Dr. Samah Jabr Talks About Mental Health in Palestine
Dr. Samah Jabr is a Palestinian psychiatrist and Jerusalemite and the Head of the Mental Health Unit at the Palestinian Ministry of Health. She is also an Assistant Clinical Professor at George Washington University and a well-known lecturer and teacher around the world. She kindly agreed to speak with Muslim Girl about her work and mental health in Palestine.
Her work on psychology and the importance of connecting individual psychological challenges to the larger political situation has been featured in blogs, news articles, interviews, documentaries, and books in many languages, including Arabic, Italian, Spanish, and French.
SARAH MOHR [FROM MUSLIMGIRL]: Thank you so much for agreeing to speak with me for this interview for Muslim Girl. It is an honor that you are taking the time for us. It’s hard to know where to start. You have spoken of the silencing of Palestinian voices. Can you say more about this?
DR. SAMAH JABR: This has been the case for so many years. I always felt that we could not talk about the Palestinian perspective easily in Western contexts, especially in my field of mental health.
It was difficult to bring the Palestinian perspective even at the level of our profession.
My work as a Palestinian policymaker put me in situations on many occasions with international colleagues, especially from Europe and the U.S. It was difficult to bring the Palestinian perspective even at the level of our profession. The misunderstanding of neutrality and impartiality in mental health has been used to silence the political aspect of our experience.
Now it became more clear that this was deliberate silencing when mental health institutions began speaking about the situation in Ukraine and people were taking sides very clearly. It became obvious that, with the situation at hand, it was based on objective facts and observations. It is not only in the field of politics but also in the field of mental health.
It has become dangerous in the last year. As a psychiatrist, I am being contacted by people. There were heavy consequences for them as individuals. The university made hearings for them, they could not continue with their studies. Now silencing is becoming more serious. In the U.S. and Germany, silencing is more brutal.
The press as well after October 7 is less tolerant. One minister of the interior issued fines on people who hold the Palestinian flag. In some countries, people who wear the keffiyeh, even the silent signs, are being silenced and there are strong responses to all of our voices.
S.M.: What is currently happening to Palestinians in Jerusalem and the West Bank from the perspective of mental health?
S.G.: It’s very tough. People are traumatized expecting something like what is happening in Gaza to happen in Jerusalem and the West Bank. After October 7, I felt unsafe driving because the settlers were attacking cars. In Jerusalem, we know people who were detained and experienced maltreatment.
We know of the case of researchers when they write facts with footnotes, the footnotes do not prevent the retaliation from taking place. You can be accused of incitement and there will be consequences. I was born into this reality, and I have lived most of my life here.
Helplessness is the end result of trauma. When people face colonization, war, and military violence, the end result is to silence them.
To not be able to voice your feelings and opinions is imposing helplessness on us. Helplessness is the end result of trauma. When people face colonization, war, and military violence, the end result is to silence them. Whether they shoot a person to silence them, or they frighten them, the end result is to silence.
With what we know about what is happening inside Israeli centers, the torture, watching acts of genocide on television, and yet the things that are possible for us to do without putting ourselves at risk are very little.
I have always been careful to do the maximum without putting my safety at risk. This creates a lot of anxiety and frustration sometimes. But this is the kind of life that we live here. We keep hoping for better times when we can contribute more effectively testify to the things we have observed and lived and do more to support the people who had worse experiences than ourselves.
S.M.: You are the Head of the Mental Health Unit at the Palestinian Ministry of Health and see the impact of the genocide firsthand daily. Can you share with our readers what your work is to help people with the impact of the occupation?
S.G.: I want to tell you about my work in general and a little about my work over the last year. I combine work in policy with work in general mental health. In policy, I develop strategies like suicide prevention, and child and adolescent mental health. This is 8-3. In the afternoon, I do clinical work. My clinical work informs my policy efforts. The big challenge is military violence and the limited number of professionals.
I have been recruiting many people in the helping professions: doctors, teachers, school counselors, training them to provide low intensity intervention. I used to go regularly to Gaza to work on building a modest yet effective mental health system. We did it with a small number of highly specialized mental health professionals.
