Amid war, Israeli Bedouin deal with mental health issues

Science and Health

When Nasser Haduba, 50, a resident of the unrecognized Bedouin village of Abu Talul, approached his doctor at the local health clinic in the Neve Midbar Regional Council, to consult about his 10-year-old daughter regressing into bed wetting after the outbreak of the war, the Jewish doctor suggested he reach out to his village’s social worker.

“We don’t have a social worker,” Haduba later recalled. “(Bed wetting regression) is an issue that can happen to other families here, but nobody wants to talk about it. When it comes to mental health and trauma services, here there are no services.”

The well-meaning doctor simply had no idea of what life is like in the unrecognized—or even recognized villages, he noted. 

“Yesterday rockets fell in our village, we heard the sirens (from the surrounding area). Since the start of the war, we have been asking the Home Front Command to supply us with mobile bomb shelters and till this day they have not arrived,” he said. “Our children are suffering from stress because of the rocket attacks. My daughter wets her bed at night; so have other children but people don’t want to talk about it.”

And while Haduba is willing to speak about bedwetting in order to highlight the need for mental health help in the Bedouin communities just like there are in the Jewish communities, he declines to give his daughter’s name because he is afraid it may stigmatize her in some way later on.

Umm al-Harin. (credit: Valentin Schmid)

The Bedouin community under threat

The Bedouin community has already come into the war from a very complex and fragile state of mental health, said Ibrahim Abu Jafar, director of the Tamar Center, a grassroots organization which bridges socio-economic gaps between Bedouin society and the rest of Israeli society.  Whether from recognized or unrecognized villages, the residents are living under constant threat of demolition of their homes, the inability to receive building permits, the pressure of growing violence in Arab and Bedouin society which has gone unchecked by Israeli authorities. They are consistently in the lowest 10 percent in the social statistics measured by the Central Bureau of Statistics. 

“We live in a state of constant emergency crisis,” Abu Jafar said. 


One unrecognized village, Um al-Hiran has been fighting the threat of its complete removal and relocation to make room for a Jewish town—Hiran–since 2006. School teacher Yacoub al-Kaeen was killed, as was a policeman, during January 2017 house demolitions, including his own.  Al-Kaeen was killed by police as he was driving his jeep in the early morning and police originally claimed he was a terrorist. Later in 2020, Prime Minister Benjamin Netanyahu apologized for the claim. 

“Having buildings in recognized towns is not the only requirement for living a normal life,” said Atef Khatib, clinical director of the Bedouin Trauma Center based in Beersheva, with branches in Rahat and Kuseife. “That doesn’t allow you a normal life when everything around you does not work—the weak education system, the shootings in Arab communities, not enough activities for youth, no internet connection which in these days has become a necessity (for long-distance learning.)”

Abu Jafar said that civil society organizations such as Tamar and the Bedouin Resilience Center have had to pick up the slack for a dearth in mental health services for Bedouin provided by government authorities.

Between Tamar and the Bedouin Resilience Center there are 15 Bedouin therapists, he said

“What is certain is that we need much more services than exist in order to address the immense need,” added Khatib. “There is a huge gap (in terms of services available) between Jewish and Arab society. There is a lot of neglect of the need for mental health treatments in Jewish society in general, so there is that much more in Arab society. There is a waiting period of six months to a year to get treatment, and even then you have to make sure that the therapist is suitable.”  

The need and openness to seek therapy is growing, noted Kher Albaz, co-executive director of Ajeec-Nisped, the Arab-Jewish Center for Empowerment, Equality and Cooperation—co-founded by Vivian Silver who was murdered by Hamas terrorists on Oct. 7, and while in Rahat there are Arabic-speaking social workers, some who have come from central and northern Israel, more emphasis needs to be put in training additional local therapists, social workers and psychologists. 

“The differences are not in treatment,” Albaz said. “The differences are on how to break the ice, how to create the initial trust. Keep in mind that the Bedouin live in community, not in individual families, the support is similar to that of in the ultra-Orthodox society.”

While such communal living can sometimes aid in providing support, it can also suffocate at times, noted Abu Jafar, so therapists must understand how to culturally manage through the framework. All work in trauma has a certain protocol, he said, and therapists working with Bedouins who have undergone traumas follow the same protocol but within their cultural context. 

As of press time the Ministry of Health had not responded to an email request for comment.

From day one of the war, therapists from Tamar and the Bedouin Resilience Center have been in touch with the community, assessing the needs, reaching out to those who may be more affected but less likely to seek help because of a number of circumstances.

