“Take your children and run away from your home!”: Violence, trauma, and resilience within the context of active warfare

“Take your children and run away from your home!”: Violence, trauma, and resilience within the context of active warfare Cindy Sousa, PhD, MSW, MPH, Bryn Mawr College, Bryn Mawr, PA and Guido Veronese, PhD, University of Milano-Bicocca, Milan, Italy APHA's 2019 Annual Meeting and Expo (Nov. 2 - Nov. 6) Background The growing body of scholarship about mental health and war suggests many factors that might contribute to the mental health sequalae resulting from armed conflict and political violence. However, we are still working to adequately conceptualize the lived experience and quotidian strategies of psychological survival in the face of totalizing experiences of active warfare. Collecting and analyzing data about the traumatic events and psychological responses that contribute to suffering and resilience during war is exceedingly difficult, yet vital to global mental health. Methods We examined the written narratives of 20 Palestinian women in Gaza, recruited via an intervention for teachers in Gaza. Women were asked to create a retrospective chronological diary of their experiences during Operation Protective Edge in 2014, a series of aerial bombardments that killed over 2,000 Palestinians and left almost a half a million displaced. Women were asked to describe the events, feelings, and strategies of psychological endurance during this time. Data were imported into qualitative data analysis software, coded line by line, and analyzed using content analysis, with special attention to the etiology of mental distress and resilience within political violence. Results Women’s narratives included memories of the moment they were exposed to bombings, injuries, death, and destruction of vital infrastructure and systems. Their forced experiences of flight were described as being exhausting and demoralizing, as their temporary shelters lacked their basic needs for sanitation, nutrition, and privacy. These experiences resulted in intense terror, grief, exhaustion, hopelessness, and isolation. Strategies of psychological survival included reframing, such as trying to appreciate “being able to escape death;” a sense of solidarity within families and neighborhoods; and pride and satisfaction found in a context of resistance and global attention to the suffering in Gaza. Implications Findings reveal the importance of tracing the events of warfare, its psycho-social consequences, and the distinct patterns of psychological endurance. Our results highlight the need to elicit narrative accounts of psychological suffering and survival that are focused on the lived experience of war. In doing so, we can better understand, design interventions, and promote social justice efforts that address the mental health ramifications of war. Diversity and culture Provision of health care to the public Public health or related research