how can it possibly not...

cause significant anxiety, depression, and other psychological disorders.
"It" being the environment of occupation.

I set out to do an interview in Jaffa (next door to Tel Aviv) on Monday, for a peacebuilding organization I am involved with called Interchange.

In a series of blog posts and invitations to other practitioners to share their stories, I am trying to make a forum that describes the overlapping work of peacebuilding and health promotion. As someone who has experience in international development and community peacebuilding, and is currently working towards a Masters of Public Health, the topic interests me greatly and allows me to give more shape and  weight to how I view good public health work. ie. raising health literacy, improving access to resources, encouraging involvement in community groups and bringing people from different sectors and walks of life together to see the social determinants of health, and how they can best provide them.

so. without going into further detail (that is what the other blog is all about!), I am interviewing organizations that I feel embody this marriage between health and peace promotion.

Yesterday, I had the privilege of meeting with Physicians for Human Rights, which is an Israeli NGO that works toward making the right to health a reality for all people living in this region. They have an open clinic in Jaffa which serves about 40 people a day, as well as mobile clinics that go into the West Bank on a weekly basis and provide health services to refugees, stateless people, and anyone else who lacks access to primary health services.

The reason I tell you this is because of my mental state once I finally arrived at their office.

I left my house in Ramallah at 1pm, to begin the journey which I knew could last 3 hours typically, even through Tel Aviv is less than 50 km away.

I got on the first bus, got out at the Kalandia check-point, waited... waited... waited for probably 30 minutes, walked through and got on another bus to Damascus Gate (or the "Arab bus station" in Jerusalem). For this portion of the journey, everyone around me is speaking Arabic, people look like they may be going to university or coming home from work. Its calm, but its sweltering. I can't imagine doing this everyday, just to attend class or go to work.

If you are foreign, or have a Jerusalem ID, you can then get on the public transit system that goes through West Jerusalem, and will take you to the Central Bus Station, where again, you must take another bus to Tel Aviv.
The duration for all of this (up to the Central Bus station) is about 2 hours. and remember one can see Ramallah from Jerusalem easily. they are close neighbors, that have become very far apart because of the apartheid wall.

I digress.

So now its 3:45. I've got my ticket to Tel Aviv. I think "no worries, shouldn't take more than an hour max" My appointment was at 5pm in Jaffa. Tons of time.
No. it was not tons of time. We took a different route, some national holiday, major traffic. I arrive in Jaffa, after another two buses, at 7pm.
I felt so helpless and inept. I couldn't call the organization I was going to meet because Palestinian phone companies have no coverage in Israel, even though cities are minutes apart. I couldn't really complain either, because I don't speak Hebrew, and few people I met in the Israeli transit system spoke English.

So in short, I came away feeling incredibly anxious, irritated and worn down. Why did that need to take sooo long?
This brings me back to my opening remark. How can this system - one of perpetual checkpoints, segregated transportation companies, and monopoly of force - not lead to depression, anxiety, chronic fatigue and a whole host of other psychological problems.

After that experience yesterday, this morning I visited Palestine's only psychiatric hospital.
It has been around since 1922, and currently serves 150 patients, 90 of which are chronic in-patients.
The building was beautiful. Old early 20th century architecture, typical of the British presence here at the turn of the century. I asked about the most common illnesses they treat. "Schizophrenia, bi-polar disorder... in some cases heavy depression."

What is the incidence of schizophrenia here in the population? "about 1%, normal, global average"

What about depression? "Way more. probably 3 or 4 times more. Its different now too. During the 1st Intifada, Israel didn't close all the borders. there was fighting, but you were still to walk around. That changed in the 2nd Intifada. They closed all the borders. Now we live in a cage. At the hospital, and mostly at our community clinics, we see so much more anxiety and depression and PTSD now, because of the Wall.

There is was again.
The physical embodiment of people's daily struggles and small tortures in this environment. The occupation penetrates one's psyche. Even if you have freedom within a jail, you are still in a jail.

I see lots of UNRWA and other NGO agencies working in psychosocial counselling and trauma therapy, but today I learned that the Palestinian Authority Mental Health Community Centres rarely have group therapists, rehabilitation services, or family therapists.
"It simply doesn't exist here. Its not taught in schools. Even if you want to become a group therapist, you cannot in Palestine right now"

I do not understand how the World Health Organization, or numerous other health monitoring bodies has not been more incriminatory against the wall. Against all that is stands for, and all that it will effect in the future health of Palestinians. They recently published an atlas on the availability, governance, financing and structure of mental heath services internationally. Palestine, or the West Bank and Gaza Strip, were not included in this Atlas. I find this hard to take.

If you have thoughts on why, please let me know.