How trauma is scarring the lives of a million young Gazans

Nick Donaldson / AP Photo

At Unicef we often get asked about the effect the unrelenting war in the Gaza Strip has on children’s mental health. As bombardments once again threaten children, this question is more important than ever before.

From other crises, we know that children are likely to show stress-related changes in behaviour as they process what happened. After the crisis subsides and the child can receive support from those around them and rely on a stable and nurturing environment, in time, most will return to their typical childhood functioning.

The Gaza Strip is different. For one million children there is no "post" traumatic stress - it is a chronic stress, of deprivation, boredom and loss. Profound, unbearable, and devastating loss. Even now, as basic food, medicine and water are denied entry into the territory, there is an ever-present threat of illness and death.

This level of chronic stress is not just harmful – it is life-threatening. Chronic stress rewires young brains and bodies, making them more vulnerable to lasting psychological and physical harm. With the recent escalation of hostilities, this chronic stress is surging once again.

'Children burn inside tents' as Israeli strikes hit Gaza camps

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We see children becoming withdrawn, irritable and struggling with clinical levels of depression and anxiety. Parents tell us they thought the worst sound imaginable was the sound of their hungry baby but then realise that the worst sound is silence from a hungry baby. Mental health practitioners describe children who have not spoken for months.

In October 2024, at the height of the fighting in the northern Gaza Strip, Unicef was asked if we could train psychologists on ”end of life counselling” for children “because these children feel they are going to die”.

We should not be resorting to this. We should be protecting children and preventing them from ever feeling this way by pursuing the only reasonable remedy: a permanent ceasefire, alongside unrestricted humanitarian aid.

To understand mental health in Gaza, we must look at what was. Before this war, Gaza had a functioning – though overburdened and underfunded – mental health system. Decades of investment by Palestinian specialists, advisers, and donors had built a robust network of well-trained professionals delivering care through a psychiatric hospital, multiple primary health care facilities integrating mental health support, and dozens of community family centres for psychosocial support – 12 of which were supported by Unicef.

Most of these facilities are now damaged or destroyed. And yet, the need for mental health support has never been greater.

In time, we must support Palestinians to rebuild this infrastructure, but it is only part of the story.

Before this war, Gaza had a functioning – though overburdened and underfunded – mental health system... Most of these facilities are now damaged or destroyed

Mental health workers, the backbone of any response, are themselves deeply affected. Many have been killed or injured. Others have watched their children or spouses die. Some have fled the strip for safety. Those who remain have been displaced, most multiple times over. And yet, they still show up.

On a short visit to the Gaza Strip this month, I met them – the ones who, through relentless bombing and unbearable hunger, still organise activities, discussions, and moments of support for children and parents. I asked them how they continued to give so much when they lost so much themselves.

"I feel a responsibility to the women and children,” one doctor told us. “I have kept working from the first day of the war until now. It is very difficult, but we do our best, even with the bombing, because we cannot leave them.”

These heroic front line workers need more support. Practitioners have told Unicef that there is a gap between the severity of what they are seeing and what they were trained on. Unicef has been stepping in and training psychologists and counsellors to treat severe traumatic stress symptoms in children. We use interventions that can be rolled at scale, in an attempt to meet the growing needs.

In February, our teams delivered training to psychologists and counsellors. As practitioners use these techniques on themselves, they find that sleep comes easier, flashbacks lessen, and hope feels possible again. Their goal is to pass these skills to the children and adolescents they serve – to give them a sense of care, support, and a belief in their ability to help each other heal.

And we are committed to doing more, as long as conditions allow. The recent resurgence in bombardments combined with the continuing stoppage of all aid and commercial supplies entering Gaza threaten every aspect of the lives of all 1.1 million children in the Gaza Strip.

Displaced Palestinian children inspect the ruined auditorium of Gaza city's Islamic University on April 16. Chronic stress rewires young brains and bodies, making them more vulnerable to lasting psychological and physical harm. AFP

We urge the immediate reinstatement and continuation of the ceasefire and call on countries with influence to prevent further escalation. International humanitarian law must be upheld, including the immediate provision of humanitarian aid, the protection of civilians, in particular children, and the release of all hostages.

Unicef is expanding mental health services across the Gaza Strip – through schools, mobile health clinics, major centres, and community spaces. We are supporting families hosting unaccompanied and separated children. We are standing with mental health workers – just as they stand with children.

We have been with families in Gaza for decades, and we will stay. Because rebuilding is not just about infrastructure. It is about reclaiming childhood. It is about centring children in the Gaza Strip’s future and ensuring their well-being and best interests guide the path forward. That is the only way to peace.