What do you do when your child keeps waking up screaming?
This was the question Ghaliah desperately asked her friends when her daughter started to change.
Nour, 11, had stopped speaking properly. She began wetting the bed, was afraid to go to the toilet on her own and clung to her mother “like a shadow”.
Ghaliah Gharabli, 35, a mother of four in Gaza, explains the family was reeling from a series of personal tragedies. Among them was the death of Nour’s brother Mohamed, 15, the breadwinner of the family who had been depressed.
He was shot in the head by Israeli soldiers in May 2018, when he sneaked off to join protests against the US moving its Israeli embassy to the contested city of Jerusalem.
Living in the vulnerable border area of Shajaiya, the Gharabli home was bombed in all of the last three wars between militants in Gaza and Israel. Nour, who was born just months before the 2008 conflict, has lived through each one.
But it was the death of her brother, and the recent rounds of airstrikes and rocketfire, that was the breaking point.
“She stopped speaking properly. If I asked her why she was silent, she would cry,” Ms Gharabli tells, under a portrait of her dead son.
“She started screaming in her sleep and having these night terrors of soldiers entering the house to kill her. I didn’t recognise my little girl,” she adds.
Aid workers, including officials at the United Nations Palestinian refugee agency (UNRWA), warn of an unprecedented mental health crisis unfurling across Gaza, exacerbated by a surge in violence over the last year and funding cuts to vital psychosocial support programmes.
The hardest hit are the children, like Nour, who live near the perimeter fence.
But there is some help. The Norwegian Refugee Council runs a three-tiered psychosocial support programme for children – which Nour managed to join. The council estimates that two-thirds of minors living in border areas such as Shajaiya have clear indications of psychosocial distress.
A study they published in March revealed that a staggering 81 per cent of schoolchildren struggle academically due to conflict-related stress.
At Nour’s school, the NRC now runs morning breathing and relaxation sessions to fight the anxiety, panic attacks, anger and violent outbursts that pupils are increasingly suffering from.
“I was afraid I would die before I started the programme,” a transformed Nour says, as she patiently sits next to her mother.
“I was afraid of everything, that there were threats everywhere. But I feel safe now.”
Abu Hussein Madi tells that psychosocial support has been invaluable for his 11-year-old son Nabeel, who also began shouting in his sleep.
Like Nour, Nabeel’s teenager brother, coincidentally called Mohamed, was also killed during the protests on the border fences.
Nabeel, who had participated with other children that day, saw the moment his brother was killed.
“Psychological support is essential to children,” says Nabeel’s father, explaining that his son needed months of help.
“It was the only way to get my son back.”
But funding cuts are threatening the future of Gaza’s mental health support.
Dr Iyad Zaqout, the head of UNRWA’s mental health and psychosocial support unit in Gaza, says that despite the fact that mental health challenges have increased over the past year, they have had to slash their programmes due to lack of funds.