MSF: War on the Palestinian psyche: the mental health toll on Palestinians in the West Bank since October 7th 2023

MSF teams are seeing intense psychological trauma among patients in the West Bank, with both children and adults exhibiting alarming behaviours, depressive symptoms, and worsening generational trauma.

People across the West Bank feel trapped in a cycle of collective punishment—living with rising settler violence, home demolitions, forced displacement, and the daily trauma of having watched two years of Gazans being killed in real time.

“Palestinians are preparing themselves for loss” – A Mental Health Perspective from the West Bank

By a psychologist working with Médecins Sans Frontières (MSF), who requested anonymity.

While violence may not be new in the West Bank, Palestine, everything intensified after 7 October 2023. We’ve seen a sharp escalation: checkpoints, roadblocks, and incursions by the Israeli forces and settlers have cut Palestinian towns and villages from each other. These restrictions are blocking Palestinians from being able to access to basic services, such as healthcare, food markets and schools.

As an MSF psychologist working in Hebron, I can see and feel how people’s fear continues to increase. Fear is everywhere and this time it is paralysing people. Palestinians aren’t just worried: they’re preparing themselves for loss. Our patients often tell us that when they see images of people in Gaza collecting the remains of their loved ones, they cannot help but think: “If I die, I want to die with my family”. These aren’t abstract thoughts. These are ways for the mind to make sense of the horrors. Instead of planning for their own or their children’s future, many are focusing on imagining the least painful way to die. A death that comes at once, and one that spares anyone from being left behind.

In the West Bank, there is a growing sense that something terrible is coming, but no one knows exactly when or how. It’s a collective awareness, a quiet, ever-present anxiety. People say it openly: “They started in Gaza. Then they moved to the north of the West Bank. Now it’s just a matter of time until it’s our turn”. Whether you're a mental health professional or a farmer, we all feel it. We’re all waiting for our turn.

In our clinics, we can see a noticeable increase in symptoms of depression, anxiety, and post-traumatic depression. The symptoms vary, but the patterns are clear. Men, especially those who have lost their sources of income, are showing more psychosomatic symptoms. It’s more socially acceptable to say, “my stomach hurts” than “I’m scared”. But fear and despair are the root causes of their expressions: fear is in their eyes.

Mothers share terrifying thoughts with us. When they imagine a potential settler attack, their minds race to ensure no one is left behind. One mother told me: “Every time I think it might happen, I keep repeating to myself: I must take all my children. I can’t forget anyone”.

Palestinians are so overwhelmed that even when MSF mobile clinics come close to them, many are too scared to come. The terror of crossing checkpoints outweighs their need for medical help, both mental or physical. Their decision to stay home isn’t out of indifference, it’s fear.

There’s a widespread belief that settlers or soldiers could enter at any moment, simply because someone posted on Facebook or spoke with a neighbour. This time, roads home are being raided and the way Palestinians are arrested by Israeli forces are deeply humiliating. There are no rules. It creates a constant state of readiness in people: a readiness to flee, to be displaced, or to be arrested. That anticipation is feeding the anxiety we see in nearly every patient.

This is not a temporary crisis. It’s a long, grinding generational trauma that Palestinians in the West Bank are being forced to live through, day by day. And in that slow erosion of safety, dignity, and hope, mental health suffers quietly, but profoundly.

Patient Testimonies

Fatima*, 35 years old, Hebron city, West Bank, Palestine *Name changed for protection of identity

My name is Fatima. I’m from Palestine, from the city of Hebron, in Khirbet Qalqas. I’m 35 years old, and I’ve built a family of my own: I have one daughter and four sons. There are seven of us: me, my husband, and our children.

Has my life changed since the war began? Definitely. The impact on us is very clear. We’re experiencing a lot of hardship here, especially in this area. In general, this is the situation across Palestine, but in Khirbet Qalqas our suffering with the checkpoint has a major impact on our daily lives.

I have children who want to live their lives and build their futures, right? My daughter is in ninth grade, and she wants to join an English course. But I don’t feel safe letting her cross the checkpoint because of the Israeli forces. That constant danger keeps me from feeling reassured about her safety.

We live here against our will: this life wasn’t our choice. But it’s the life we’re living, and we have to keep going. My family lives far from this area, so I’ve been visiting them much less, and of course my children are affected. For example, if one of them gets sick at night, how am I supposed to take them through the checkpoint? I would have to carry them in my arms; there’s no way to drive straight to the hospital. That alone is a major struggle.

