Gaza Community Mental Health Programme

2^nd International Conference

“Palestinians in Transition: Rehabilitation and Community Development”

13-15 September 1995

GCMHP held its second international conference, “Palestinians in Transition: Rehabilitation and Community Development,” September 13-15 at the Rashad Shawwa Cultural Center in Gaza City. Dr. Eyad El-Sarraj, GCMHP director, began the conference by welcoming over 250 participants comprised of intellectuals and professionals from all over the world and stated that the varied themes of this unique conference reflect Palestinian concerns during this period. In 1948, Palestinians lost not only their homeland, but also their identity; thus the PLO became a symbol of the homeland, Dr. El-Sarraj maintained. Now that the PLO is present physically in Palestine, feelings towards it are mixed: on one hand the human rights abuses are alarming, on the other hand, it represents an island of hope.

Hanan Ashrawi, Palestinian Independent Commission for Citizen Rights, was the first speaker in the morning plenary session. She spoke about the difficulties Palestinians face during the transition period. Usually such a period can be characterized as moving from a known state to clearly defined objectives. Ashrawi maintained that although for the Palestinians the objectives are clear, such as self-determination over their own land, these objectives are not recognized by Israel or the international community. She urged Palestinians to dispel the “grand deception,” that the Palestinian Question has been solved when in actuality Israel has been reneging on its promised in regards to issues such as Palestinian prisoners and safe passages and continues to confiscate Palestinian land and expand settlements especially in the Jerusalem area. “What is agreed on now will determine the future,” she warned. Ashrawi went on to say that since the Palestinian people have been collectively traumatized, they should undergo a process of rehabilitation during this period. They need to create a unified legal system, which nullifies the systems of the occupation, not built new ones, like the State Security Courts. “Having mechanisms for democratic debate is the best method for dealing with opposition – no one has the right to use violence against civilians,” she stated.

Next, Dr. Haidar Abdel Shafi, founder of the Movement for Building Democracy, spoke on “Democracy in Palestine” and attributed many of the setbacks the Palestinians have experienced to a lack of democratic leadership. He stated that under the Oslo agreement Israel is preempting the final status arrangements and robbing the Palestinian people of credibility. For example, under the Oslo Agreement, Israel is given enormous influence in the issue of elections, which have still not occurred in Palestine although they are necessary for democracy and preventing the abuse of authority.

Dr. Ryad El-Zanoun, minister of health, described the difficulties the Palestinian health care system is facing during this transitional period, especially with the sudden influx of released prisoners and returnees into the Palestinian areas. Local non-governmental organizations and the Palestinian National Auithority are now experiencing serious financial difficulties due to the perception among international donors that there is peace in Palestine and no longer a need to fund its organization.

Michael Adams, Palestine Studies Trust, shared his reflections on the situation since his arrival in Jerusalem and then Gaza earlier in the week. He said that in contrast to the euphoria experienced after the signing of the DOP two years ago, racism and hatred are more prevalent in these areas today. He spoke about the Israeli settlements, saying they are by nature undemocratic and discriminatory, but if the settlers had been confronted by the Israeli government earlier, the problem would never have reached the magnitudes it has today. He said that “If you don’t jump on evil from the start, you may never get rid of it.”

Professor Paul De Waart, Faculty of Law, Amsterdam Free University, gave a lecture entitled, “Aligning the West and Islam in Respect to Social Integration.” He argued that International Law has a role to play in mediating the Palestinian-Israeli conflict despite its failure in the past.

A film, “On the Road to Peace,” ended the morning plenary session. It was a joint production between Final Cut, Denmark, and the Gaza Community Mental Health Programme. The film describes, through the eyes of a Palestinian family living in Gaza’s Beach camp the effects of the occupation on Palestinian society and the changes that have taken place in Gaza since the Oslo accords.

Dr. Mohamad Zein El-Dean, blood Bank Society, was the chairperson for the afternoon plenary session, which consisted of lectures by Moshe Landsman, Israeli Mental Health Workers, IMUT, and Raji El-Sourani, Palestinian Center for Human Rights. El-Sourani described the human rights abuses that are being perpetrated against the Palestinians by both the Israeli and Palestinian authorities. He mentioned that the “safe passages” promised by Israel in April 1994 are still not existent; Bir Zeit students from Gaza have been stuck in Gaza, still not knowing when or if they’ll be given permission from the Israelis to return to their studied and the issue of Palestinian political prisoners is also being ignored. In regards to the performance of the PNA, El-Sourani expressed concern over four issues in particular: the establishment of the military high court, illegal arrests, restrictions on freedom of expression, and security prisoners.

