Dear Editor,
The West Bank (including East Jerusalem) and the Gaza Strip, together known as the Occupied Palestinian Territories (OPT), are also recognised as Palestine, a small Middle Eastern country. The population was 5202,977 as of May 2021, representing for 0.07% of the world population. Authorities are battling to provide enough services to the vastly dispersed population, which is expanding at a rate of 2.65% per year as of 2019. Palestine is now struggling to provide for its population due to significant unemployment, poverty, and migration. Physical impairments and traumatism have also increased because of long-term military occupation, crime, and conflict.
Water lines, sewage management, and power have all been destroyed as a result of the continuous hostilities, which include the Israeli occupation and internal Palestinian split. The disintegration of the OPT in the West Bank, as well as the resulting jurisdictional structures, has exacerbated health and humanitarian issues in some places, such as Area C. Living under Israeli military occupation in the West Bank and the Gaza Strip has its own set of risks, such as disability, deprivation, social instability, and the loss of family and friends, all of which hurt people's social, psychological, and mental health.
Since the first case of COVID-19 was discovered in Palestine, there has been a cascade of unresolved mental health issues with the elderly and those with concomitant chronic medical conditions had the greatest death rates across all nations (Tandon, 2021b). COVID-19 exposure in the camp causes millions of contagions per year, putting additional pressure on Palestine's already overburdened mental health system. Because of a constant state of war, brutality, and terror, as well as constant, repeated traumatic events such as bombings, unlawful detention, house demolitions, movement restrictions on civilians, the export of vital humanitarian and medical products, and rising unemployment, the Palestinian health system is in a state of disarray as similar to Afghanistan (Saleem et al., 2021). People living in confinement and occupation zones do not feel safe, and they suffer from long-term psychological consequences such as post-traumatic stress disorder (PTSD), anxiety, mood changes, agitation, disobedience, sleeplessness, and other issues as a result of the military invasion (Thabet et al., 2004). Around 54% of boys and 46.5% of girls aged 6–12 have mental health or behavioral problems, and many of them have permanent disabilities as a result of physical injuries sustained during conflicts or bombing/shelling, which raises anxiety, tension, and other harmful coping mechanisms (Khamis, 2008). Similar patterns have been observed in women who have experienced high levels of domestic violence, which has had a significant negative impact on their mental health, resulting in infertility, anxiety, binge eating disorders, sub-optimal prenatal care, and psychological distress. According to a descriptive survey of pregnant women in refugee camps, about 30.7% had mild anxiety, 17.5% had moderate pressure, and 12% had extreme stress (Al-Tell, 2019).
Improved mental health initiatives, civic involvement, awareness campaigns, and mental health restoration services are all urgently needed in Palestine. Government and non-governmental groups in the region have developed a community-based psychosocial intervention strategy to provide psychological assistance. During an actual armed conflict, however, establishing and maintaining the same intervention approach will be challenging. In order to establish ideas and techniques for Palestine's present mental health crisis, researchers, practitioners, and policymakers are all critically needed. Stability and the re-integration of civil society are required to alleviate the burden, but this is an additional challenge during the current Palestinian conflict.
There is also a pressing need for researchers, practitioners, and policymakers to devise strategies and approaches considering Palestine's current mental health situation. For streamlined treatment, a dedicated mental health care system emphasizing mental health is on the way, as is legitimate legislation to distribute funds. The Ministry of Health and other stakeholders must collaborate to obtain the most significant funding, build hospitals, and hire specialist physicians. Mental health treatment should be further integrated into the primary care system. Training primary care physicians and increasing outreach, accessibility, acceptability, and monitoring for mental health services should be prioritized, particularly in marginalized communities. Authorities must work to raise public consciousness about the benefits of psychological treatment. Despite the Palestinian community's disintegration, mental well-being is difficult to attain, aside from the constant trauma that Palestinians face. People are threatened with losing their lives, their loved ones, or their land regularly. Despite attempts to integrate mental health services into primary care, we continue to see people ignore them. The stigma associated with mental illness and Palestinians' lack of understanding of the value of psychiatric care and consultations is a significant barrier. Furthermore, the cultural reasons for psychiatric diseases and their religious roots show undervalued psychological and mental well-being. International humanitarian aid is required for the ongoing war in Palestine, as well as the COVID-19 response. The ongoing political struggle and the COVID-19 pandemic have created a worldwide mental health emergency, which has clashed with an increased complicated humanitarian situation in Palestine, adding to the country's rising mental health burden.
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CRediT authorship contribution statement
Sheikh Shoib: Conceptualization, Formal analysis, Methodology, Writing – original draft, Data curation, Validation, Visualization, Investigation, Project administration, Resources, Supervision, Writing – review & editing. Apeksha Gupta: Conceptualization, Formal analysis, Methodology, Writing – original draft, Data curation, Validation, Visualization. Duha Shellah: Conceptualization, Formal analysis, Methodology, Writing – original draft, Data curation, Validation, Visualization, Writing – review & editing. Sheikh Mohd Saleem: Conceptualization, Formal analysis, Methodology, Writing – original draft, Data curation, Validation, Visualization, Writing – review & editing. Jibril I.M. Handuleh: Conceptualization, Data curation, Formal analysis, Methodology, Writing – review & editing, Investigation, Project administration, Resources, Supervision.
Contribution
All Authors contributed equally to the Entire paper work form idea generation to structuring.
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Declaration of Competing Interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgement
SM Yasir Arafat, Enam Medical College Dhaka, Bangladesh for support and inputs.
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References
- Al-Tell M. Factors associated with antenatal depression in Palestinian Refugee Camps in West Bank /Palestine: cross sectional study. Glob. J. Reprod. Med. 2019;7(3):50–56. doi: 10.19080/gjorm.2020.07.555712. [DOI] [Google Scholar]
- Khamis V. Post-traumatic stress and psychiatric disorders in Palestinian adolescents following intifada-related injuries. Soc. Sci. Med. 2008;67(8):1199–1207. doi: 10.1016/j.socscimed.2008.06.013. [DOI] [PubMed] [Google Scholar]
- Saleem Sheikh Mohd, Shoib Sheikh, Dazhamyar, Riaz Ahmad, Chandraadasa M. Afghanistan: decades of collective trauma, ongoing humanitarian crises, Taliban rulers, and mental health of the displaced population. Asian J. Psychiatr. 2021;65 doi: 10.1016/j.ajp.2021.102854. [DOI] [PubMed] [Google Scholar]
- Tandon R. The bitter lessons of COVID-19: acknowledging and working through many points of tension. Asian J. Psychiatr. 2021;55 doi: 10.1016/j.ajp.2021.102545. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thabet A.A.M., Abed Y., Vostanis P. Comorbidity of PTSD and depression among refugee children during war conflict. J. Child Psychol. Psychiatry Allied Discip. 2004;45(3):533–542. doi: 10.1111/j.1469-7610.2004.00243.x. [DOI] [PubMed] [Google Scholar]
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