7 April 2017
Today is World Health Day, and this year’s theme is ‘Let’s Talk’, with a focus on the topic of depression – the leading cause of ill health and disability worldwide.
Men, women and children living under occupation and/or blockade in the occupied Palestinian territory are subject to stress in every aspect of their daily lives. Restrictions on movement, settler violence, threats of home demolition, unemployment and trauma caused by conflict and displacement are all facts of daily life. This puts members of these communities at heightened risk of mental ill health, including anxiety disorders and depression.
For Palestinians living under occupation who also suffer physical health problems, these problems are compounded. The additional obstacles to accessing care, and patients’ fear for the wellbeing of their families can create significant stress.
Medical Aid for Palestinians (MAP) has long supported mental health and psychosocial support programmes across our areas of operation, from our in partnership with UNICEF in Lebanon providing care for Palestinian refugee children from Syria, to our work with Al Saraya centre in East Jerusalem, where Palestinian children living in the old city can learn life skills and safely discuss the daily challenges they face.
Our programmes also seek to offer psychological support to Palestinians with physical health problems, including women affected by breast and gynaecological cancers who visit the Dunya Women’s Cancer Centre in Ramallah, in the occupied West Bank.
We have highlighted the obstacles to care for Palestinian women diagnosed with cancer living under occupation before. This week we spoke to social worker Marah Salman Amro, who works at the Dunya Centre thanks to MAP funding, about how these stresses affect the women she works with:
“The women come to the centre from different areas of the West Bank (North, South and Central), all either directly or referred by their doctor or the various health centres. Here they can receive several diagnostic tests: breast ultrasound, mammogram, biopsy, pap smears, laboratory tests … They can also receive an assertive marker to determine the location of the tumour prior to the operation, consultation with the oncologist, and psychosocial support for patients and their families.”
“Many have a stereotypical picture of the disease socially, and link it to the idea of death. They also have fears about changes to their body associated with the disease and treatment, such as hair loss and breast loss in the event of mastectomies. Women sometimes become depressed, and sometimes hesitate in their decision to proceed with treatment.
Some women also have difficulty accepting themselves after treatment, blaming themselves and having fear that the disease will return.”
“Women in Palestinian society suffer a great deal because of the occupation. In the case of patients with cancer, these difficulties are concentrated on the delays when trying to get to treatment sessions, especially with the presence of soldiers and checkpoints who do not take into account the health status of the patients.
Often the occupation means that facilities are not available locally for patients. So the woman must go alone to treatment centres elsewhere. She must go to areas outside her neighbourhood, accompanied by fears for her family - will she return safely and quickly to her home, or is it possible that checkpoints will be closed? This is all the more difficult because patients need constant follow-up.
One cancer survivor told me that her session at one of the treatment was at 12 pm but she had to leave her house at 6 am to get there on time. On one occasion her companion was arrested. He was a young man of 20 years and her youngest brother was affected. The family sometimes hesitates to send someone to accompany her during the treatment.”
“Counselling may not only be related to the disease, but considers the needs of the woman such as experience of violence, family problems, or financial difficulties. Sometimes we refer them to other specialist organisations.
In individual sessions, we enable women to know accurate and correct information about the disease and tumour, and help them to be calm. We also see some women before they are examined if they suffer extreme tension. We also listen to their concerns, and can help them apply for breast prostheses and wigs if needed.
We also work with a support group, which consists of a group of women survivors of breast cancer. At the meetings they work together for psychological support, education, entertainment, and to develop their skills to be able to support the new members of the group and any women in their community.”
Next week, we will launch Chapter 3 of our Health Under Occupation briefing series, on the subject of the mental health and quality of life impact of the occupation. To keep up to date with this and other information about our programmes and campaigns, sign up to our mailing list below:
