Introduction: The Great Refusal
He [the enemy]: “Where does hope come from?”
I: “It comes from the air.”
—Mahmoud Darwish 
THE THREE PAPERS that comprise this dossier vary widely but benefit greatly from being read together. One presents results from an ambitious twenty-five–year study tracking the generation of Palestinians who participated in the first intifada and constitutes an unprecedented piece of research in terms of its length and breadth; the second paints a picture of the late vision and practice of Dr. Eyad El Sarraj, one of the authors of the original study and the man who pioneered psychiatry in Gaza and wedded mental health to the struggle for human rights and political liberation; the third is a recent interview with Dr. Yasser Abu Jamei, the current executive director of the Gaza Community Mental Health Programme (GCHMP) which El Sarraj founded in 1990.
Though different in genre, content, and perspective, the pieces weave together a common set of core themes: dignity and humiliation; hope and despair; adversity and survival. Each offers insights into the collective Palestinian struggle to maintain moral, political, and social cohesion under conditions that appear increasingly pernicious and precarious. Either directly or indirectly, each poses urgent questions that demand sustained critical discourse and debate.
The distillation of all of those questions can perhaps be summarized as follows: What does resistance mean at this juncture in Palestinian history . . . and how can it be mobilized in the face of an implacable Israeli juggernaut; a territorial split between the West Bank and Gaza that threatens to give rise to two peoples with two distinct economies, mentalities, and modes of coping; and a feckless international community that seems incapable of holding Tel Aviv to account? And, derivatively, what is an appropriately nuanced stance towards the aid industry, which on the one hand serves as a source of funds to relieve suffering and on the other hand inherently contributes to a culture of dependency? How can the voices, views, and energies of the enormous Palestinian youth cohort help revise and reanimate a national project and master-narrative?
In “Whither the ‘Children of the Stone’?,” principal investigator Brian K. Barber has assembled and synthesized an enormous amount of compelling longitudinal data drawn from respondents across Gaza, the West Bank, and East Jerusalem. A veteran researcher whose fieldwork in Palestine dates back almost two decades, Barber has written widely about youth and political conflict. He has played a leading role in debunking the premise that exposure to extreme events necessarily produces maladjustment and to demonstrate that youth activism, when linked to a perceived just cause, promotes later well-being, and in demonstrating that political activism on the part of youth, especially when driven by a clear purpose of achieving rights and dignity, is promotive to later well-being.
Among this study’s wealth of findings is the degree to which political violence has shaped the lives of an entire generation. Study participants report fear for self, family, and the future. In contrast to individual dysfunction implied by conventional measures of depression and PTSD, what emerges from this research is a picture of collective suffering rooted in a shared experience of pervasive insecurity and humiliation. While participants report feeling “broken and destroyed,” they also manage to persevere, often drawing strength from their past engagement in a united struggle that continues to serve as a wellspring of dignity.
But what of the current generation of Palestinian youth, the children of this storied generation of first intifada activists? Young Palestinians under twenty-nine, who now make up 69.7 percent of the population (73.1 percent in Gaza, of whom a full 43.2 percent are fourteen or under),  have been shaped by a very different reality: territorial and political fragmentation; escalating and unrestrained Israeli violence; bloody factional rivalries; and the ludicrous futility of the so-called peace process. Few among the successor generation to the “children of the stone” can draw from such society-wide memories of prideful joint endeavor. Catastrophic events recur at increasingly brief intervals; shambles accumulate; wreckage on wreckage.
Nowhere, of course, is this truer than in Gaza, which Israel has made a wasteland. The GCMHP, which Abu Jamei directs, struggles to provide treatment in a toxic environment where psychological wounds are being constantly reinfected. “There is no ‘pre-,’” as he says in the interview, “because 2014 was preceded by 2012, was preceded by 2008, was preceded by the second intifada in 2000. . . . And . . . the ‘post-’ is not a real ‘post-.’” The challenge is enormously difficult: How to do both therapy and the political work that alone could make therapy less of a need? How to strike a balance between relieving the distress of vulnerable populations (especially children), demanding rights and justice, and working to expose and undermine structures of hegemony that perpetuate chronic warlike conditions? How to solicit funds from donors while simultaneously exerting pressure on these same donors to confront policymakers and the powers-that-be?
Illana Feldman, an especially astute analyst of these dilemmas, argued in the Journal of Palestine Studies that it is vital to understand that “the most noble humanitarian efforts can unwittingly impede political resolution. As long as Palestinians are dependent on the compassion of others, they are also vulnerable to the perils of being denied that compassion. The humanitarian position is a precarious one. As soon as people express a more robust sense of themselves as social and political actors, they run the risk of losing their categorization as ‘exemplary’ and ‘proper’ victims and thus of falling outside the frame through which humanitarianism can understand and assist them.” 
Dr. Ahmed Abu-Tawahina, Abu Jamei’s immediate predecessor at GCMHP, compared Gazans “to subjects in a Pavlovian experiment, betrayed by political parties and donors wherever they turn. ‘We go to each corner of the cage and are shocked; then we stand in the middle of the cage, totally paranoid and abandoned.’”  The “idea of ‘trauma,’” he went on, “may make sense in Geneva, where there is safety, stability, and routine,” but it fails to represent the lived experience of a battered and besieged people in constant fear, including the fear of the next war being just around the corner  (and of its being worse than the last, as the 2014 war was indeed unimaginably worse than that of 2008–9). As an alternative to the term trauma, he suggested using “musiba”—calamity, misfortune, or ordeal in Arabic—a term which pushes back against the medicalization of distress, restoring pride of place to cultural norms of family support, community intervention, and local grassroots initiative.
