Drawing Gaza: psychosocial support for children amidst a genocide
Mental health needs in Gaza are enormous, but the services and the spaces available for children to recover remain severely limited following the systematic decimation of the health system by Israeli forces. Strengthening the capacities is crucial.
In Gaza, virtually everyone has lost someone or endured direct episodes of violence from Israeli forces in the last three years. Airstrikes, drone attacks, shelling and shootings have shaped the life of nearly two million people in the Strip amid the genocide; 90% of the population has been displaced, often many times, and the space where communities are forced to live keeps shrinking.
People have seen their homes, livelihoods and dreams vanish and continue to endure catastrophic living conditions, inadequate shelter, poor access to health, food and water, and lack of hygiene forced on them by the continued Israeli blockade. WHO estimates that the number of people in Gaza requiring urgent mental health and psychosocial support has more than doubled over the last three years, rising from 485,000 before the conflict to over one million.
In this context, children emerge as a particularly vulnerable group. Many have witnessed massive violence and lost relatives and friends. Those ones in their late childhood have lost their school, mosque and home; fetching water or going to the charity kitchen to collect food have become daily responsibilities for them.
Children who today are three or four years old don't know what "home" or some basic things mean. They have always lived in a tent and never experienced living in a house; they have got used to playing in the streets, in places that have been reduced to rubble and demolished. They've started inventing games based on what they witnessed, such as violence and hunger.
When some children returned to their places, they didn't find their toys or the bag with their belongings, so they lost the safe space where they used to express themselves. They now feel fear and anxiety; they are afraid of gunfire and other dangers, and many present behaviours like nail-biting, involuntary urination, aggressive behaviour, and screaming.
Mental health services are a crucial component of MSF’s work in Gaza and are integrated into the medical system. MSF teams include counsellors and psychologists, and they carry out individual consultations, psychosocial and psychoeducational groups with adults, as well as recreational activities with children and adolescents. Between the end of 2023 and September 2026, our teams provided more than 132,000 individual consultations and have also supported over 246,000 people in mental health group activities.
Between June and August this year, the most predominant symptoms among children aged 17 or below who received mental health support at some of the MSF clinics were behavioural problems, psychosomatic reactions, anxiety, cognitive problems, post-traumatic disorders and depression.
In the Zaytoun clinic in Gaza City, we provide psychosocial support to children through the Carnival programme, which is built around music, games, and entertainment.
Counsellors share stories related to behavioural values and engage in a discussion about what they are living through during the war. Afterwards the counsellors hold four sessions focusing on aspects such as trying to remind them as children or raising awareness of their bodily boundaries so they know their body is their own kingdom.
During group activities children express themselves by drawing the realities surrounding them, and it is a key tool in their recovery.
Dina, Rahaf and Motassem are two girls and a boy aged between 9 and 14 years old, and they explain what they see and feel, their memories and dreams: the queue to collect food, the rain pouring through the tent, the tank bulldozing buildings, the omnipresent quadcopter or the friends they used to play with. These are just a few drawings, some stories out of many, and a small attempt to grasp the toll that the last three years have had on the mental health of the younger generation of Gaza.
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