The Uninterrupted Cycle of Violence

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I came to Hebron on the 10th of February this year. Time has passed.

The first time I experienced a rocket attack, I was in Jerusalem. Although in Jerusalem, most were being intercepted by the Iron Dome – the sounds were very audible. I heard this one, and initially I couldn’t figure out if it was an ambulance or a siren.  We said “Oh, it’s a siren”, and we started moving away from the windows and the doors, to the designated area for taking shelter during rocket attacks.  And before you know it, there’s a huge booming noise…I had no way of knowing then but was hoping that it was the sound of the rocket being intercepted. Hebron was not a target, but several rockets landed there as well. And as it is the West Bank, there is no protective Iron Dome here. Every time a rocket landed in Hebron, the first thing that came to my mind was – where and how is the rest of the staff? That was one of the major realizations of what being a Field Coordinator is like.

Everyday clashes, incursions and arrests are a part of the daily life of Palestinians living in the West Bank. However, after the start of the Gaza war, it intensified ten-fold.  As a result of operation “Brothers´ Keepers”, there were very heavy, very violent crackdowns on the population in Hebron; and this was coupled with the Gaza war and the violent daily clashes that followed. Apart from their own state after the crackdown, it seemed to me that people were anguished and angry also because they had family in Gaza, and they could see on TV every day what was happening there. I think it was a combined effect from what they went through themselves, and what they saw in Gaza, so it had a double whammy impact on their mental health.

During Ramadan, the clashes happened every night after the day’s fast broke.  

As a part of MSF, you want to be where the need is absolute, immense, and immediate. Coming from a project like Kala-azar, which is very medical, very vertical and very technical in terms of its implementation, and then working with one based on mental health – it’s an experience of a lifetime.

I’ve realized that the physical impact of conflict is more apparent than other damages; but the mental impact on the minds of people in conflict situations, if left untreated, lasts forever. I always knew what “direct impact” meant – when you’re directly affected by an event – disease, for example. Here it is in the form of incursions. Your house has been demolished in front of your eyes, or you’ve been arrested, beaten, detained, or worse. But there’s also a very important term that I learnt here in terms of mental health – “indirect impact”, where you’ve witnessed things – children have seen elders being beaten; spouses, parents and siblings have seen their loved ones being arrested or at the receiving end of brutality. Witnessing clashes, losing your family – this is something understated, unseen, but something that stays with you and maybe scars you for your entire life. The stories of the patients here bear witness to this.

Around 40 per cent of our beneficiaries at the project are children. This is what they grow up with, and live with, for the rest of their lives.

As a society, the Palestinians are a proud people. For instance, it’s very difficult for the men to admit that they are going through psychological problems. So there is always a feeling of hidden hopelessness, of suppressed helplessness. For example, during the violent clashes that were a result of the war in Gaza, a lot of men were badly injured by live ammunition and were admitted in the hospitals. Identifying the need to attend to them, our psychosocial workers went to the hospitals and saw these people injured not just physically, but both mentally and in spirit. We are attending to a large population here, so it is important for us to acquaint people with the importance of mental health and the situation that they are in. To let them know that what they are going through is not normal, but what they experience mentally because of going through all of this, is normal.


As a Field Coordinator, it is very important for me to ensure security for my teams and to ensure access. I am in touch with Palestinian police and constantly coordinating with Israeli authorities, saying – “This is my team; we need to move in this area to do our work.” During the emergency intervention, we were focusing on the conflict’s hotspots, so we sent teams out to these tense areas to assess what the situation was. Thus getting the assurance of security from their end was a vital necessity.  We attended to 1146 affected beneficiaries in less than a month by offering psychological first aid (PFA) within the first few days of impact.

When I first came to the West Bank, I could never have thought that the conflict would escalate to this level.  But that’s what MSF is all about. That’s what life is all about –  you never know what happens next. It’s like a ticking clock…everything is fine, you’re watching movements, you’re managing security, but any little thing can blow out of proportion at any moment. So even though I wasn’t expecting anything, I was prepared. 

This is because MSF has very strict rules about operating in conflicts, not to mention very good liaisoning with the local authorities and other NGOs. We double check every movement of ours in times of crises.

It is also always difficult to stay impartial in situations like this. For me, personally, just the sheer amount of firepower deployed in the area was difficult to deal with. But I had to, and still have to do my best at work to stay impartial. If MSF doesn’t stay neutral and impartial towards both sides, we lose access to beneficiaries. The healer’s primary objective is just that – to heal. 

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