Wednesday, September 8, 2010

Palestine/Israel Conflict


        My first introduction to the problems that Palestinian physicians, teachers and mental health workers face took place as part of a five-day training program in Cairo, Egypt. Our team from the University of Missouri’s International Center for Psychosocial Trauma consisted of our leader Dr. Arshad Husain, Maureen Allwood, a psychology Ph.D. candidate, Dr. Carla Anderson, a psychologist in private practice, and me.
        This was the first time these two women had been on a training team for the center. My wife, Carla, has a subspecialty in marital abuse, a problem that seemed of concern to our participants as many men in Palestine have no jobs, are tense about their futures and are often traumatized by how badly they are treated by Israeli authorities. The pressures are sometimes taken out on wives and children in the form of verbal and physical abuse.


        Our host city, Cairo, with 18 million people, was an exotic mob scene of the old and the new — traditional and modern dress, donkeys and BMWs, shanties and expensive hotels — in an ever-changing kaleidoscopic pattern.
       Newcomers pouring in from the countryside find themselves vying for limited space. The massive graveyard around the "must-see" Mosque of Qaitbey in northern Cairo is full of the living and the dead as masses of the homeless live among the mausoleums.
       The city’s major source of income is the tourists, and the locals are friendly and the guides well-trained. You have a problem? The general response is, "No problem. We’ll take care of it."
        Carla and I did some touring of the city with a guide. If the guide said getting somewhere would take five minutes, she meant less than half-an-hour. If she said half-an-hour, it meant less than an hour-and-a-half. It’s called Egyptian time. Getting places in Cairo takes time, and it’s not because drivers don’t drive fast — they do. It’s just that streets seem to run in some kind of pattern where there is much backtracking.
        Egypt doesn’t make it onto any of the lists of the most dangerous places in the world. Because of terrorist attacks in the late 1990s, however, there is a preoccupation with security in Cairo. Tourism accounts for one-fifth of the Egyptian economy and any security threats would cut that drastically.
        As a result precautions were very apparent. At the entrance to our hotel, there was a metal detector and several guards, and white-suited police were visible everywhere. Even McDonalds had an armed guard.
        It was an ideal place for our participants from Palestine who needed the opportunity to move freely and to be treated as valued visitors. They were so excited to be out of the hazards of Palestine that they hardly slept because they found so much to do.


        Forty of the 60 participants in our training program were Palestinian. In the beginning they had trouble concentrating in the training sessions.
        The violence of the Intifada had been very traumatic for them. Having spent recent months dealing with the psychological aftermath of suicide bombings and Israeli incursions into territory controlled by the Palestinian Authority, the participants looked totally overwhelmed and overworked. Like their clients, many suffered from post-traumatic stress disorder and desperately needed a week away from the front lines.
        Some had to walk mountain paths to bypass Israeli checkpoints just to attend the conference on violence and mental health. The other participants in the program were professionals from Algeria, Egypt, Kuwait and Yemen.
        We felt we were doing as much therapy for our participants as we were training them in helping skills. They needed to talk about their experiences and explore ways of not only their clients’ dealing with the trauma but also with their dealing with their own trauma.
        Our training techniques lend themselves to this by our often putting the participants in small groups. This allowed them not only to practice new skills, but also to talk about what was happening to them and sharing ways they had developed to deal with their own trauma.


        Although the University of Missouri-Columbia team crossed the globe to provide assistance, it was impossible not to learn from the participants.
        Individual discussions provided insight into what the situation looks like through the eyes of mental health workers who have to deal with the emotional consequences of ongoing death and destruction in Palestine.

Participants are placed in small groups to practice skills and discuss problem solutions. The instructor is Dr. Carla Anderson.

        Publicity about the Intifada in our American media tended to make the Palestinians the bad guys with the implication they are not worthy of our sympathy. It quickly became evident that our participants were good people. They bled and hurt just like the rest of us and their religion provides limited protection from the grief, hopelessness and fear that had become a focal point of their lives.


