Dr. Alice Rothchild on health and women's issues in Gaza after Cast Lead

This episode features a conversation Just World Ed President Helena Cobban held  with Alice Rothchild, who’s a member of our Board of Directors and a veteran activist in the field of health and human rights. Alice is a recently retired OB/GYN who has authored three books on the health and rights situation in the areas currently under Israel’s control. The latest was Condition Critical: Life and Death in Israel/Palestine, which was published by Just World Books in Fall 2016.

Dr Rothchild has spent significant amounts of time in Gaza on three occasions, in 2005, 2015, and 2017 and currently serves on the board of the Gaza Community Mental Health Foundation.

Transcript

Speaker 1: 0:00

Today from just world podcast, I'm Helen, I carbon the president of just world educational. We worked to expand the discourse on vital issues of global peace and justice, especially in the long troubled Middle East. This is the sixth episode in a special mini series we're releasing as part of our cost lead plus 10 project, which started last December 27th and it's running for 22 days. This project marks the anniversary of Israel operation cast lead assault against Gaza during these same 22 days, 10 years ago. If you're on social media, we using the Hashtag Hash cost lead plus 10 to draw together all the activities. We're running on our twitter and facebook accounts to follow us on both platforms on twitter. Our handle is at just world Ed. We also have a great page on operation cast lead in the resource section of our website, www.justworldeducational.org. There you'll find links to all the episodes in this podcast, miniseries and many other useful materials. In this episode. You'll hear a conversation I held recently with Alice Rothschild, who who's a member of our board of directors and also a veteran activists in the field of health and human rights. Alice is a recently retired Ob Gyn who has authored three books on the health and rights situation in the areas currently under Israel's control. The latest was conditioned, critical life and death in Israel, Palestine, which was published by just world books in fall, 2016. Alice Rothchild has spent significant amounts of time in Gaza on three occasions in 2005, 2015 and 2017. In the conversation I had with her, she started by talking about her first visit there, back in 2005, which was the year that Israeli Prime Minister Ariel Sharon announced, and then undertook Israel's unilateral withdrawal of settlers and troops from within Gaza to Israel. Continued thereafter and and until today, to control all of the crossing points between Gaza and the outside world that could enabled Gaza's 2 million Palestinian residents to retain their ability to travel to or trade freely with the peoples of the rest of the world. Anyway. Here's how Alice Ross child describe that first stage she had in Gaza back in 2005. So it was in March of 2005, so it was before the.