El Sarraj, the pathological optimist, understood musiba in his bones. He hoped against hope even while harboring bleak thoughts of defeat, and he was never immune to bouts of despair. But what distinguished him was his capacity to summon up courage in himself, to transmit it to others, and to keep faith in the worthiness and dignity of ordinary Palestinians. This was all hard-won—especially towards the end of his life, when the Gaza he knew and loved experienced such anguish.
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Taken as a whole, the three contributions prompt important questions about collective will. Why do Palestinians in general, and Gazans in particular, insist on “being good” under conditions which Israel has designed to breed narrow self-interest, pettiness, and mutual exploitation? What are the resources to maintain moral integrity? How does the social fabric—what El Sarraj termed “our biggest asset, our treasure, our power” —still remain so intact?
Radical fragility and contingency more than ever define the collective experience of Palestinians, especially in Gaza. There, it is as if it were the last day of the 2014 war forever. People live with an absence of any horizon of possibility. The young express in existential terms their felt need to leave, if only temporarily, as never before in a decade of siege (made worse by the unprecedented degree to which leaving must be assumed to be impossible with the Rafah crossing all but hermetically closed by Egypt since the 2014 war). The situation becomes absurd, as a result “of [the] confrontation between human need and the unreasonable silence of the world,” as Camus explains so well in The Myth of Sisyphus. 
Yet even in circumstances meant to degrade, disorient, and dehumanize in the confines of this laboratory/detention center, there continue to be displays of endurance and extraordinary generosity. When any kind of power to shape a tomorrow that one can predict and control has all but vanished, agency appears to be channeled into daily personal behavior. Stubborn insistence on remaining kind, honest, and dutiful serve as expressions of defiance that help carve out a liberated zone, a redoubt, a locus of control beyond Israeli reach.
No matter that in Gaza more than 70 percent of households receive six to eight hours piped water once every two to four days, and that the entire population suffers from scheduled electricity blackouts for twelve to sixteen hours a day,  a mother insists that her daughter’s hair is neatly combed and braided before she leaves for school each morning. No matter how extreme and widespread poverty may be, a fruit vendor will chase after a customer to return a single shekel (twenty-five cents) that was overpaid. In the midst of an epic sandstorm in deserted streets, the rider of a motorbike overflowing with his own family will insist, ignoring all protest, on driving a stranded pedestrian to their door. In Shuja‘iya, Stalingrad of the 2014 war, at the close of an infernally hot and humid day without electricity in August 2015, the lights come on next door, at 10:30 P.M., half an hour behind schedule. The mother of the house: “Oh, we must remember to connect our power supply to the neighbor’s—so when we get power first, we can share it with them.”
Such small-scale, often invisible acts and instincts of rectitude and responsibility serve as antibodies that offer protection against helplessness and hopelessness, boost a sense of dignity, self-respect, and moral worth, and strengthen communal trust and collective staying power. Decency represents the vernacular language of what might be termed “the great refusal”: no to siege and injustice; no to depictions of us as demonic followers of a death cult; no to compliance with the rules of a rigged game; no to surrender. Such insistence on decency provides a weapon in a popular struggle that can be fought by ordinary citizens and not just by members of an austere and disciplined military elite. Resistance inheres in neighbors watching out for the kids down the street, in everyday behavior that signals and performs caring and kindness and concern.
It incarnates a society-wide recognition that, absent internalized allegiance to ethical rules, Palestinian society could come unglued—and that refusing such ethical defeat may be what most effectively thwarts the Israeli agenda. It enables reaffirming (without the dangers of reifying or fetishizing their suffering) what El Sarraj said in 2002, at the height of the second intifada: “These people can take so much, I tell you. They can take so much more, so much more. That’s why, deep inside, they are still so defiant.” 
Paul Gaston Aaron is a writer and researcher who worked closely with the late Dr. Eyad El Sarraj, Gaza’s pioneering psychiatrist. Thomas W. Hill has a doctorate in history from Cambridge University. During a recent teaching stint at the University of California, Berkeley, he taught a course titled “Gaza Since 1920.”
1 From Mahmoud Darwish, “Senario jahez” [A Prepared Scenario], in La uridu li-hadhi al-qasida ‘an tantahi [I do not want this poem to end] (Beirut: Riad el-rayyes, 2009), p. 60.
2 “Figures for 2014,” Palestinian Central Bureau of Statistics, accessed 10 January 2016, http://www.pcbs.gov.ps.
3 Ilana Feldman, “Gaza’s Humanitarianism Problem,” Journal of Palestine Studies ( JPS) 38, no. 3 (Spring 2009), pp. 33–34.
4 RajaieBatniji,“The Art of Medicine: Searching for Dignity,” Lancet 380, no. 9840 (2012), pp. 466–67.
5 Batniji,“The Art of Medicine,” pp. 466–67.
6 Husam al-Nono (staff member, Gaza Community Mental Health Programme), in discussion with authors.
7 Albert Camus, The Myth of Sisyphus and Other Essays (London: Vintage, 1991), p. 28.
8 United Nations Office for the Coordination of Humanitarian Affairs, “The Gaza Strip: The Long Term Impact of the 2014 Hostilities on Women and Girls,” fact sheet, 4 January 2016, http://www.ochaopt.org/documents/women_factsheet_january2016_english.pdf.
9 Linda Butler, “Suicide Bombers: Dignity, Despair, and the Need for Hope: An Interview with Eyad El Sarraj,” JPS 31, no. 4 (Summer 2002), p. 76.