How the October 7 attack impacted the Bedouin communities

At least 20 Bedouins were killed during the Hamas onslaught on Israel’s southern communities on Oct. 7, seven from rockets—the some 35 unrecognized villages dotting the Negev have no warning sirens and until recently not one bomb shelter—and the rest were murdered in the rampage, many of them while they were working in the kibbutzim that early Saturday morning. Six other Bedouin have been kidnapped, with two teens who had been working at the Holit dairy with their father—Aisha,17, and Bilal, 18, Ziadana—were released from Hamas captivity on the last day of the truce. Their father and older brother remain in Gaza.

The siblings are now at home, and together with governmental social services they are being accompanied by Bedouin therapists to assist in culturally aware treatment.  

A hotline run by the Resilience Center opened already at 7 a.m. on Oct. 7 received hundreds of calls—some also from Jewish Israelis from the Gaza border area who were unable to reach any other organization. Because of their knowledge of the community—even down to the minute differences of neighborhoods within the same the town—counselors from both organizations have been able to accommodate the different needs and methods of communications of the community. 

Because of their knowledge of the communities, the counselors from both organizations are able to identify not only those who may be in need of some counseling, but also those who have been affected directly by the situation and need immediate and specific attention, such as women whose husbands have been killed but are unable to leave their homes to seek help from a therapist. Sometimes zoom sessions are not on option because of the lack of internet, and so the therapists go visit them.

Or as in the case of some 50 youth who had been working with their fathers in the kibbutzim on Oct. 7 and somehow made it through the horrific day. Because they are from the community therapists knew these teens—some as young as 13—had experienced trauma but were not having a chance to speak about it because their parents were afraid the authorities would accuse them of having sent their underage sons to work illegally, said Khatib.

So they set up a safe space in a school, inviting the boys and their parents to come and take part in group activities, where the boys were able to speak about their experiences with counselors in small groups and parents had specially-tailored activities to also help them confront some of their fears and concerns.

Notably, Khatib said, the parents’ worries of bringing their children for treatment points more to a distrust of the authorities given the reality they live in rather than their lack of desire to help their sons. They needed to be reassured that as mental health professionals, no one was interested in that issue.

It was critically important to reach the boys as soon as possible so their trauma could be treated early on before it became more acute and turned into PTSD, said Khatib, so their ability to identify the need—and the reason why parents were avoiding turning for help–was vital in getting the boys the help they needed. 

“It is crucial to be very sensitive and culturally aware, speak the language, the slang, understand the background of a place of the people who you are working with,” said Khatib. “Bedouin Arab society is very heterogenous in its reactions, so it is hard to put everyone into one camp. You can’t characterize everyone the same way. There are those in treatment who are very open and comfortable with speaking about their feelings, and there are others where special efforts need to be made to have them speak about their feelings, others don’t speak about feelings but respond more to cognitive ideas. The variety is so big, you can’t just think of the Bedouin society in general terms of one big group.”

In some families it is only acceptable for women to speak to women psychologists, in others it is less important. Sometimes a wife feels more comfortable if her husband stays with her in the space in their home, others prefer to meet on-line or in an office—as with any therapy, therapists adjust themselves to the needs of the clients but with a nuanced cultural understanding of the varying needs of different segments of the Bedouin community, he added.

“In treatment we ask difficult questions in the right way (for Bedouin society,)” he said, sometimes that includes bringing in tenents of their religious faith and Bedouin metaphors. “This is a natural situation in an unnatural situation.” 

In Um al-Hiran a group of gap-year young women volunteers from Ajeec-Nisped have brought out paints and brushes, and cranked up the music as the children of the village return from school, trekking several kilometers on a dirt path from the main road to reach the village. In the entrance of the village is the first cement mobile bomb shelter the children have seen, brought in by IsraAid. 

“At first we were all afraid because no one knew what was happening,” said program coordinator Sajood Abu Kaf, from the recognized village of Um Baten. “The young people were worried about their future…and they were worried that they were in a place that was not safe. I also want my family to be safe. We spoke a lot about it.”

The volunteers are creating a “friendly space” around the shelter so the children will not be scared if and when they need to use it in case of a rocket attack, said Abu Kaf.  The music, the dancing, the costumes and painting colorful scenes on the cement walls of the shelter are all a kind of relief for both the young volunteers–who are waiting for their university studies to begin–and the children who have been traumatized by the sound of sirens and rocket attacks.

Still, she said, culturally it is not “respectful” for the women of the village to come out to the entrance of the village to use the shelter, and certainly not to be together in a shelter in such close proximity with men of the village. She said she hoped the next shelters would be separate for men and women.

Shachar May, IsraAid press officer, noted that two more shelters are scheduled to be brought to the village and will be placed in consultation with village residents.