Speaker 2: 3:00

And I was with a group that was invited to visit Daza by the Gaza community mental health program. Um, what we did was we toured the Gaza Strip, uh, we met with clinicians and social workers and teachers and regular folks. Um, and for me, one of the most powerful memories was visiting the rough a border, which is the southern border of Gaza with Egypt. And there had recently been a bulldozing and military operation at the border to create a buffer zone between Gaza and Egypt for the Israeli forces to have their way in that area. And for me that was the first time I'd actually been in a war zone. So just touring the, um, the buffer zone, seeing the rubble, looking at children's toys and Legos and teacups and underwear and just, you know, all the detritus of regular life that's crushed wood stones and Samantha and concrete. And it was a pretty emotionally devastating experience for me because it made more very real. And then I heard the stories of families fleeing in the middle of the night as the bulldozers came and the horses came in and, you know, the military operation happened. Uh, so that was a very powerful experience. I also spent some time at the guys, the Community Mental Health Program and interviewed Dr Yan, Elsa, Raj, and he was this amazing psychiatrist. He used to be the only psychiatrist in the Gaza Strip. And he founded the Gaza Community Mental Health Program in 1990 after, uh, uh, the beginning of the first thing to father and the program was founded to support the children. They will call the children with stones because these were the children who were throwing stones at the tanks. And what they found in a dealing with these children is that not only were they enraged and defined, which was the obvious emotion you could see, but they were also incredibly anxious, depressed, a vigilant, and they had really, I'm in a childlike way internalized the meaning of occupation, their lack of value in the world. And they have experienced a huge amount of trauma because of all the Israeli encouragement and operations and what the researchers found is that these kids had turned humiliation into active resistance. So the act of throwing a stone became an act of stating, this is mine and I'm going to defend mine against you. Um, so it was a very interesting beginning for a mental health program. And so they began working with these kids and then obviously they began working with the mothers of these kids and the other kids in the family and found just a huge level of what we call post traumatic stress disorder. But in Gaza is never post. It's more ongoing. So, you know, these kids might be throwing stones in the afternoon, but at night they were bad wedding, which was and continues to be epidemic and the Gaza Strip. And then as they got to know the families better, they realize obviously they will fathers involved. And many of these fathers had been in prison, both in Israeli and Palestinian Authority jails and many of them had been tortured. So these fathers were also damaged psychologically and often physically. And um, you know, the culture in Gaza is not one where fathers and mothers go to family therapy that is not the same there, but they found that they could reach the fathers to their children. So they began dealing with families as a whole and they realized that the key to successful healing when the family was the mother, because the mother's, like women everywhere were much more willing to talk about their feelings and to work through the kind of trauma that the family had experienced. So that was sort of the beginning of the program. So it was developed into this amazing group of therapists, professional staff. They do trainings for all sorts of levels of mental health care. They do a lot of outreach in schools. They do a lot of teaching kids how to mediate without turning to more violent activities. They worked in clinics and prevention. Um, and they have a very interesting, uh, research unit which is focused on understanding Karma in a political and cultural context. So this is very different than a lot of, you know, therapy like in the United States where it's like you focused on the individual, this is looking at how is the individual part of the political and cultural world they live in. Um, and they were finding that children who have experienced a, this kind of trauma and loss both had emotional and cognitive impacts. So they focused on the children. They focused on women who had been victims of violence, domestic or otherwise, and then who had been imprisoned and tortured. And uh, the research unit found all sorts of very interesting. I remember, um, one of the researchers telling me about how they would watch children play games because that's how children work things out. And one of the popular children's Games was called the martyr game. And one kid would be in Israeli soldier and the other kid would be a Palestinian fighter and they would have a fight and the Palestinian would die and become a martyr. And then they would switch places. And the other one would be the martyr and the other one would be the soldier. So we've kind of worked out their experiences. Um, the other thing that they were able to document is that with fathers who we either absent because they were in prison or I'm damaged in some way from their trauma, uh, that there was a real loss of authority of the father figure. So kids were looking for some sort of male authority and they would often turn to more aggressive, militant males for that need. And so it was very interesting hear how they got to understand the ways that children were growing up in this particular culture as well as the women and the mothers and the fathers. So I returned in 2015, which was right after the last big war, operation protective edge. And by that point, you know, he had had died and um, uh, Dr[inaudible] had taken over as the executive director in 2013. And um, he's this incredible psychiatrist at that visit. Mostly what people, him and everybody else I talked to want us to talk about was the war. I mean, that was 51 days of fear and death and insecurity for everybody. Interject between 2005 and 2050. We had not only share on withdrawal of centralized and, and soldiers from within Gaza, um, but then we had the elections and then we had the, the restaurants by the Israelis insulted by the us to those