After the afternoon plenary session, the participants were divided into three workshops. Workshop 1 was on Mental Health Services and was chaired by Dr. John Raasoch, Monadock Family Services, USA. Abdel Hamid Afana, GCMHP training officer, presented a paper, “Mental Health Planning in Palestine: Community Approach. “Dr. Abdel Aziz Thabet, director of Mental Health Services in the Ministry of Health; Dr. Raasoch; and Dr. Harvey Gordon, Broadmor Hospital, UK, also presented papers.

Workshop 2 on Human Rights was chaired by Dr. Mustafa El-Masri, senior medical officer at GCMHP, and included presentations by Taysir Abdullah, Faculty of Education, Ramallah; Ramadan Kodiah, Faculty of Education; and Dona McIvor Joss, Worcester State College, USA.

The theme of workshop 3 was Psychotherapy in a Traditional Society and was chaired by Karin Kallsmyr, researcher at GCMHP. Professor Marwan Dwairy, from Nova Southeastern University, Usa, presented a paper, “Western Psychotherapy in Traditional Arab Societies.”

On September 14, the morning plenary session was chaired by Dr. Haidar Abdel Shafi. Dr. Ruchama Marton, Chairperson of the Association of Israeli-Palestinian Physicians for Human Rights, Spoke on “Ideology, Democracy and Mental Health.” She gave several examples of how Palestinian prisoners with severe mental illness are misdiagnosed by Israeli physicians as having no mental illness. Marton believes this is not a result of professional ignorance, but because the physicians are acting in cooperation with the security forces. Such cooperation stems not from “direct orders,” but from a blind submission to the “spirit of things” which is a larger system of evil.

Imad El-Falouji, editor of Al-Watan, followed with a presentation entitled, “Islam and Human Rights.” He maintained that Islam upholds and encourages human rights, viewing all people as equal regardless of race, religion or gender and calls for abolishing classes within society. El-Falouji claimed that Islam provides for the right to private ownership, the right for people to be the source of authority, the right to life and self-protection and freedom of thought. Muslims upheld these principles in the “ages of Islam” as an example for future generations.

Next, Nancy Murray, director of the Middle East Justice Network, USA, gave a presentation entitled, “In Whose Interest: US Policy and Democracy in Palestine.” She described how during her latest visit to the Palestinian areas, she was struck by the deepening of the Israeli government’s apartheid policies. She defined apartheid as systematically separating groups to perpetuate the dominance of one group. Murray addressed the question of how Palestinians in this transition period can work for a different outcome, maintaining that if on a political level, Palestinians mobilize to tell the world they will not accept an apartheid solution, it will spur anti-apartheid movements all over the world, particularly in the United States. This approach would be successful because the anti-apartheid movement which fought apartheid in South Africa was very strong and so the ground work for a movement against apartheid has already been laid.

During the morning session Dr. El-Sarraj made an announcement concerning settler and Israeli army violence in Hebron. On September 14, about 50 Palestinian girls were injured by settlers who attacked their school in Hebron. The girls were taken to Alia Hospital. Also, 17 children between 1-18 months old were hospitalized after Israeli soldiers unleashed tear gas outside their day care center. The participants of the conference agreed to draft a statement condemning the actions of the Israeli settlers and soldiers and holding the settlers responsible for the problems in Hebron.

After the morning plenary session, the participants were divided into two workshops. Workshop 1 on Ideology was chaired by Dr. Jumana Odeh, Palestinian Medical Relief Committees, and included presentations by Vic Sarovlian, editor-in-chief of Al-Quds Magazine; Dr. Menachem Carmi, IMUT, Tel Aviv; and Wael El-Qadi, An-Najah University, Nablus.

Workshop 2 on Democracy was chaired by Dr. Dered Summerfield, Medical Foundation for the Care of Victims of Torture, UK Saber el-Neirab, GCMHP social worker, presented a paper, “Impact of the New Political Reality on Sociocultural Structure of Palestinian Society” Ibrahim Bisharat, Human Rights Education (HRE) Campaign, Jerusalem, and Abdel Rahman Abu Nasser, Palestinian Lawyers of Human Rights, also gave presentations.

Dr. Ruchama Marton chaired the afternoon plenary session. The first speaker, Dr. Summerfield, gave a presentation entitled, “Community Development or Trauma Work? Some International Issues for Programmes Assistin War Affected Populations.” He described how Western rehabilitation programs become involved with the victims of the world’s conflicts, which are primarily civilians. According to Summerfield, these programs often perpetuate Western imperialism by responding to Western priorities, not those of the community. Western psychological treatment is in many cased not appropriate to the needs of a given “traumatized” population whose problems are often economic or political not psychological. These rehabilitation projects also often fail to address issues of human rights and inequalities of power between aid recipients and providers. Thus psychological programs must take a pluralistic approach when addressing the needs of the population they are working with.

