Outbreak of war sheds light on Gaza's dire conditions and rising suicide rate

Suicide attempts have been happening almost daily in Gaza, and though only a few end with death, most are being kept secret by families due to stigma and a desire to protect so-called social harmony.

However, these traditional viewpoints hardly help to mitigate suicide or identify and address its root causes.

A personal story

I personally know two people who committed suicide in Gaza, among scores of other attempts.

In 2017, the news of the death by suicide of a gentle and kindhearted friend, Muhannad Younes, shocked Palestinian intellectual circles. He excelled at writing short stories in his own distinctive style and showed promise as a future literary figure.

As a close friend, he opened up about his desire to leave Gaza to start a new life elsewhere, one that would amount to something. But he couldn't leave due to a strict travel ban imposed by Israel.

Thus, Younes chose to depart from this life altogether.

Recently, there was more devastating news: the suicide of another friend – the poet Muhammad al-Najjar, who suffered from long-term depression, an illness aggravated by difficult socio-economic circumstances.

Before taking his own life, Al-Najjar posted a suicide note on his Facebook page, stating: "I must leave this world after the failure of all my attempts over eight years to relieve myself of depression, the latest of which was electroconvulsive therapy sessions that I started a year ago. I tried my best but to no avail. I do not blame anyone for it, but I simply cannot endure all that amount of pain deep inside anymore. I am terribly sorry."

Younes and al-Najjar were both deeply cherished, but a bleak life in Gaza offered them no reprieve to thrive and prosper.

These two stories are a fraction of the bigger picture; they are a frightening indication of the speed at which suicide rates are rising in Gaza, especially amid unbearable living conditions and the lack of prospects.

Society in Gaza has traditionally been religiously conservative, at least to an outsider's eye. However, this alleged conservatism has failed to provide any tangible solace to many Gazans who are living through a daily nightmare, making suicide seem like their only option.

'Unimaginable psychological burden'

Social worker Dr Khitam Abu Awdeh says that, while no society worldwide is free of suicide, the increasing rates of suicide in Palestine are alarming.

"In recent years, Gaza has been witnessing an increase in the number of young people who choose death. This is somewhat of an unprecedented phenomenon in Palestinian society, which has been by and large a conservative one that adheres to religious guidelines that prohibit suicide," she says.

"However, several factors have conspired in recent years to make life in Gaza unbearable to many, including socio-economic hardships, the political split between Hamas and Fatah, the Israeli economic and geographical blockade, and the recurring wars," she adds.

The result is "an unimaginable psychological burden on Gazans", and those who consider suicide will almost certainly have experienced "a trauma too hard to handle." This leads to suicide attempts through "hanging, self-immolation, explosives, firearms, drug overdose, or any other method."

Young people at higher risk

"Anyone who attempts to take their own life has a bleak perspective and can find no room or space to try to start anew," says Abu Awdeh.

"Unfortunately, almost everyone in Gaza is at risk of going through this dark tunnel, due to the lack of prospects for a better future."

Young Gazans, aged 18 to 30, are at the highest risk.

However, social norms in Gaza still consider suicide to be an unacceptable social "taboo". It's something that is seen to bring shame to the victim's family due to deep-rooted religious principles.

Regardless, the circumstances leading to these incidents cannot be ignored.

"Many university graduates in Gaza never find any job opportunities that match their fields of study. Moreover, if someone does find work at all, the salaries are usually very low," says Abu Awdeh.

"Since the political split of 2007, the Palestinian Authority has been providing no work opportunities.

"Also, most available jobs in Gaza are partisan-affiliated, where each political faction solely provides its direct supporters with a limited income. Thus, most people are left alone in the face of utter poverty and unemployment," she adds.

Another kind of suicide

Abu Awdeh points out a related worrisome trend in Gaza – learning how to swim, to make a perilous escape to another country.

"Since it's so hard for them to travel through the formal border crossings of Erez with Israel or Rafah with Egypt, the alternative they think of is attempting to migrate via the Mediterranean, which is just another kind of potential suicide," she says.

Meanwhile, Abu Awdeh states that social support centres in Gaza can provide care to people in psychological distress.

However, she notes that social stigma – including being labelled "crazy" and bringing strife to their families – stops many people from seeking help.

"Even when someone consults specialists at these centres, they don't always reveal every detail (of their suffering) out of social or religious considerations. As a result, their condition often deteriorates," she says.

To help mitigate that situation, Abu Awdeh calls on Palestinian universities to support their graduates by waiving certificate fees, which most students cannot afford.

She also stresses the need to spread awareness in Gazan society about the necessity of psychiatric and psychological treatment through various programmes provided by civil society.

Abu Awdeh also calls on Friday sermon preachers to shed light on the phenomenon of suicide and the importance of caring for one's mental health, pointing out that this topic never appears in their speeches.

She emphasises the importance of this inclusion, as Gazan communities are largely influenced by religious discussions.

Social stigma

Psychiatrist Ismael Ahl tells Al Majalla that the rejection of psychiatry as a treatment method by Palestinian society is one of the most significant factors behind the recent increase in suicide rates.

"Typically speaking, a family with a suicidal member would resort to supposedly pious individuals or sorcerers and reveal the secrets of their struggling relative to them," he says.

"This reflects a mistrust towards psychiatry, which has been inherited from traditional social norms. It's something that has been reinforced by old Arab television series and films that depict both the patient and the psychiatrist as madmen.

"Therefore, due to their ignorance of the genuine role of psychiatry, most families would do anything to avoid making themselves prone to social stigma."

Ahl attributes the prevailing psychological disorders among young people in Gaza to several factors.

"Oftentimes, these young people had a difficult upbringing, witnessed domestic abuse, or had childhood traumas," he says.

"Furthermore, the persistent and challenging economic, political, and social conditions and the lack of prospects, particularly following the Palestinian political split, have worsened things.

"Add to this that some influencers in real life, or on social media, have a negative impact on the youth and promote self-destructive concepts. The outcome is deteriorating mental health and possible suicide."

Some institutions across Gaza provide psychological counselling to people in need, and in some cases, they have successfully talked vulnerable individuals out of suicide. However, Ahl confirms, it is still unusual for Gazans to seek help from these institutions.

"We have more than 300 institutions across Gaza that are ready to receive patients suffering mentally and assist them with psychological relief," says Ahl. "However, these institutions are rarely sought by people needing mental support."

The power of a diagnosis

In cases where a Gazan suffering from a psychological disorder does seek professional help, a psychiatrist can assess the severity of their case and what it entails. This considers the likelihood that the patient might harm themselves or others.

"Unfortunately, in several cases, the people close to the patient do not take the professional psychological assessment seriously, and the result is often suicide," says Ahl.

Many loved ones fail to deal with mental illness as a serious matter. Friends and relatives might even assume that the patient is intentionally exaggerating. Their neglect or downplaying of the situation can contribute to a decline in the patient's well-being.

Ahl adds that many people are unaware of the symptoms of serious psychological disorders, including "a severe change in personal habits and mindsets, accompanied by mood fluctuations, a total rejection of reality, social norms and traditions, and increased proneness to violence."

"Some families take the social care money allocated by charity institutions to mental patients to fund their daily needs. Thus, they leave the patient wandering aimlessly across the streets without being cared for," says Ahl.

"It's also astonishing how this kind of intentional negligence can happen without any follow-up or legal accountability, neither before nor after the suicide attempt."

The Palestinian judicial system

Lawyer Muhammad al-Masri tells Al Majalla that, from a legal standpoint, it's straightforward: "When someone kills themselves, this is considered suicide."

Article 225 of Law 74 issued in 1936 of Palestinian jurisprudence considers suicide "a felony" and punishes anyone who attempts to encourage others to commit suicide, rendering them "a felon".

However, Al-Masri criticises the socially imposed censorship regarding suicide attempts.

"Suicide attempts are frequently reported to police stations across Gaza. However, they are mostly kept secret, especially if the victim is a woman," he says.

"Hence, most families deal with these incidents quietly to avoid the likelihood of rumours spreading about them, and in fear of social stigma."

He adds: "The family of the victim, and the legal centres in Gaza, always do their best to bury any suicide story, disregarding the Palestinian law and its requirements. Throughout my long years as a lawyer, I have never received one case related to a suicide attempt."