The system is like a pyramid with the community-based services at the bottom and the highly specialized work like what I do at the top. And I want to tell you that and share with you some of the things that I have been seeing in my clinic which are unique to this period.
I have observed in the last year a few people from the West Bank and Jerusalem who come and complain of a thorn in their throat, inability to swallow, stomach ache, or feelings of nausea.
You know we talk about eating disorders, when people stop eating due to problems with their body image and so on. But I have observed in the last year a few people from the West Bank, and Jerusalem who come and complain of a thorn in their throat, inability to swallow, stomach ache, or feelings of nausea.
They say they are disgusted when they see meat when they see flour. When they reveal more they will talk about the weaponized starvation in Gaza as the circumstances that are associated with the onset of the symptoms. For example, a young girl told me that her family members are detained and she heard that prisoners are being starved and sexually harassed. So this is why I call it disordered eating and not eating disorders.
Another example is suicide. We know that suicide is associated with psychiatric disorders. But more recently I started seeing people with suicidal ideation or behavior who do not have clinical disorder. There is no bipolar, depression, or schizophrenia. I am worried about it because it is becoming an outlook. Their view of this world has changed.
The genocide has colored their perspective and their role as parents instead of celebrating bringing a child into this world, they feel remorse about it.
I have always been receiving women with postpartum depression, however, now they express guilt because they gave birth in a dangerous world. The genocide has colored their perspective and their role as parents instead of celebrating bringing a child into this world, they feel remorse about it.
I observed and have spoken about how the political intertwines with the personal but now it is becoming more important. Like after the assassination of Hasan Nasrallah, the Lebanese leader, I had a clinic the following day and I saw 16 patients.
It was my long Saturday. And maybe five of the 16 just wanted to speak about the impact of the assassination on them, their grief reaction to this event. This is the clinical work that I do.
I want to talk about how this impacts my view of policy making. Soon after the huge attack in Gaza, the psychiatric hospital and six mental health centers were demolished. Everyone that we trained and relied on became displaced.
Many lost family members, and many are injured themselves. During COVID, we developed a teletherapy program. It was not possible to rely on it because of the cuts in electricity and internet.
It became clear to me that we cannot treat everyone individually. Everyone is touched and we cannot put everyone in the therapy chair. And I do not know what can be best, what are the best mental health interventions.
Everyone has been trained on psychological first aid, but this needs to be implemented after the traumatic event is over and it is not over.
Everyone has been trained in psychological first aid, but this needs to be implemented after the traumatic event is over and it is not over. How do we implement it when people function under bombardment?
I saw an older adolescent gather young children and teach them to recite verses from the Quran. I saw a teacher who gathers children who are cut off from their schools, very young ones, and teach them to read and write. I saw some people providing entertainment, and telling stories to children. One mother told me she brought a cat into her tent and now the children are distracted trying to take care of the cat.
So what I want to say is the whole experience is making me humble about what can be offered. In our work with interventions like healing circles, expressive spaces, and relying on the spirituality of people, we should be guided by people. Collective interventions are more important.
This is not to say individual therapy is not important. It is still important. However, the experiences are damaging our connections and this needs to be taken care of. This best happens when we allow people to heal collectively.
There are countless examples of children who are in families where a parent has been killed and they take over the care of the other children. This is changing the structure of the family and the society and this also needs to be taken into account.
When I observe how invisible Palestinian leadership is, and how ordinary people are becoming the ambassadors of the people, this also speaks to the changing structures of Palestinian society.
There are big changes in the roles of people in society. Whenever there is a political impasse, the youth step in and take the frontlines and try to defend the Palestinian community.
S.M.: Something you write about is the role of dignity in Islam. The so-called aid efforts of the West have been highly criticized for hypocrisy, like the insulting dignity kits. Can you speak about your perspective both on human dignity in Islam, and how the aid efforts contradict this?
