2009 08

Tue, 25 Aug 2009

Education among the ruins – Crisis intervention work with traumatise children in Gaza II

At the end of 2008 and beginning of 2009, conflict shook the Gaza Strip. The “Friends of Waldorf Education” sent a crisis intervention team to Gaza to support traumatised children as early as the end of January, but the team was forced to leave sooner than intended because of Egypt’s closure of the border (see NNA report, 6 January 2009). Recently a new emergency team consisting of ten psychologists, teachers and therapists was allowed to return to Gaza via the Isræli Erez crossing point with the help of the German foreign office (see NNA report, 3 July 2009). Once in Gaza, the team was able to resume its Waldorf crisis intervention work where it had left off in February: in the Gaza City orphanage. In this second and last part of his report, team leader Bernd Ruf describes the work with parents and teachers and future perspectives.

KARLSRUHE (NNA) - Trauma is contagious. Even children who have not personally suffered from traumatic events can become “infected” by their parents’ trauma. This is described as “secondary traumatisation”. Thus 60-year-old Mohammadeya El Samouni, mother of seven children, speaks about her own trauma, caused by the death of two of her children, in the context of difficulties in bringing up her other children. “I was with remaining members of our family, fleeing to Gaza City, and did not see my two children die. I still dream about these dead children and simply cannot believe that they really are dead. I see them in reality. I keep encountering my deceased children in the street!”

Children often react to psychologically traumatic experiences with psychosomatic reactions or behavioural disorders, and these can present a serious challenge for parents and teachers. “My children now become scared at night. They cry, they scream, and they wet the beds. Since the start of the war my seven-year-old daughter is afraid of anything that moves!” says 24-year-old Rana Zayed, a mother of three. “All the children are scared, especially when aircraft come!” adds Ebtesam Talmes, 42 years old and mother of ten. And 35-year-old Somaya El Sultan, mother of six, adds: “My three-year-old son is even afraid of birds. He always wants to sleep!”

We hear many similar reports of traumatised reactions and symptoms throughout the Gaza Strip. “Many of our children fight constantly. They are aggressive, they are becoming more and more intractable, and they lose their patience very quickly,” complains Sahar Samouni, 37, mother of 10 children, and adds: “But the adults are stressed and aggressive as well. They lose their patience very quickly!” Other parents report that their children no longer do as they are told and even react by hitting out at them. Many parents are desperate. They no longer understand their children’s behaviour, and their last resort is corporal punishment, which certainly does not contribute to their healing.

Reports of regressive or self-harming behaviour in children are also common. Somaya El Sultan from Salatine explains: “I had weaned my 3-year-old son four months before the war began. During the bombing raids he began to demand the breast again. Only when I gave it to him did he stop crying. Even now, if I refuse him, he screams. He keeps shouting “We are next!” Another mother tells how her 4-year-old son bites the tip of his thumb until it bleeds.

Parents desperately need to be shown how to deal with the symptoms of their psychologically traumatised children. With this in mind, the crisis intervention team offered well-attended parent mentoring sessions in both Zeitoun and Salatine. Attendees were divided into groups based on gender, and the team sought to answer their questions and suggest culturally appropriate solutions to the problems these parents face. In this context the following elements always remained central: love, affection and security, rhythm and ritualisation (daily routine, regular meals, sleep), movement and play (ball games, rope games, swinging, circle games), artistic activity (painting, drawing, clay modelling, craft projects), physical contact (massage) and maintaining a sense of religiosity and spirituality.

Another important thing was to teach parents emergency techniques they can use with their children to try and interrupt panic attacks through breathing exercises and flashbacks through movement of the eyes. These suggestions were designed to provide stabilising measures for emergency situations, in the absence of professional help or treatment.

Continuing training courses for teachers and therapists: “This education gives strength!”

In response to the urgent request of our partner in the Gaza Strip, the Gaza Community Mental Health Programme, the team sent by the “Friends of Waldorf Education” offered a four-day continuing training course for teachers and therapists in the Al Qattan Centre in Gaza City which was attended by about 100 enthusiastic participants.

Each morning, after the introductory activities, lectures were held addressing issues of educational development in psychologically traumatised children. In addition to general questions about emergency education and psychotraumatology, teachers focused especially on child development in the first and second seven-year cycles and the ways in which this can be disrupted by traumatic experiences. Afterwards there were practical working groups in eurythmy, painting, drawing, experiential education, sand play therapy and games for pre-school children. At the end of each day, all participants came together in a “closing group” for rhythmical movement exercises and singing. On the last day, the results of the workshops were presented in a plenary session and the training programme was concluded with a question and answer session. One participant summarised the results of the program by saying: “This education gives strength!”