elections, which was to type in the siege of Gaza. And then we had lead and then another military incursion, right. Israel. And, and then the 2014. And so a lot had happened between your two visits. Right? Right. And obviously with all of those things, a life in Gaza got a more and more difficult and a human rights issues became more human rights and humanitarian issues became a much more prominent. And even though they were prominent before, um, so in, in that visit, the conversation was all about the war. And it's, there's something about, um, talking with, you know, a psychiatrist about, uh, you know, the bombs are falling. They're trying to support the staff who were trying to support patients, but no one can get anywhere and people are running in the night and they're hiding and they're losing their families and they're losing their homes and they're trying to be professional. So, um, it was very remarkable to have a situation where the caregivers were as traumatized as their patients. So for instance, Dr. Yes sir. Had I think something like 27 family members have a massive bombing and meanwhile he's trying to provide therapy to people who've lost their family members and it's very challenging to do that kind of thing. But he also has the analysis that links the trauma to the CS, the occupation to colonialism to racism, you know, that whole, uh, linking a mental health with human rights, which is I think the big contribution of the Gaza community mental health program that you can't have mental health unless you have human rights. Um, and then I came back two years later and people were much more able to focus on things that were not about the last more but about what was going on presently and attempt to rebuild. And um, you know, the, the wall was less in their face, although it was clearly in the background. And so I'm meeting with Dr Azar. He now has about professionals. They see about 3000 patients per year. Um, they do a lot of training, so they're a impact as much broader than 45 professionals and they also train a community based organization. So they're trying to decentralize their ability to provide care. And what he did was he reviewed the last 10 years that he had been working there. One of the things that I found really interesting was he said that, you know, a lot of people who were treated for post traumatic stress disorder as best it could be post and who seem to be doing well, would easily relapsed with the first reminder of a bombing or a war. So for instance, a child who had been bed wetting or having horrible nightmares who worked through the therapy, who got better, you know, a bomb drops in the other house and the kid starts screaming in the night and bedwetting again. So he had this whole concept of delayed onset, posttraumatic stress disorder where a current events trigger old trauma and it just gets layered and layered into the psychology of the person and also the fact that they can't escape it. So one of the critical features above that that is that there was no safe place and um, also that the care givers are as traumatized as their patients. Um, so what he described was, you know, that they try to do therapy with a focus on the future and on hope and on the good things and you're still alive and you did not lose your children and that kind of stuff. But the population is slowly being depleted both psychologically and financially and, and the, he sees a meeting of the ability of people to love and comfort each other and have a full emotional life because people are, uh, have less and less reserve is how he described it. Um, and one of the examples he gave is that during the war there were huge number of casualties. Uh, but there were no funerals because the Israelis were bombing groups of people. They were bombing people in cemeteries so that they couldn't do their usual death rituals, so funerals and morning houses and grieving. And so all of that got frozen because they couldn't live that normal human experience and way of sort of completing the grieving of their relatives. So that's like an example of what thousands are facing, a sort of a chronic experience of trauma. But, you know, the thing that I found fascinating is 2017 was in both the strength and the resilience of the people I was dealing with. Um, they're working, they're doing their training programs, they're doing their community interventions that have a hotline. They were building this new building. And when I was there at the building was the external building was up and we toured the facilities, which was all, you know, building construction inside, but huge dreams about what this building is going to be so that the center can move in and they can be self sufficient than they can have a radio program and they can have a restaurant and train people with making. So, I mean, they were full of dreams. And, um, I just find it stunning that people who live in Gaza can still be full of dreams, like talking about, um, you know, layer upon layer of trauma and about, you know, retraumatization and late onset trauma and all those things, but they're also layer upon layer of resilience, right. It strikes me that the community mental health project and other community based organizations in Gaza play a massive role in actually building the resilience or keeping it, keeping it from eroding. Right. I think that that's correct. I think it's getting increasingly challenging every year, but that is definitely the role they play. I haven't a, just a little purple example, one of the, uh, the woman who was my interpreter and who also works in the program, she's the dynamic 20 something educated, good English, two kids, a husband, you know, full of spit and vinegar. And um, she described the impact of the fact that they have very intermittent where electricity as when I was there, it was like in the four hours a day kind of electricity. Um, but it's not only four hours a day, it's not a four hours a day straight and it's anytime in the 24 hours and it's not predictable. So if you can imagine this. And so she described to come home and they were her kids and they weren't school. Um, if there was electricity, they would cook dinner and do their thing and if it wasn't, they would just go to bed. But they would leave the TV on. And then whenever the TV went on, which meant they had electricity, everybody would wake up, they would