After the war began, I bought a car for myself. I had no choice. I didn’t even have a driver’s license, so I went and got one. It’s impossible to cross such distances without a car. My husband has a car too. We really do need two cars.

But even with cars, we still worry: we have to park near the checkpoint, and that makes us anxious because the Israeli forces have smashed or burned cars there multiple times.

We live in Palestine under occupation, and that takes a toll on our mental health. I get nightmares. The war made that pressure even worse. I feel like my mental health has weakened. I had plans, things I wanted to do with my daughter once she reached a certain age. I wanted to start a project with her. But the war disrupted everything, and I had to cancel all of it.

I was waiting for my daughter to turn 15. I promised her many things. I told her, “When you turn 15, we’ll do several activities together, and we’ll join a swimming course, just you and I.” She wanted to register for an English class, but I worry about her so much that I never let her cross that checkpoint alone. Sometimes there’s an army jeep parked nearby, and that fills me with fear and unease.

We’re stuck. Our movements are restricted. She was upset and told me, “You promised me that when I turned 15, we’d start these activities.” She understands what we’re going through, so she has to adapt.

God told us in the Quran that if we are patient through hardship, we are steadfast. So, we try to follow that path. Of course, I’ve thought of leaving this house and moving elsewhere; that idea has crossed my mind many times, because life here brings so much suffering. Even something as simple as changing the furniture is difficult. My couches are very old, and I wanted to replace them, but that’s hard to do: the roads are closed and even searching for new furniture is a struggle.

But Palestine is the land of steadfastness. God promised that if we are patient, we will be rewarded. So praise be to God—we will stay here, and by God’s will, the occupation will end.

Reema*, 13 years old, Masafer Yatta, West Bank, Palestine *Name changed for protection of identity.

The day our home was demolished started like any other. It was 7 May 2024, a Tuesday. After the sixth lesson, we left school, and on the way out I heard people talking about a house being demolished. I didn’t even think for a moment that it could be ours. We hadn’t received any alert, any message, nothing. I was sure it must’ve been a neighbour’s.

When I reached the hill near our house, I saw the bulldozers driving away. My heart dropped. I looked past them, toward where our home should have been and saw nothing but rubble. Our house was gone.

I froze. The shock was so heavy that words wouldn’t come out. When I finally walked closer, I saw my mom. She wrapped her arms around me and whispered, “Don’t worry, the house can be replaced.”

But then I noticed my brother. He had been beaten. They had pushed him onto the ground and injured him. The sight of him like that felt unreal. Everyone around me was shouting, crying, calling out, but I couldn’t do anything. I just stood there.

I went to look at what was left of our home. Everything was destroyed: my toys, my coloured pencils, all of it. I kept saying to myself, “It’s okay.”

I walked around the house like I always used to. The mint plants and the little trees we planted were crushed. Our grapevine too was broken. And still I kept saying, “It’s okay, it’s not a problem.”

My uncles and aunts hugged me. I heard myself say it again: “It’s okay, this is normal.” In Gaza, people have their homes destroyed over their heads. We lost our house, yes, but we survived.

Our neighbours’ house had been bulldozed too. But what shocked me most was that it happened without any warning at all. They even beat my mother. My little sister was crying. They beat my brother again.

Now we live in a nearby house that belongs to my cousin. There are seven of us, three boys and four girls.

I keep remembering what my mother told me that day: “Gaza has it worse. If they demolish our houses, we’ll come back tomorrow and rebuild them.”

When I draw, I draw the suffering of Gaza, the crimes committed by the occupation, the horrors inflicted on Gaza’s children. Every day children die, from hunger or from bombs. Gaza is in ruins, and no Arab leaders are helping. Children are killed before they even understand what war is. Mothers give birth only to lose their babies in their arms.

So many massacres, so much destruction, yet the people of Gaza still stand strong. They say, “Tomorrow, the sun of freedom will rise over Gaza.” They hold on to hope, the hope that Gaza will one day return to how it was.

As for my feelings: what’s happening in Gaza is unbearable. It breaks my heart. Innocent children are dying; entire families are erased. And here too, the soldiers and settlers come, they shoot, they beat us, they attack civilians. But we stay. We remain rooted in our land.

Because this is our home—no matter how many times it’s destroyed.

Photos: © MSF