Future perspectives: “Please return”

On the last day of work, the emergency team together with the leaders of the Gaza Community Mental Health Programme discussed and evaluated the team’s work. The head of the psychological department, Hasan Shaban Zeyada, thanked the team for their committed work with the affected children and adults, as well as for the many creative suggestions they provided through their continuing education seminars. “Many experts have come to Gaza to share their theories. You have convinced us through the practical work you have accomplished here. The endless trauma work has worn us down and we can no longer see the wood for the trees. We need your outside perspective and your creative suggestions. Please don’t leave us alone! Please return!”

In view of the unimaginable degree of emotional suffering which has followed the violent conflict in the Gaza Strip, the “Friends of Waldorf Education” will have to think about consequences and longer-term perspectives once the results of the second emergency assistance mission have been evaluated. Perhaps it will be possible to develop ideas in collaboration with the Gaza Community Mental Health Programme and other partners which offer longer-term perspectives on the development of Waldorf education beyond the acute emergency crisis intervention work.

Then there are also the many specific destinies which remain desperately in need of creative solutions: two-and-a-half-year-old, phosphorus-burned Farrah, whose grandmother does not see any hope for her future; five-year-old Mohammed, whose arm was destroyed by shrapnel from a rocket-propelled grenade, yet who, with the help reconstructive surgery, would not need to have his arm amputated; six-year-old Karam Nedal Awad, who cannot coordinate his movements and who desperately needs long-term therapy; or the 43-year-old destitute Mazen, whose cervical spine and spinal cord were damaged, and who received an offer from a German hospital to be transferred to Berlin for treatment at a cost of 154,000 euros, payable in advance. Real people in tangible need. Will their cries for help be heard?

Joy heals

What remains? What were we able to achieve? Waldorf education is based on the anthroposophical understanding of the human being and meets all the requirements of a stabilising educational influence needed by children to activate their own powers of self-healing after they have been traumatised by extreme experiences. Even if all educational efforts were ineffective, the unforgettable moments would remain when children began to speak again as a result of human affection, when children’s eyes began to gleam again, or when a child’s frozen facial expression thawed and life returned.

Such joyful moments increase the organism’s ability to heal itself. There are studies from the University of Pittsburgh (e.g. David Servan-Schreiber, “Die neue Medizin der Emotionen”, Munich 2006 (tenth edition), p.78ff. Original French title: “Guérir le stress, l'anxiété et la dépression sans médicaments ni psychanalyse”. Published in the UK as “Healing without Freud or Prozac” and in the US as “The instinct to heal”) which indicate that there is a connection between a person’s stress level and the probability that he or she will fall ill with a cold. Stress, anger, frustration or negative memories trigger chaotic heart rhythms for a few minutes, and the results weaken the immune system for approximately six hours. Immunoglobulin A is produced constantly in the mucous membrane and protects against infections, but its levels decrease dramatically in instances of stress, which also weakens an organism’s resistance. For this reason, individuals have a notably higher risk of infection after a traumatic experience. On the other hand, feelings of joy, the sensation of empathy and positive memories lead to coherent heart rhythms, to an increase in the production of immunoglobulin A, and therefore to an increase in resistance. Joy activates powers of self-healing, joy heals!

The Waldorf educational crisis intervention measures build on connections and insights based on such an understanding of the human being. Developing them effectively for the benefit of people in extreme emergency situations will be our task over the coming years.

END/nna/cva

The crisis intervention team sent by the Friends of Waldorf Education consisted of the following members: Manfred Hartmann (teacher), Friedgard Kniebe (early childhood teacher), Peter Lang (teacher), Lukas Mall (experiential education teacher), Kristina Manz (assistant), Bernhard Merzenich (curative education teacher and eurythmist), Yoko Miwa (psychologist), Bernd Ruf (special education teacher and team leader), Anni Sauerland (experiential education teacher), Heidi Wolf (art therapist), Yehia Hassouna (translator).