cook dinner, they would do the laundry, they would do whatever you do when you have electricity and they will do that until the electricity went off. And then they would go back to sleep. And that kind of ability to function under that kind of stress and disruption was stunning to me. And she was telling me the story like this is how we do it. And I thought, wow, that is amazing to me because it means these kids live a totally disrupted sleep life. But they have figured out how to get done, what they need to get done within the context of an unlivable situation. I think it's almost impossible for most people here in the United States to imagine what it's like to live in such a place. And I think it's great that you give these very concrete examples because this is something that Gaza is 2 million people have been living through for many years now and it's not just, there's no geographic escape insights. I don't think there's much of a political escape insight. I mean, this could go on for a long time. Right? Right. So what do you think that people here in the United States can do and should we be advocating people doing political advocacy or should we be advocating people to give money to the Gaza community mental health program or other networks of professionals in this country that are supporting what's happening there that we can support? What is your, your view of what should happen? What, what concerns, but I get. I'm very much in the, you know, all of the above categories. So that means I've got to get beyond our linear time to whoever else supports their news needs to be understood about life on the ground is and understand how demonized Gazans have been and even though demonized Tomasa's and Hamas has been responsible for many horrific things, but it's also responsible for a huge social service network and orphanages and schools also have medical facilities. And I think people need to really pay attention to what are the realities on the ground for these people. It would be fabulous to support the designated mental health program. There's actually, I'm a five, zero, one c, three in Cambridge. Mass raises money for the program is for other mental health programs called the mental health foundation. Um, and I have to full disclosure say that I'm on the board of that program and we do raise money to support, uh, the governmental health program in Gaza and um, that would be fabulous. So for people to do, you know, under the UN Relief and Works Agency which provides healthcare and education and some hoping for, um, 70 percent of Gazans who are refugees has been defended by the United States. And so, you know, that is a much bigger organization, but you know, people want to support. Oh no, that would be super. Um, the other thing, uh, I don't know, have, you know, a professional organization that has taken his role to support Gaza in healthcare, that kind of thing. Um, I think the main thing that, the other main political activity besides constantly by your congress person who will not listen, but there are more congress people who are aware of the situation and we now have Palestinian Congressperson, which is fabulous, is to uh, support the boycott divest sanction movement, which is really an international movement that's putting pressure on Israel to end the season in the occupation because there's not going to be any, any change until the sesions. And that's pretty clear. Um, so that's the political action that I think people need to take home. Alex, tell us a little about the women's organizations that you've met with in Gaza. Sure. So, um, as partly because I'm a obstetrician gynecologist with a particular interest in how women live and cope in the world, I sent some focus of my time in Gaza on the situation for women. And first of all, I think we have to be clear that there are a lot of different kinds of women in Gaza. Um, well there's a huge burden of poverty. There are also middle class women, there are a lot of educated women, many of them unemployed, um, and they're women that are living in very conservative families or women who are living in more progressive family. So we'd have to be careful not to generalize, but women form a, you know, a strong core of the society. Um, the other thing I think we need to realize is that the more there is a crushing of the economy and the political landscape, the more oppressed and constricted the lives of women become. So in Gaza we can really see how a war, patriarchy, psychological illness, domestic violence culture. I'm really come together to create realities for women. Um, and if you think about the role of women in Gaza society, you know, they're responsible for the home and for the raising the children and they tend to have a larger numbers of children than we do in the US. So there are frequently issues around pregnancy, childbirth, uh, you know, they have to interact with the medical system, they have to be sure their children are living in a safe environment, that they have water, that they have electricity, they actually have a huge responsibility for how the society functions. And if you think about all those things, those are all impacted by recurrent bore incursions, see husband's in prison, all that kind of stuff. Um, and as things have gotten more difficult, um, there's been a rise in domestic violence, early marriage, you know, women tend to bear the brunt of male trauma and impotence and rage. So it's a highly challenging place for women to be. Um, and since they're also responsible for the healthcare of their families, the fact that people can't get permits to go to higher level healthcare in Israel, the West Bank or Egypt, um, means that women are dying of breast cancer. They're dying of ovarian cancer. Their, you know, their children aren't getting their care that they need. So they're very, uh, central, uh, to this conversation. Now there were um, three centers that kind of spun off from the desert community mental health program. I'm the one in the north is called Ayesha and then there's one sort of in the middle of Gaza that's called. And then there's one in the south called reef and these centers in various different ways. A really focus on, um, first of all providing women a place to talk and do. So group therapy. Talk about war trauma, do that kind of sort of psychological work, um, because you know, the husbands aren't