S.G.: You know, the dignity kits are just a small detail. All that we observe is mindblowing. Countries that support genocide, financially, politically, and at the diplomatic level, especially the United States and its followers, Britain, France, Italy, Australia, and Canada, will come later to ease their guilt feelings, and allow some foreign ministries to provide some mental health or false charity. Then they start bragging about it.
I saw images of Israeli soldiers in the North of Gaza where starvation is at its worst. They bring some bottles of water and give them to very elderly people or very young children to show the false image that they care about these individuals and then they take pictures of it.
The governments of the West are doing the same thing. They allow this protracted war. They did not stop it when they could stop it. At the same time, Britain and the U.S. send parachutes of food to try to maintain an appearance of humanity. There is such a dire need. People cannot deny it.
The dignity kits are provided by the British government. It’s a misnomer, I would call them hypocrisy kits. If I were responsible for the government of Palestine, I would prevent any country that is implicit in the genocide from providing false charity and bragging about it.
They can create this split like the Palestinian women are more innocent than the men. It is a misunderstanding of what dignity means to us.
The dignity kits are hygiene kits. They are gender specific. They have sanitary pads. They can create this split like the Palestinian women are more innocent than the men. It is a misunderstanding of what dignity means to us. Dignity is not separate from our walk and journey for sovereignty and freedom. It is not separate from our understanding of the obligation to fight for justice and human dignity.
Receiving this kind of false charity is another attack on our dignity, but the need is so bad that some people cannot say no. People are starved, they do not have water to drink. Even when it is given by the enemy, people cannot refuse it.
Neighboring countries are also complicit in our dependency. Silencing is also happening in neighboring countries that are puppets for Western countries and they are another tool to impose this silencing and dependency.
S.M.: Would you please speak about Sumud? It is so important to understand why the Palestinian people continue to be heroically resilient.
S.G.: Sumud, to be fair, is referred to by different people in different ways, and there is a feeling that we mean the same thing. Unfortunately we have not studied the concept using solid methodology, psychometric characteristics of the term. What I am sharing is my impression.
It was in the literature before the word resilience became popular. It is related to one of the names of God, As-Samad, the Ultimate Refuge, the Ultimate Protection.
It is related to this concept of seeking protection. Many years ago, in the early Arab culture, a samad was the one that people came to who was an important warrior who could provide protection. In the Muslim faith, God is the ultimate Samad.
In the Palestinian literature, some people speak about Sumud as resilience, steadfastness and political action in the path of justice, for liberation. It is a state of mind but it is also about political action for the liberation fo Palestine.
It was also used by Arab governments as a midway in the dialectic between fighting and surrendering completely. After the Arab defeat in 1967, some literature was written promoting people to not continue to conflict but to be in a state of Sumud. They do not surrender or go to a peace treaty, but they stay in the land and stick to it. This last one, the dialectic between conflict and surrender is less common.
If you ask a simple Palestinian person, they will tell you it is like the olive tree; we stay rooted in the land.
If you ask a simple Palestinian person, they will tell you it is like the olive tree; we stay rooted in the land. That is the image that stays in the mind of most people. It is about psychological steadfastness and action for liberation.
S.M.: Is there anything you would like to say that you haven’t said yet?
S.G.: Maybe I will finish with this. I hope that Muslim readers share the Palestinian feeling that standing up to the occupation and challenging it is not only our human right, it is our moral duty as Palestinians but as Muslims as well. My call for my Muslim brothers and sisters is to be aware of this challenge at this time.
It is an obligation for all Muslims to fight colonization, imperialism, and oppression. I am reminded by the verse in the Quran (20:43, 79:17) about challenging the Pharaoh because he has transgressed. This verse is repeated twice because it is important. Many Muslim people in the West sense their precariousness. They face Islamophobia themselves. They are aware of silencing regarding Palestine. They try not to challenge but it is an obligation to speak up and challenge the power structures. The more we talk the safer we are. The less we talk the danger is bigger.
So my call for my Muslim brothers and sisters is to speak up about Palestine, to not forget about Palestine, and connect Palestine to larger issues of justice and in other parts of the world.
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