Bank details for donations:

Freunde der Erziehungskunst: Account / IBAN: DE91 6001 0070 0039 8007 04, SWIFT / BIC: PBNKDEFF (Postbank Stuttgart), reference: Emergency Education

Freunde der Erziehungskunst: Account / IBAN: DE47 4306 0967 0013 0420 10, SWIFT / BIC: GENODEM1GLS (GLS Gemeinschaftsbank Bochum), reference: Emergency Education

www.freunde-waldorf.de

Item: 090825-02EN Date: 25 August 2009

More NNA reports at: www.nna-news.org/en/

Education among the ruins – Crisis intervention work with traumatise children in Gaza I

At the end of 2008 and beginning of 2009, conflict shook the Gaza Strip. The “Friends of Waldorf Education” sent a crisis intervention team to Gaza to support traumatised children as early as the end of January, but the team was forced to leave earlier than intended because of Egypt’s closure of the border (see NNA report, 6 January 2009). Recently a new emergency team consisting of ten psychologists, teachers and therapists was allowed to return to Gaza via the Isræli Erez crossing point with the help of the German foreign office (see NNA report, 3 July 2009). Once in Gaza, the team was able to resume its Waldorf crisis intervention work where it had left off in February: in the Gaza City orphanage. In this first part of a two-part report, team leader Bernd Ruf describes working with the children traumatised by conflict.

KARLSRUHE (NNA) - The three weeks of fighting cost approximately 1,400 lives, including many children. Over 5,500 were seriously injured. In the course of the struggle 22,000 homes were destroyed and Gaza’s infrastructure was left almost totally in ruins. Since then, 80 percent of the approximately 1.2 million residents have been living below the UN-defined poverty line and at least half of them are children under the age of fifteen. A blockade continues to be imposed on the Gaza Strip. Provisions come in largely through the over 2,000 illegal tunnels dug under the border with Egypt.

Many children in the Gaza Strip are no longer able to leave their homes because of their serious injuries. Others are so extremely traumatised that they hide in their homes, reacting with panic attacks if they are forced to leave. Still others have experienced such dramatic psychopathological changes as a result of the trauma that their distraught parents hide them or lock them away.

Farrah, two-and-a-half years old, lives with the surviving members of her family in the remains of her charred house in northern Gaza. On 4 January 2009, phosphorus missiles struck her home where the sixteen family members had sought refuge. Farrah’s grandfather, Sadaka (45), and her brothers Adavahim (14), Zad (12) and Hamsa (9) were burned to death. Her sister Shakes (one-and-a-half years old) was nursing at the time and was killed by the shockwave. Farrah was transported to a military hospital in Egypt with her mother, Rada (20). The crisis team’s efforts to visit her there in January were blocked by bureaucratic obstacles. Her mother ultimately died as a result of her injuries, and Farrah is branded with extreme phosphorus burns. Now back in Gaza, she suffers from “fuming wounds” which are sealed with makeshift silicon coverings in a tent hospital.

In addition to her serious injuries, Farrah suffers no less from the serious emotional wounds she has received. The once carefree girl stopped playing after her terrible experience. She is socially withdrawn und suffers from eating and digestive disorders. She receives sleeping pills each night so that she can fall asleep, but wakes again in the middle of the night with nightmares, often screaming and bathed in sweat. She is completely fixated upon her father, Mohamed (24). Whenever she is separated from him she reacts with panic and helplessness.

As we left, her 45-year-old grandmother Sabah Salama Al Suleima Abu Halami said quietly amidst her tears: “This child has no future!” Farrah desperately requires medical and psychotherapeutic attention in another country, and she is only one of many.

Working with children: “Why have you destroyed our childhood?”

Fates such as Farrah’s can be found everywhere in the Gaza Strip. Even months after the military catastrophe, deep psychological wounds have yet to heal, especially in the souls of so many of the affected children. From the over 500 children with whom the emergency team worked, approximately 50 percent showed acute symptoms of posttraumatic stress disorder.

At a summer camp for children in the heavily affected city district of Jabaliya, the team meets with a group of about 60 children. The majority show signs of challenging behaviour. Many attempt to gain attention through aggressive disruption, fighting to hold the supporting and guiding hand of the carers during circle games, and arguing with each other over clumps of modelling clay. Others withdraw from the group, seemingly depressed to the point of physical paralysis. Movement exercises conducted in a circle attempt to address through play the frequently evident disrupted sense of rhythm, lack of concentration and movement disorders (hyperactivity or aversion to movement). Since, as the common expression has it, fear often has a paralysing effect, all forms of movement become especially important because they can work to break down the internal blockages and paralysis.

Similar symptoms can be observed among the children and young people at the Al Amal Institute for Orphans in Gaza City. Many find it impossible to speak about their traumatic experiences. For this reason other methods of creative expression are introduced such as the opportunity to make music, knead modelling clay, draw, paint, or experiment with role play. These children need security and a sense of ritual to help them orient themselves, especially so that they can begin to adjust again to rules and boundaries now that the effects of the war have left them so completely without limitations. Approximately 20 children participate with great concentration in a “Sleeping Beauty Game”. Their facial expressions slowly becomes more relaxed and natural, the look in their eyes begins to open. It is as though these children are experiencing a springtime thaw after a long internal ice age.

