health, working for an HIV clinic, volunteering for a refugee agency, studying Arabic, and doing freelance writing. She may be contacted at This email address is being protected from spambots. You need JavaScript enabled to view it. .

*Photo Credit: Rusty Stewart

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