going to come, so the women have to do the therapy for the family and they also deal with a disease burdens for their children. Um, and not only the children have a, you know, a huge experience of trauma, um, there's also a higher level of what we call disease burden, another words, hereditary diseases because there's a high rate of a marriage of first cousins and close relatives. So this is a big problem that women have to deal with. And then you put on top of that, you know, a toxic environment from war. I'm now nutrition, lack of quality, medical care for all the reasons of the seizure and defunding on rotten, that kind of stuff. So they've got that going. Um, and you know, oftentimes in a stress family, this turns into domestic violence, you know, that's complicated by poverty. So I saw women who were very depressed somewhere suicidal, but they get support and therapy from these organizations. Um, the other thing they focus on is providing a training so that women can become more economically, um, uh, you know, able to support themselves economically, which gives them more power in the marriage or if they end up being divorced. Um, so they do a lot of work around women's empowerment and development of skills. Um, I also visited a, the Hyatt multipurpose center, which is a project that looks at, um, women's legal rights and consulting, so they helped women around issues of gender violence and they work as mediators between husbands and wives so they don't have to go to court. So that was also a very powerful experience with these women really taking on the system and, and, and fighting for the rights of women. Um, I just also want to mention another group that was so impressive to me and really shows the power of women. Um, there is a group that's called, uh, the now, uh, for Culture and Arts Association. And this was a group that was founded by women then Remote Abo Jabir and the Apollo Robello a area. And these, just this like force of nature. So she, after the 2014 war, decided that children needed to be supported. And the way to do this was to empower young Palestinians to traditional culture and arts. So she focused on families in this region who were severely hit by the door and they do psychosocial support. They do childhood early childhood education. They do professional development for teachers and they focus on the preservation of Palestinian culture. So we went to her center and there's all this embroidery and poetry and, you know, just a, um, a real celebration of Palestinian culture, the kids saying all sorts of songs about peace and love. And it was really a stunning experience. And one of her projects was to turn this 1700 year old monastery that has a mosque downstairs in the monastery upstairs into a garden and a children's library. So we went to visit this archeological piece of rebels and she thought as this library and we toured the area and she has actually gotten funding and has UNESCO support and it's going to make this into a children's library and a garden for the kids. And it was, for me an example of the kind of strength that women have there. And also the ability to envision something better than what they've got. So I want them to be sure, uh, to sort of give us a call out to her because she was so inspirational. Uh, when we, when we met her and met with the kids and saw what their buildings, I think that's fascinating because right here in the states right now we've been having this amazing moment of Palestinian cultural pride that I see in my 35 years in this country with the Hashtag tweet your so and you know, around the world tweeting pictures of themselves with traditional Palestinian embroidery. So it's kind of interesting to hear that that has something to do with what's going on in Gaza and of course, cultural expression and activities is also a part of the great much of return. Um, so I think hanging onto the, the cultural aspects of being Palestinian and asserting them in the face of repeated Israeli Zionist attempts to eat a crush them or expropriate them is really an interesting thing. And it's great to hear about this, uh, inspirational woman in data. You know, dad actually means a monastery. So devin, a good space to have have an ancient monastery doing great things. Now, um, I hope it works out. I mean, the other thing, I went to the kindergarten called the near the kindergarten, and this was also run by this amazing woman named was done via who runs his kindergarten and during the war there was a bombing of the city of Chicago idea, um, and, and basically this huge city was bombed system of the rings and people fled in wave. They said it was like 1948. I mean, women described, um, you know, running over dead bodies and, you know, pieces of limbs and grabbing their children. It's just horrific things. And so this woman decided to take in a whole bunch of kids who had survived this horrific trauma into her kindergarten. Um, and she provided a safe space. They had play groups, they had clowns, they had all sorts of things to help kids feel better. And one of the things the kids did while we were there was to show us their folks that so the kids get, some of the girls got dressed up in dresses and you know, it was very clear that this was part of their pride and being Palestinian and part of their healing from this incredible trauma. Fascinating. Well listen, I think we're probably out of time now, but thank you so much. It's great for us to be able to hear your, your view of what it's like to actually be a woman or a person on the ground in Gaza. So thank you alice. So thank you.

Speaker 1: 30:40

Hi again. I hope you enjoyed that conversation I had with Dr Alice Ross child and found it informative. This has been the sixth episode in our podcast series on cost lead plus 10 years. You can find out a lot more about our cost lead plus 10 project at our website, www.justworldeducational.org where you'll also find a resource page that will link you to a rich array of resources about Israel. Cost load, assault against Gaza in 2008, 2009 about the situation in Gaza today, and what you can do about it on our website, you'll also find a donate page where you can learn how to support our important work on this and other issues going into the future. Thanks. Be sure to follow what we do and stay well for just world podcast. I'm having a carbon here in Washington DC.