Eastern Mediterranean Health Journal | All issues | Volume 31 2025 | Volume 31, issue 4 | Restoring stolen dreams and futures, saving Gaza’s children from generational trauma

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Restoring stolen dreams and futures, saving Gaza’s children from generational trauma

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Commentary

Izzeldin Abuelaish1, Negar Balouchestani-Asli2, Sara Tamjidi1, Lana Yacoub3 and Jocelyn Brady2

1Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. 2School of Population and Public Health, University of British Columbia, Vancouver, Canada (Correspondence to Jocelyn Brady: This e-mail address is being protected from spambots. You need JavaScript enabled to view it and Izzeldin Abuelaish: This e-mail address is being protected from spambots. You need JavaScript enabled to view it ). 3Faculty of Science, University of Windsor, Windsor, Canada.

Keywords: starvation, malnutrition, famine, siege, warfare, right to food, right to health, Gaza

Citation: Abuelaish I, Balouchestani-Asli N, Tamjidi S, Yacoub L, Brady J. Restoring stolen dreams and futures, saving Gaza’s children from generational trauma. East Mediterr Health J. 2025;31(4):216–218. https://doi.org/10.26719/2025.31.4.216.

Received: 13/12/2024; Accepted: 25/03/2025

Copyright © Authors 2025; Licensee: World Health Organization. EMHJ is an open-access journal. This paper is available under the Creative Commons Attribution Non-Commercial ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

For nearly a century, Palestinians in the Gaza Strip have been experiencing consistent, continuous and deliberate trauma due to colonization and violence (1). For example, an 18-year-old in Gaza today has endured 6 wars, a blockade imposed since 2007, and the October 2023 war (Table 1). Article 6 of the Convention on the Rights of the Child (1989) affirms that every child has the inherent right to life, and it obligates State Parties to ensure–to the maximum extent possible–the survival and development of children (3). Yet, the Israeli military attacks in Gaza continues as a normalized occurrence.

In a UNICEF interview in Gaza in 2023, 10-year-old Rahaf said: “I dream of a future where I can live without the constant fear of being killed.” This statement highlights how the constant war has created a state of hopelessness for the future of children in Gaza (4). In each of the conflicts in the Gaza Strip since 2008, Palestinian children have been killed by Israeli occupation forces (Table 1) through attacks on civilians (5). The survival of children in Gaza means living with chronic violence, conflict and trauma. A recent report by the United Nations High Commissioner for Human Rights of attacks in the Gaza Strip shows that 44% of victims were children (6). Targeting schools, hospitals and places of refuge results in mass casualties among children and undermines future generations (6), and violence against children is a violation of international law and a tragic assault on their right to grow, learn and thrive in peace.

The Israeli attacks, occupation and colonization of Palestinians, including the restrictions on water, food, education, and access to medicines is a kind of collective punishment for the civilian population (7), which robs them of their future.

As of 3 February 2025, an estimated 61 709 Palestinians in the Gaza Strip and 905 in the West Bank and East Jerusalem had been killed during attacks by Israeli forces, and more than 111 588 people in the Gaza Strip had been injured (8). About 90% of the 2.3 million Palestinians in the Gaza Strip are internally displaced, and that number continues to increase (8) because there is no safe place in the Gaza Strip.

The endless conflicts breed instability and leave feelings of hopelessness in children, and the emotional, spiritual, mental, physical, and social wounds decimate every aspect of their individual and collective health (9). The heavy bombardments from the air raids, ground invasions and constant threats of explosions, imprisonment and death force children in the Gaza Strip to navigate life with the complete loss of every basic necessity of life, including food, housing, water, family, security, medical care, and education (7). As of 17 October 2024, an estimated 80% of the population in Gaza Strip were experiencing acute food crisis; 133 000 people were in phase 5 (Catastrophe) classification of the food security analysis (10). Alongside mass starvation, the pillars of community growth, including access to education, have been demolished. Over 80% of Gaza’s schools, including 100% of its universities, have been damaged or destroyed, in what could be referred to as scholasticide (11).

Another critical resource, water, has been heavily polluted with the sources destroyed, and there is a ban on new infrastructure development without an Israeli permit (12). This puts children in Gaza at risk of waterborne diseases, with many already suffering from conditions like diarrhoea and hepatitis A alongside a growing threat of cholera (12). Over a quarter of Gaza’s population has fallen seriously ill from preventable diseases due to inadequate clean water and sanitation facilities. As famine looms, malnourished under-5 children with diarrheal disease face a higher risk of death (12). The destruction of hospitals and infrastructure and the blockades prevent the entry of medical professionals and supplies. They have severely exacerbated the spread of infectious diseases and increased mortality from injuries and malnutrition (12).

The violence of war has created a perpetual cycle of chronic trauma, stripping children in Gaza of their hopes and dreams. Although prevalence of post-traumatic stress disorder (PTSD) is high among children traumatized by exposure to violence and war, current PTSD diagnostic criteria do not cover symptoms from exposure to traumatic stress (13). Therefore, PTSD has limited applicability to the current context, underscoring the need for a more specialised and more accurate classification of the experiences of children in Gaza. The term continuous traumatic stress (CTS) has emerged for describing the continuous experience of violence in Gaza (14). This distinction is crucial because current PTSD frameworks are based on an assumption of a past traumatic event, whereas CTS accounts for the persistent and continuous nature of trauma in the context of chronic violence and oppression. CTS will also address intergenerational and transgenerational trauma within the broader community.

The accumulation of stressors overwhelms a child’s ability to cope or adapt. It manifests as various symptoms such as regression, emotional dysregulation, distrust, and social withdrawal (13). Children are not only victims of extremely long-lasting impairments from bombs or bullets but also from the long-term legacies of war, especially when violence becomes a part of everyday life. When it becomes a near-permanent occurrence, war disrupts recovery and resilience-building while repeated stress wears the mind and body, suppresses the ability to cope and accelerates disease progression (9).

The people of Gaza are already suffering the consequences of the war in the form of grief, lost family ties, forced starvation, anxiety, and a lack of supportive infrastructure. Forced displacement and expulsion have repercussions and the associated trans-generational trauma impacts Gaza’s youth. If the cycle continues, the resulting trauma will be passed on to future generations of Palestinians, with catastrophic impact on their physical, emotional and epigenetic health.

The first essential step in addressing this long-term systemic issue is a permanent cessation of military action by Israeli occupation forces in Gaza. This will require substantial pressure from the international community to dismantle the violent blockade and provide unrestricted access to lifesaving resources such as food, water, sanitation, health care, education, etc (2,3,15). The weaponization and destruction of every aspect of the Palestinian life must stop as already being advocated by several parties (15,16). We implore the international community to ask: At what point do we stop making excuses and start demanding accountability for the lives and futures being destroyed?

Funding: None.

Conflict of interest: None declared.

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