In Salatine, a tent city for the homeless in northern Gaza, word of the emergency team’s work spreads like wildfire. In a short time, over 120 children and many mothers have gathered. Life here is miserable. A charity provides a hot lunch three times per week. In addition to this external need, the internal needs are also great. Ranin, a girl of nine years, recounts watching on the third day of the attacks as a missile struck a group of people, killing many of them. She was fleeing with her family to relatives in Jabaliya. Since this experience, her life has changed. Nightmares trouble her sleep, she screams each night, has begun again to wet her bed, and she has become violent and aggressive toward those around her. “We had houses, now we live in tents. No one cares. What has this girl done that she should be forced to live in a tent without hope for the future?” asks Mohammed Zaid, a farmer who fled his bombed-out home in northern Gaza.

Zenab El Samouni is 37 years old. We meet this completely destitute woman with two of her six surviving children in a ruin in Zeitoun, a south-eastern section of Gaza City. Zenab El Samouni relates that her husband was required by the Isræli military to leave their house, and was then shot on the doorstep. “We couldn’t take him to a hospital because of the Isræli blockade. He died in front of the house and lay there dead for 18 days.” Somewhat doubtful, we double checked and received confirmation of her statement. Other witnesses also testified that the dead were not allowed to be buried during the occupation. Zenab El Samouni continues: “I was alone in the house with 15 children. I had to hold these scared, screaming children together as soldiers entered the house. During the invasion the soldiers shot my four-year-old son, Ahmet!” Zenab El Samouni shows us a picture of a child’s corpse and points to a streak of blood on the wall.

The surviving members of the Samouni Clan, consisting of more than 100 relatives, descendants of farmers, live among the ruins of Zeitoun. Their houses were largely destroyed by missiles. Thirty-six family members, including many children, died. Red Crescent rescuers were forced to wait four days before being able to help the injured and those buried in the rubble. During the first crisis intervention in February 2009, one of the focal points of the educational and therapeutic work of the Waldorf team was the children of the Samouni Clan.

Meeting them again was a shocking experience. The five-year-old boy Islam, whose parents were killed during the attacks, has suffered since their deaths from panic attacks, nightmares, nervous sweats each night, a sleeping disorder, social withdrawal and a burning allergic symptom in one eye. His 15-year-old brother, Helmi, relates, quietly crying, how he found his father’s severed head lying in his lap after the missiles detonated. He suffers from the painful results of an unsuccessful emergency operation, which was necessary because of the shrapnel injuries he received to the stomach. Doctors cannot offer him any hope of improvement. Issa, eight years old, lost his parents and siblings and has since begun to beg, constantly and mechanically repeating the same phrases to himself. Nearly all the children of the Samouni Clan suffer from the emotional effects of their terrible war experiences. The immense trauma devours their souls.

The setting is bizarre. We have erected a huge tent (over 300 square metres) in the middle of a field of rubble as protection from the burning sun. In its shade at least 120 children walk rhythmically in a circle. Experiential education games, juggling and acrobatics have been planned. Not far away is a former storage area where a makeshift art studio has been set up. The children push for space to draw or paint with watercolours. Nearby, in the ruins of a house, where the blood of the dead four-year-old Ahmet is still visible on the wall, another group of children practices eurythmy.

In the shadows of a small tree, in front of one of the three remaining houses, kindergarten games are played with pre-school children. The children dance, make music and create artwork and crafts. Some distance away, a sick donkey stands next to a shelter in which the heavily traumatised 12-year-old Mahmoud is given emergency psychological care. “Soldiers in tanks shot at us with smoke. My sister lay injured in the street. Two helicopters circled over her. Many fled. Many lay dead by the petrol station. My sister’s son is dead, her husband is dead, and my sister’s other son is injured. Each night I dream of blood and death. I cannot concentrate any more in school!” Mahmoud had attracted attention because of the exceptionally brutal content of his pictures.

We meet Shaban and Issa again who enthusiastically did eurythmy with us in the same room where the other members of their family died, and where, as the family told us, Isræli soldiers crudely defaced the walls. Also Almesa and Zenab, the two thirteen-year-old girls, recognise us immediately. Almesa described how she clung to her deceased parents for four days after their deaths. She explained how she desperately tried to scare away the vermin as they came and began to devour the corpses. In the interim, both girls appear to have matured “forcibly” well beyond their years. They enthusiastically join the other children painting. On her finished painting Almesa writes: “Why have you destroyed our childhood?”

END/nna/cva

Part II to follow.