        Jennifer Jordan, a Canadian psychologist with the Palestinian Red Crescent Association, was the coordinator of the work of a group of Palestinian mental health workers who were in our workshop. I found her account of life in the West Bank troubling.
        "Basically we’re living in a community with three million people under house arrest," she said. "The curfew comes and goes. They lift the curfew for a few hours every few days so people can get food. When curfew is on, you can’t even go outside your door. I’ve found it is even dangerous to show yourself at a window; they will shoot at you. Some children who took a chance to play in the street have been shot at."
        Because of the actions of suicide bombers, it’s a terrifying time to be a Palestinian, Jordan indicated.
        "They (the Israelis) search for terrorists by going house to house, making mass arrests of men 15 to 45 and putting them all in a school that is treated as a military prison. People who are stopped by soldiers may be beaten and things in their houses destroyed. Residents can be in the house when occupied by soldiers, but they are not allowed to move freely."
        Ambulance drivers and their families, she noted, are among the most at-risk psychologically.
        "It’s dangerous work. Three ambulance drivers have been killed, and 70 percent have been injured," she explained. "The TV here is not edited, so children of these drivers see the bodies of the casualties and the blood. This frightens them for the safety of their fathers. Their families want them to stop, but they are very dedicated."
        As unemployment in the West Bank is 80 percent, the drivers are reluctant to give up their jobs, Jordan indicated. With little assistance, the alternative is a life of poverty and, often, crime.
        "People are out of money, and some of the women are starting to steal because they can’t pay for food. As many as 22 percent of the people suffer from malnutrition, and dental problems are rife. The U.N. has been effectively stopped from helping, as has the Red Cross.
        "Most suicide bombers come from refugee camps. These people have no money, no jobs, no food, and everything seems hopeless. They will commit suicide one way or another, and it carries more honor to do it as a suicide bomber.
        "Neither side understands the cultural nature of the other. There are better ways to handle this, but what the soldiers are doing is pleasing to the Israeli public."


        Jordan’s observations were hardly rare.
        Another mental health professional working in the West Bank said life there is a daily struggle to survive. The worker asked not to be identified because of the danger of retaliation.
        Just getting to the conference in Cairo was difficult, the worker said, explaining that it was a three-hour walk through the mountains with a donkey. "It is illegal to go out when there is a curfew. At night, they will shoot you on sight.
        "During the day, they hold you up. You must take off your shirt" so soldiers can check for explosives. "They take your identity card and check on the radio. Then they may let you go home or they may take you to a location to be held.
        "This week is different than last week; it depends on how angry they are, what their orders are from the top. You just can’t guess, and things change by the minute."
        It has changed the very fabric of life for Palestinians who need medical attention and other needs--heart, pregnancy, kidney--cannot get it," the worker added. "Some women have died in childbirth because they could not get to the hospital."
        The Israelis are trying to force their will on the Palestinians. Since June 20 the Palestinians have been subjected to a curfew almost daily. They’ve become dependent upon charitable groups for survival, but even the Red Cross has been hampered by Israeli soldiers.
        "They want to injure or hurt people to create fear," the worker added. "June, July and August the occupation has become much more dangerous. The psychological effect is double over previous occupations.
        "What we have rebuilt after the last occupation has been destroyed. At the checkpoints bulldozers have destroyed streets. Telephone lines are cut and transportation shut down. It is almost impossible to get enough food and to take care of basic needs."
        The worker said that living with the threat of retaliatory shootings and missile strikes has made the Palestinians tense and uneasy.
        "They want to clear the territory and kill the resistance movement. They destroy 20 houses and arrest 100 people. They want to cut off the head of the snake, but if they kill 10 it creates 100 more terrorists," the worker said.


