In Gaza, emotional wounds of war remain unhealed

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In this Wednesday, Aug. 13, 2014 photo, Mouin Quishta holds photographs of his daughter Shahed, 8, who was killed on July 22, in the town of Beit Lahiya, northern Gaza Strip. Almost a month after her death from what her father says was an Israeli tank shell, her family remains paralyzed by grief. (AP Photo/Khalil Hamra)

In this Wednesday, Aug. 13, 2014 photo, Mouin Quishta holds photographs of his daughter Shahed, 8, who was killed on July 22, in the town of Beit Lahiya, northern Gaza Strip. Almost a month after her death from what her father says was an Israeli tank shell, her family remains paralyzed by grief. (AP Photo/Khalil Hamra)

This undated family photograph shows Shahed Quishta, 8, who was killed while sitting in her living room on July 22, 2014, when an Israeli tank shell slammed into her home in Beit Lahiya, Gaza Strip. The Quishtas are among thousands who suffered a loss during the current Israel-Hamas war, the third in Gaza in just over five years. The emotional wounds, though sometimes hidden, can be seen in the grim statistics of the conflict. (AP Photo/Quishta family)

This Wednesday, Aug. 13, 2014 photo shows a portrait of Shahed Quishta, 8, in the living room where she was killed while sitting in the armchair, seen in the background, on July 22, and a piece of shrapnel from the the Israeli tank shell that slammed into her home. Almost a month after her death, her family remains paralyzed by grief. (AP Photo/Khalil Hamra)

In this Saturday Aug. 16, 2014 photo shows, a portrait of Shahed Quishta, 8, in the living room where she was killed by an Israeli tank shell on July 22 in Beit Lahiya, Gaza Strip. The Quishtas are among thousands who suffered a loss during the current Israel-Hamas war, the third in Gaza in just over five years.(AP Photo/Khalil Hamra)

In this Saturday Aug. 16, 2014 photo, the family members of Shahed Quishta, 8, seen in the framed picture wearing pink, gather for a family portrait in the living room where Shahed was killed on July 22 in an Israeli tank shelling in Beit Lahiya, Gaza Strip. The Quishtas are among thousands who suffered a loss during the current Israel-Hamas war, the third in Gaza in just over five years. The emotional wounds, though sometimes hidden, can be seen in the grim statistics of the conflict. (AP Photo/Khalil Hamra)

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BEIT LAHIYA, Gaza Strip (AP) — Shahed Quishta was curled up in an armchair one late afternoon during the Gaza war when a shell slammed into her living room. Shrapnel pierced the 8-year-old’s head and neck, and she died minutes after arriving at a hospital.

Her funeral was held before nightfall, in line with Muslim tradition. Her family couldn’t host a customary three-day wake, typically attended by hundreds of people, because streets remained dangerous during ongoing fighting between Israel and Gaza militants.

Almost a month after her death from what her father says was an Israeli tank shell, her family remains paralyzed by grief.

Sister Rojina, 14, can’t sleep in the room they shared, spending nights on a mattress in the hallway. Her mother Nisreen, 38, takes clothes from Shahed’s closet from time to time, crying as she inhales the lingering scent.

The Quishtas are among thousands who suffered a loss during the current Israel-Hamas war, the third in Gaza in just over five years. The emotional wounds, though sometimes hidden, can be seen in the grim statistics of the conflict.

Close to 2,000 Palestinians were killed, including 459 children, and more than 10,000 people were wounded since fighting began July 8, according to U.N. figures. About 20 percent of Gaza’s population of 1.8 million people has been displaced, including about 100,000 whose homes were destroyed or damaged beyond repair.

Based on these numbers, “the psychological effects (in this war) will be much higher than in the previous ones,” said Dr. Iyad Zaqout, who runs the community mental health program of Gaza’s main aid group, the U.N. Relief and Works Agency.

Children are especially vulnerable because they can’t put their experiences into context yet, he said.

The U.N. estimates that about 373,000 children in Gaza need direct psychological intervention because they’ve witnessed violence, lost a relative or have been displaced. Such children often display one or more of a range of symptoms, including bed-wetting, nightmares, irritability or clinging to parents.

In the last major round of fighting in Gaza in the winter of 2008-2009, about 18,000 of some 190,000 children attending U.N.-run schools required counseling, Zaqout said. Several hundred still haven’t recovered, he said, adding that repeated exposure to trauma — a given in Gaza — compounds the problem.

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Some 100 U.N. trauma counselors now visit several dozen crowded U.N. schools that have been turned into shelters for those who fled or were made homeless by the fighting. Several private groups providing trauma relief have also sprung up in recent years, though the demand continues to outstrip available treatment.

The counselors offer psychological “first aid” to those at the shelters. Children are usually accessible, eagerly joining playgroups in school courtyards or picking up crayons to draw what they saw in the war. At least 30 percent of the children at the shelters will need longer-term treatment, Zaqout estimated.

Adults are often reluctant — especially men.

On a recent morning, counselor Kamel Kahlout from the Gaza branch of a U.S.-based group, the Center for Mind-Body Medicine, persuaded about a dozen men to join him in therapy session at the Abu Hussein school, a shelter in the Jebaliya refugee camp.

Kahlout led them through a simple breathing exercise and asked them to close their eyes. Many found it difficult to sit still, with the noise from the crowded courtyard outside. When asked to share their concerns, the men stuck to politics, avoiding the personal. The men need more time to open up, he said.

Those at the Abu Hussein

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