Please note this was sent to AOTA over a week ago prior to the 4 day pause which is not a #ceasefire.
Dear AOTA,
I read an Instagram post condemning the Hamas Attacks on Israel. I agree that these attacks needed to be condemned. I think there is a deeper issue of Generational Trauma intertwined with the ACEs that needs to be recognized. As Occupational Therapy practitioners, we have the unique ability to convey the impact of Social Determinants of Health to our fellow Americans. Please allow me to elaborate.
In 1947 during the partition of India, my father was less than 2 years old living at a refugee camp in Lahore, Pakistan. His mother died shortly after. If that refugee camp were bombed or massacred the way the Jabalya Refugee camp in Gaza was bombed in late October 2023, my father likely would not have survived and I would not have had the privilege of serving children from Los Angeles, to Oakland, California, and now Houston, Texas.
When I think about my father’s early life I see all the red flags of the ACES. The CDC defines ACEs as “potentially traumatic events that occur in childhood (0-17 years)”. The “ACEs are linked to chronic health problems, mental illness, and substance use problems in adolescence and adulthood.” Using this ACE survey my father would have checked off 4 of the ACEs in addition to being in a warzone which is not included in this survey.
Growing up as a first-generation Indo-Fijian born in the US was challenging. I associated much of the verbal abuse and physical violence I experienced from my father with his lack of empathy due to his chronic back issues. I know now that his back alone was not the issue. His childhood experiences with the ACEs impacted his development. Although he was a grown adult he did not have the skills necessary to regulate his emotions and be emotionally available. My father’s early life impacted his brain in a way that negatively affected me as a child.
The children in Israel and Palestine are experiencing the effects of war and extreme violence. Many Israeli and Palestinian children have lost their parents, family members, and their lives. As of today, there is little aid, water, food, electricity, and medical supplies making their way into Gaza due to the blockade which could also be referred to as neglect. By this logic, children in Gaza are likely experiencing three of the ACEs all at once.
According to NPR half of the 2 million inhabitants of Gaza are children. That means up to 1 million of those who are being bombarded are susceptible to the ACEs. As of November 9, 2023, there are 10,500 human lives lost in Gaza alone according to the UN, and approximately 1,400 lives in Israel.
What does this mean for the future?
This means that over a million children from this region will be on a journey of health issues and possibly even an early death. If we look at the ACE pyramid on the CDC website it shows that the groundwork for a life of suffering and early death is being strategically laid out.
The bottom of the pyramid is Generational Embodiment/ Historical Trauma. Both the Jewish settlers who were displaced and entered Palestine after experiencing the Holocaust and the local Palestinians who were forcibly removed from their homes and land to the settlers have historical trauma embedded in their DNA through epigenetics. The current Social conditions of blockade and cancellation of work permits and the local context of 75 years of war are the next layer. Then add on the ACEs which I explained earlier and the foundation for risky behavior and early death is set. These children will likely experience Disrupted Neurodevelopment which could mean many issues from delays in the development of skills such as speech and fine motor skills to inability to attend/focus and/or read. These children will have challenges in school if they even have a school to attend. They will likely have impaired social, emotional, and cognitive development; this means they will not be able to interact with other humans as easily as we do. This could manifest as a lack of empathy for others due to their inhumane living conditions. When a child is not supported and experiences so much trauma they are likely to adopt risky health behaviors such as smoking cigarettes or joining the local militia because they will be provided with a sense of stability through housing and food. This is very likely to lead to disease, disability, and early death because they may not feel like they have much to live for anyway.
In the event that the people of Gaza are displaced into southern Gaza and eventually the Sinai desert in Egypt. Egypt will not be likely to care for them the same way Israel is able to in terms of healthcare and mental health services.
Why should we as Americans care?
The FBI has made it clear that we need to be vigilant due to possible terrorist threats. The border crisis continues to require our attention because millions of people are entering the US through our southern border. These people are not just from Mexico they are from all over the world. They could be coming to this country from other parts of the world that are experiencing massive displacement like the 6.9 million people in Congo or 100,0000 displaced from Genocide in Armenia. These people will require proper medical care and mental health services. If their trauma goes unaddressed it could lead to outcomes that are detrimental to our society.
My father, uncle, and aunts survived the Partition of India and experienced many of the ACEs, I can personally attest to the fact that these experiences have lasting negative effects on individuals and everyone in their lineage.
Please put pressure on the Biden administration to end the cycle of violence and call for a ceasefire today. When Hamas killed Israelis they created trauma and those affected by the violence are likely to have hatred towards Palestinians and those who advocate for Palestinian people. The thousands of Palestinians who continue to be killed and forcibly displaced from their ancestral land in Gaza will create even more humans who have hate in their hearts for Israelis. The outcome of this continued bombardment and military occupation is more trauma and hate.