Dr. Inge Genefke, medical director of the Rehabilitation and Research Center for Torture Victims, Denmark, spoke next, arguing that torture is the most effective weapon against democracy. She showed how torture is an instrument of power and is used by many governments throughout the world to maintain their power base and exercise control over their citizens; this violates the UN Convention, which issued a declaration against torture in 1987. She described various torture methods and said that despite the long-term effects of torture, torture victims can be rehabilitated.

Two workshops were held after the plenary session. Dr. Geneflke, chaired Workshop 1 on Therapy and Rehabilitation. The first presenter, Ahmad Abu Tawahina, psychologist and deputy director of GCMHP, described the programme’s project for torture victims and outlined some cultural aspects which need to be considered in the rehabilitation process. To avoid the stigmatization associated with being a victim and to reach out to a large number of people in need, a new approach was developed: The staff at GCMHP address key persons and groups in the community, using a “one-to-many” approach. Shabnam Holliday, conference coordinator, read the paper of Dr. Gina Giovinvo, University of Central Florida, who was unable to attend the conference. Following this, Dr. Soren Bojholm, Rehabilitation and Research Center for Torture Victims; Francois Fleury and Bruno Zucchelli, Appartences, Switzerland; and Dr. Chapelle, Medecines du Monde, also presented papers.

Marwan Dwairy chaired Workshop 2 on Therapy and Rehabilitation Issues. Papers were presented by Dr. Paul Nasser, forensic and clinical psychiatrist, USA; Rona Fields, Association in Community Psychology, USA; Maria Piniou-Kalli, the Rehabilitation Center for Torture Victims in Athens; and Dr. David Henley, Diakonia, Jerusalem.

On September 15 the morning plenary session was chaired by Dr. Helen Bamber, Medical Foundation for the Care of Victims of Torture, UK. The first presenter was Dr. Judith Issrroff, the Israeli Association for Social Change and Solution of Conflicts, who stressed that a population can only absorb a limited number of traumatized individuals, after that democracy is jeopardized. She stressed the urgent need for developing innovative programs to help Israeli and Palestinian societies deal with trauma.

In this presentation, Professor Alastair Ager, Refugee Studies Program, University of Oxford examined the validity of applying Western psychological techniques to non-Western populations, which have experienced some sort of large-scale trauma. He suggested that clinical psychology may have a role to play in these situations provided that: it considers the unique and specific situation of a given population, that it encourages an indigenous, not a technical, interpretation of traumatic experiences and that it is community oriented, not intent on targeting particular individuals as needing help. He also urged the empowerment of non-Western voices in the psychosocial debate.

Professor Nahla Abdo of Carleton University, Canada, presented a paper entitled, “Gender, Colonialism and Nationalism: Women as the Last Colony.” She argued that Palestinian women, as other women in the third world, are doubly exploited: by the Israeli occupation and also by patriarchal elements in their society. The Palestinian family structure and the national movement have devalued women by valuing women only in their reproductive capacities, in their roles as mothers or wives. She asked if the new Palestinian Authority will promote gender equality or will continue to exploit the patriarchal elements in society as Zionism has.

Raija-Leena Punamaki, Department of Psychology, University of Helsinki, presented a paper, “The Function of where she discussed the relationship between trauma and dreaming. She raised the question of whether recurring nightmares which cause one to awake suddenly can have a healing function.

Following the session a film, “Screaming in Silence,” was shown about the Women’s Empowerment Project at GCMHP in which some of the women from the project described the violence and hardship they have suffered. It was produced by GCMHP in cooperation with the Women’s Affairs Center.

Afterwards the participants ivided into two workshops. Workshop 1, on Children, was chaired by Sylvie Mansour, child psychologist, who emphasized the importance of such a gathering. Raghda Saba, GCMHP psychologist, made a joint presentation with Helen Christie, psychologist representing Norwegian people’s Aid, on summer camps for children in Gaza. Presentations were also given by Vivica Hazboun, Guidance and Training Center for the Child and Family, Jerusalem; Dr. Brian Barber, Brigham Young University, USA; and Dr. Samia Dawud Noursi, University of Maryland, USA.