        Other participants were eager to tell their stories, again with the provision that no names be used.
        "I was born in a refugee camp. Our generation has been raised here, but we are displaced persons. Proposition 194 says we must have two states. Our people have the position we will not leave our land, and if they come to take us away ... we are not afraid to die," a worker said.
        It was obvious that the mental health professionals saw Israel as trying to force them out of their country and that Israel’s retaliation for the suicide bombings was not bringing the situation any closer to a peaceful settlement.
        Men who are detained have been shot with the claim that they were trying to escape, the participants said. They were concerned that Israeli soldiers have demolished homes with little pretext.
        The Israeli army has destroyed homes and property of relatives of people connected to terrorist attacks, they said. The participants were concerned that the rest of the world is not paying attention to the dehumanizing collective punishment strategy employed by Israel.
        The Palestinians believe they have been dehumanized. They feel helpless to do anything about it. The workers were not surprised that some of their people have carried out suicide bombings--in their final moments they feel that they can accomplish something to help their people.
        Several stressed that the United States is wrong to classify the suicide bombings in the region with the terrorist attacks on America.
        The United States, the workers said, is not an occupied country with no way to fight against oppression. I heard these other comments.
        "We’re under occupation. We’d just like rights as normal people living under freedom.”
        "The more pressure they put on us, the more we attack. There are reasons for the attacks; we want the occupation to stop.”
        "Since 1948 our land has been taken and settlers are squeezing us. We’re humiliated every day, and our IDs are checked everywhere. We are desperate people, and desperate people do dangerous things. We can’t fight back any other way.”
        "The army blows holes in our walls to get from one place to another. The dead are left in the streets. It looks to me just like the holocaust. Why didn’t they learn from their own experience?”
        "I don’t want to smell death any more."

Wednesday, September 1, 2010



         The present situation is a bad state of affairs for both sides. Both Israel and Palestine are losers in this unending conflict. Two of the big areas of loss are financial and talented people. On the Israeli side the security measures eat a significant portion of the government’s income. The settlement movement has cost Israel some $100 billion over the past 40 years. This plus the building of the wall, the maintenance of checkpoints and other security measures is costly. As a result considerable outside money is needed to keep Israel solvent.
        The Congressional Research Service’s U.S. Foreign Aid to Israel, updated February 2009, reported that the U.S. had already given Israel $2.55 billion in military aid. This is in addition to economic aid over the years. Although much of this aid would need to be continued even if the Palestinian problem were solved, peace would free up much funds for other infrastructure needs in the country.
        Palestine, on the other hand, receives much support from the European Union. In 2008 the EU provided a total of 551 million pounds to help with the difficult economic situation in Palestine.
         Israel has a booming technology industry and has been generating innovations for years. The EETimes Europe reported in 2007 there were 3,000 technology companies in Israel generating 15 billion dollars a year. A brain drain is occurring as many of the brightest behind this technology boom are taking jobs in foreign countries and not returning to their homeland. This failure to return is influenced by the warlike conditions in their home state.
         A peaceful Israel could become even wealthier if they could keep the innovators at home.  Many of the people leaving Palestine are skilled individuals who can find work elsewhere; most often this appears to be in Europe. A significant reason for their leaving is the hostile environment in Palestine.

         The fact that 70 percent of Americans support Israelis and less than 10 percent support Palestinians reflects a lack of media coverage of the situation in Palestine. With more knowledge of the state of affairs perhaps we would have more people supporting some kind of resolution of the problem rather than taking the position that one group has right on its side and the other does not.
         My experience is that boundaries set up around the West Bank and Gaza Strip have in fact created a vast prison system where the inhabitants are treated as if they have committed some crime and are in need of being incarcerated If they are incarcerated, they must be bad people and therefore whatever is done to them is justified.
        Israelis stress their need for security and to achieve it they say they must take drastic steps. I will look at various factors from the point of view of what these steps do to the Palestinians. These factors are:

• The checkpoints

• Settlements

• The wall

• The destruction of infrastructure

• The curfew

• Loss of employment opportunities.

          As I have discussed elsewhere, checkpoints often are under the control of young soldiers who use this as an opportunity to be arbitrary in how rules are enforced. Medical emergencies, people going to work, food or medical supplies coming in are held up often to a life-threatening level. The victims of this behavior are left feeling less than human.
         Two classic studies in psychology cast light on why individuals engage in the mistreatment of others who have been placed under their authority. First is the Milgram experiment done in 1961 and 1962 on the power of persons in authority to force people to cause others pain, especially when they believe someone else is taking responsibility for the abuse. Second is Zimbardo’s 1971 study on the consequences of making one group of university students "prisoners" and another group "guards" with authority to control and discipline.
         Experiments like Milgram’s on obedience continued for 25 years and were repeated in Australia, South Africa and European countries. The results were always the same: Most people will follow orders given by someone in authority who takes responsibility for any damage. As one would expect from history, the Germans were best at following orders, with more than 85 percent of the "teachers" willing to administer a lethal electric shock to the "learner" as long as the experimenter took responsibility.
         Keep in mind these were experimental conditions where the experimenter did not have control of incentives such as the keeping of a job or punishments such as jail for failure to obey. A boss or higher-ranking officer in the military would have much more power to control an enlisted soldier’s behavior.
         These results are disturbing because of what they say about human nature--it is normal for most people to follow orders when they are given by someone in authority who takes responsibility for the consequences. On the other hand, if people did not follow directions given by leaders, we would not have developed an advanced civilization.
        The second study that helps us understand the Palestine situation was done by Philip Zimbardo in 1971 on "prisoners" and "guards" in a simulated prison at Stanford University. One group of student volunteers was arrested, booked, fingerprinted, blindfolded and placed in a holding cell. Guards and prisoners were healthy, intelligent, middle-class males. Who became prisoners and who were guards was decided by a flip of a coin.
         The prisoners were subjected to humiliation from the start; they were stripped naked, deloused with a spray and forced to wear a dress or smock and no underclothes. The guards were told to keep order, were given no training and were limited to the use of push-ups for punishment. When the prisoners attempted to assert themselves, they were stripped naked, their beds were removed and the ringleaders put into solitary confinement.
         Zimbardo’s study suggests that up to a third of normal, intelligent males will engage in sadistic behavior when put in total control of others who have been labeled prisoners. The study also suggested those who do not engage in this behavior will not interfere with those who are abusing power.
         Historically, what we are seeing in Palestine has been common even by modern nations: the British in Ireland, French in Algeria, Russians in Chechnya, Chinese to U.S. troops in Korea, Vietnamese in Vietnam and Serbs in Bosnia. The conclusion is that it is easy to train people to abuse others as long as the rationalizations are given and those in authority take responsibility or choose to overlook what their troops are doing.

         Much of the Palestinians’ West Bank has been lost to Israelis who are building settlements within the borders of Palestinian territory for immigrants to Israel. At this time 280,000 Israelis live in 121 settlements in the West Bank and another 190,000 in East Jerusalem.
        The three largest settlements have over 30,000 residents making them good-sized communities. Palestinians believe they have a right to control what is built on their remaining territory, but the Israelis believe the land is theirs by right of God’s grant.
         The problem will only get worse because Israel encourages the immigration of all Jews and needs to provide space for them to live. As mentioned, fire fights between settlers and Palestinians are not uncommon. Remember that Palestinians feel that they were unjustly displaced from their homes into these refugee camps, but that now they are losing control over the limited territory assigned to them. The 2000 to 2006 Intifada was a response to the Palestinians’ total frustration with their lack of power and input into what was happening to them and their territory.

The Israeli settlement of Psagot sits right above the West Bank city of Ramallah.

         The wall was built inside the green line and in such a way that farms and orchards were destroyed. The building of the wall has made it difficult for Palestinians to move around in their own territory. A farmer may have to go a long distance to find an opening so he can get to his field. To put up the wall olive and orange groves were bulldozed, which attracted foreign church groups who put their bodies in front of the equipment. They along with Palestinians were arrested and in some cases served time in jail.

A Palestinian boy and Israeli soldier in front of the Israeli West Bank Barrier. Picture taken by Justin McIntosh, August 2004.

        Most shops that build something can be considered as potential weapons depots, and as a result Israelis seldom let them continue to exist. Their bombing is quite precise and they do give warning before hitting a place, but they will not allow the development of anything that can produce goods. The pilot I talked to had the funds to start a small airline, but as I pointed out this was considered a danger.
        The fishing offshore to provide food for Gaza is tightly controlled, again because fishing boats could carry bombs. This is a real dilemma. Nothing that poses a danger to Israel can be allowed to exist, which means that there are few opportunities for the Palestinians to become independent of control by Israel. No place to go, nothing to do--what a bind to be in.

Fishing boats are not allowed out to good fishing waters.

        As one of my informants told me during the Intifada that started in 2000, “We are living in a community with three million people under house arrest. The curfew comes and goes. They lift the curfew for a few hours every few days so people can get food. When the curfew is on, you can’t even go outside your door. I’ve found it’s dangerous to show yourself at a window; they will shoot at you. Some children who took a chance to play in the street have been shot at.”
         Because of the lack of employment Palestinians need to rely on outside help for food and other basic supplies if they are to continue to exist. The curfews make it difficult and in some cases impossible for the volunteers from other countries to make their supplies available.