Workshop 2 was chaired by Nahla Abdo. The first presenter. Shadia Matar, coordinator for the GCMHP’s Women Empowerment Project, told the stories of two women from the project and discussed domestic violence against women in Palestinian society. She described the injustice women face in education, work and arranged marriages and urged that Palestinian women participate in rebuilding their society. Abdel Latif Athamna, MSF, lectured on, “Women Healing Process Within the Context of their Social-Political Circumstances;” and Augustin Velloso, University of Nicaragua 2, Spain, on, “Women, Society and Education in Palestine.” Michael Sansur, Catholic Relief Services, Jerusalem, presented his study on the mental health of Palestinian women of all ages from villages, towns and refugee camps in the West Bank nd the Gaza Strip and discussed the correlation between psychological symptoms and life events. Finally, Dr. Mustafa El-Masri presented a paper on women in Gaza. He analyzed certain mental disorders and discussed specific factors which effect women’s mental health such as education, early marriage, religion and the political situation.

Two more workshops took place in the afternoon. Workshop 1, on Children, was chaired by Raiji-Leena Punamaki. Presentations were given by Barbara Duarte-Esgalhado, Colombia University, USA, Dr. Anna von der Lippe, University of Oslo; Samir Quta, GCMHP research officer; and Lilian Peters from Pax Christi Utrech. Azah Kassem, Women’s Childhood Committee, Gaza, read Fadwa El-Sher’s paper. Workshop 2, on Women, was chaired by Judith Issrroff and included presentations by Yvonne Deutsh, Women in Black; Dr. John Raasoch; and Ray Huntington, Brigham Young University, USA.

Following the workshops Dr. El-Sarraj chaired the closing session because Dr. Mamdouh Al-Aker, Mandela Institute, who was scheduled to chair the session, had difficulties entering Gaza. Although he had obtained permission to enter Gaza he was delayed at Erez checkpoint by the Israeli soldiers for several hous. Dr. El-Sarraj pointed out that this is only one example of the difficulties facing Palestinians during the transitional period.

Dr. Mostapha Barghouti, director of Palestinian Medical Relief Committees, Jerusalem, gave a powerful speech, “Palestinians in Transition,” which described this transition as a process occurring at many levels, making the problems facing the Palestinians even more complex. Dr. Barghouti argued vehemently that Israel has undermined the negotiations and continues to carry out oppressive and humiliating polices towards the Palestinians. In his concluding remarks he stressed the need for economic development to ensure stability and warned against the dependence of the emerging Palestinian state on foreign aid. He concluded that democracy has become a pre-condition for Palestinian society.

Dr. El-Sarraj closed the conference by suggesting that a statement should be drafted addressing the Israeli and Palestinian authorities, as well as the international community.

The participants of Gaza Community Mental Health Programme’s second international conference, “Palestinians in Transition: Rehabilitation and Community Development,” held September 13-15 1995 at Rashad Shawwa Cultural Center have noted the following:

1) They are fully aware of the Challenges facing Palestinians during the transition period and the limitations of the Oslo agreements between the PLO and Israel.

2) There are serious difficulties in implementing the agreements between the PLO and Israel.

3) The peace process is losing its credibility due to the persistent Israeli policies of closures and the intransigent policies of intimidation, inequality and injustice. It has been noted that Israeli activity disregards the peace process by supporting and expanding settlement activity in Gaza and the West Bank. For example, in Hebron 200 settlers are jeopardizing the peace process by maintaining an aggressive presence in the area.

Having noted the above, the participants would like to urge the following:

First, that Israeli government

1) Abide by and fulfill its responsibilities and duties in implementing the withdrawal of its forces from the West Bank and it discourage settlement activity.

2) Respect international conventions and principles of human rights in their treatment of Palestinians.

3) Release all Palestinian political prisoners.

4) Realize that Jerusalem is the capital for both the Israeli and Palestinian peoples and cease its policies regarding Jerusalem, which deny Palestinian claims to the city.

Secondly, that the Palestinian National Authority

1) Fulfill their commitments in building a democratic society respecting basic human rights. This is not without understanding the immense difficulties facing the PNA due to the limitations of the Oslo accords and due to the pressure put on the PNA by Israel and other forces regarding security issues.

2) Urge the further participation of Palestinian people, including women, in the development of their society.

3) Strengthen the role of the NGO’s and assist them in their efforts to provide the various and necessary services for the society.

4) Ensure the human rights of children though socialization and education in the spirit of peace, dignity, freedom, equality and solidarity.

Thirdly, that both Israeli and Palestinians put an unconditional stop to torture.

Fourthly, that the international community fulfill their promises to help the PNA and change their attitude of apathy and helplessness towards Israeli intransigence.