         Palestinian Central Bureau of Statistics (PCBS) reports that the unemployment rate in the Gaza Strip is 30.3 percent and 20.3 percent in the West Bank. That is about double that of Israel and neighboring Jordan. Because of the problems listed above it makes it difficult for workers to find, keep and get to their jobs, especially if they are within Israel. With more emphasis on developing work within the confines of Palestine the situation would improve.

Driving an ambulance is risky work, but drivers stay on regardless.

        I feel a need to say something about the kind of resistance that the Palestinians are putting up. On the face of it the resistance, such as suicide bombers, doesn’t make sense since these actions only bring on a much stronger negative reaction on the part of Israelis and the Palestinians lose more in the end. If we look at how members of the resistance relabeled their actions, it makes more sense.

Suicide bombers are one such example. I made the mistake of using the term “suicide bombers” with a group of Afghani doctors and school administrators and was confronted on my “misuse” of the word.
        Islam, like Christianity, does not condone suicide. Members of both religions generally view suicide as selfish and against religious teachings. However, insurgents have reframed the act as a sacrifice for their people or as a service to Allah in the war against infidels. This follows a basic psychological principle that the meaning we attach to any event depends on the words used to evaluate it.
        When working with clients, therapists often reframe something that the client is doing to put a more positive spin on it. For example, the client is unhappy because he keeps telling himself he "needs to” or "must do” something and feels guilty or depressed when he doesn’t do it. The therapist reframes it for the client as you "want to" or "would like to" do something, which takes some pressure off.
        Why use suicide bombers? Bruce Hoffman of the Rand Institute has called suicide bombers the ultimate smart bomb. As such, they are of great value to leaders as pawns in the struggle against Israel. But to use them, the leader has to create a willingness to die, and to do this he must convince others of the importance of the sacrifice of their lives.
        This is done by reframing the meaning of what they are doing by relabeling it, which causes people to have a different emotional reaction to what they are doing. For us to understand how the Palestinians are fighting in Israel, we need to see how insurgents have reframed what they are doing.
        Recruits join the insurgents for a combination of reasons: anger, revenge, hopelessness, to be significant to a group, for the money their family will receive on their death, or to make a contribution to their group’s freedom. We need to keep in mind that these are not individually motivated attacks but occur in the context of social political issues. The individual belongs to a group that needs--would like--someone to become a smart bomb, contributing to the cause of his group by becoming a martyr.
        The checkpoints aren’t keeping suicide bombers out of Israel, so a new method of defense is being tried. Ordinary citizens are being trained to disarm suicide bombers, and the process is interesting.
        First they must learn to spot someone who might have a bomb on his or her body. Two persons must then coordinate the disarming because the main thing is to keep the bomber’s fingers off the detonator. Each of the defenders rushes at the suspect and grabs an arm, at the same time throwing the suspect to the ground. If there is a bomb, the defenders are taught to break the suspect’s arms and, if he continues to struggle, to bite through the carotid artery in the throat.

         Certain changes are necessary before the situation can be improved. Without them the situation will remain basically what it is now.

The changes needed:

• Palestinians must accept that Israel is going to exist; the rest of the world will not let it be annihilated.

• The Palestinians must accept the loss of territory and stop seeing themselves as displaced persons. Our experience with the grieving of loss is that it cannot be overcome until the reality of that loss is accepted.

• The settlements must stop expanding and hopefully be removed from Palestinian territory.

• An establishment of hope for a better future must be restored especially for children who seeing the situation as hopeless turn to suicide bombing.

• International recognition must be given to the injustices that have been done to the Palestinians. They want and need validation of what has happened to them.

• Some way must be found to allow Palestinians to keep their infrastructure, whether it is small factories, their water supply, their fields and orchards, and their fishing rights. The present situation wipes out their basic means of survival.

• Soldiers need to be retrained to act like responsible adults showing respect and caring for those under their domination.

If all of this sounds impossible, we truly have a no-win situation for both parties.