It's time to switch off today's news talk radio very entertaining TNT. Welcome back folks. We're still in the first hour of this live broadcast. Again, I'm your host Patrick Kennyston. Welcome again to the program. And a big thank you to everybody for coming into the TNT chat community. I want to pivot right now over to a serious situation, which we alluded to before the break. The situation in Gaza, we often hear complaints about people war fatigue. Some people are tired of looking at images on social media. They're traumatized by it, albeit in a remote fashion. Now, just imagine what it's like to have that as your daily reality for the last eight months, going on nine months very soon. This is the situation right now in Gaza like it is in most war zones, but this one's different. This is a protracted war of attrition, the likes of which we have not seen in the modern era. This is new territory for humanity with huge consequences. I want to welcome on to the program right now, special guests. And we're going to talk about the effect of trauma on the children of Gaza with Dr. Sarah Fernandez joining us right now. Thank you very much for coming on to the program. Thank you for having me. And as I was explaining just before Sandra, this is kind of a new situation, that the length of time, the continuous bombardment, the absolutely relentless military attacks by the Israelis, your thoughts on the uniqueness of the situation and what are the ramifications of it? I think definitely Patrick is the sense that everybody in Gaza is experiencing something that is beyond post-traumatic stress disorder. We're talking about complex trauma. We're layers upon layers of exposure to events that are just unimaginable and it's the constant bombardment. It's the constant once life being under threat. And I think those experiences are really actually even beyond what we are used to in the study of post-traumatic stress disorder. And I think the difficulty that's going to arise is for future generations because of the intergenerational repercussions from the trauma that in particular the children are very susceptible to. So I think it's something that is quite incomprehensible. You know, I can't really, really have an understanding in my mind what anybody there is experiencing. And in terms of how can you place this in perspective of other conflicts, we do have some recent experience, a lot of data from places like Iraq and other war zones. How is this one markedly different from the others? Well, I think it's been the intensity of the bombardments within a very short period of time. So it's something that's quite unique to this particular conflict that hasn't really been seen over the previous conflicts. And I think it's also, if we look at the children in Gaza, is that there's been more casualties in regard to the children. More children have been killed in this particular war than they have over the last sort of 45 years in all the wars combined in the world. So it is something that is quite different. And I think it's because of the intensity and the severity of the injuries and just the ongoing displacement of people. And I think that's the tremendous exposure to the ongoing violence that people are experiencing there. And one of the things we're hearing a lot of, we've been following reports from the beginning of this phase of hostilities in Gaza. And one of the reports that we're hearing is not only do you have this kind of post-traumatic stress disorder as well, you have this sort of normalization of violence and normalizing of suffering to the point where people tend to internalize these sort of things as a coping mechanism. And over a long period of time, it can have disastrous effects on the behavior, the neuro reactions and normal emotional regulations that people have. Can you speak to this more subtle issue? Yes, I think in particular, if we look at children, because the brains are still developing, is that ongoing trauma and severity of trauma exposure actually causes structural changes to the brain. In particular, deep levels within the brain, such as the amygdala and the hippocampal area, there's a lot of neuro hormonal changes that take place. And as a result of this, there's an ongoing sort of learned helplessness that people also seems to take place, but also that this chronic exposure of the trauma results in multiple sort of effects on their health. And because the children are still developing, their brains are developing, it results in ongoing sort of development of things like depression, anxiety, lots of neurobehavioral changes, difficulties with the expression of the emotions of coping mechanisms, a sense of complete helplessness. So I think it has profound changes, not just at a sort of physical level, but at a neuro anatomical level too, and a physiological level in the brain. And a lot of the effects of this, they're not necessarily going to be manifested immediately. In some cases, these are suppressed, the reactions, they're stored, and then they might manifest much later, perhaps when the conflict is finally finished. And that could be anything from weeks to months, or possibly another year or two, we don't know. But is that a common phenomenon? Yes, definitely. And I think the thing is that trauma really expresses itself in a way, in multiple ways, in different people. So it can be quite unique to the individual. And it's dependent on a whole multiple factors, such as, for example, the person's genetic makeup, their upbringing, their personality structure, the way that they generally manage their emotions, their coping mechanisms. So everybody handles trauma in their own specific way. And some people might, in many ways, experience those expressions of their trauma quite acutely. But chronic trauma or chronic post-traumatic stress disorder can actually develop years after the actual event. It doesn't have to be something that happens in the acute presentation, can actually in some cases even present two years or five years down the line. So yes, that is something that one does see in post-traumatic stress disorder. But I want to just maybe highlight that this almost feels like it's something that's even just quite beyond post-traumatic stress disorder. It really is an ongoing stress response, because post-traumatic stress disorder essentially implies that it happens post the actual traumatic event. Whereas here, we're looking at the trauma that is just ongoing. It's just continuous. There isn't a pause in the kind of the trauma that the person is experienced, to allow them a safe space to be able to perhaps have a sense of trying to integrate the experience into the everyday thinking and the experiences that's happening around them. There is no safety net that the person that these people have in gauss in order to just have a pause in what is happening to be able to almost be able to have a sense of peace within your mind to be able to make sense of what is happening. We have a clip here. Actually, this was posted on X, Twitter platform just in the last day or so. We'll go ahead and it's kind of a Gaza trauma clip here just a few seconds. But I think it illustrates the sort of day-to-day, minute-to-minute life on a knife-edge that we're talking about here. Let's roll this and I'll get your reaction to this, Dr. Freer. Okay, well, the audio unfortunately didn't come through on that, but basically it was people just reacting to artillery fire and gunshots. It's just random, so you can never be quite settled in that respect. I remember when I was covering the war in Syria in 2017 in Damascus, not far away from where the fighting was. We wake up in the morning to very loud booms that shook the building that were maybe a half a mile away, but that's where the fighting was. It wasn't far, but every day was like that. At the beginning, it was a little bit of a shock and you were stressed and you start thinking, "What do I do next if that comes closer?" But after a few days, you normalize it and it just becomes background noise. I had suppressed it for a month and a half or however long I was there during that period in different places, but then when I came back to normal society, I found myself a little bit confused sometimes in terms of having to measure what's a stressful experience and what's not when you see something and also just the reaction to watching the news, for instance, things like that. But your commentary just generally on this topic. I think because of the heightened responses of these particular areas in our brain, amygdala and hippocampus, which are particular areas that process highly charged emotions, learning and memory that starts from that particular deep-seated areas in the brain, is that quite often with heightened scenes of threatened, where your own life feels threatened, is that these particular networks within our brain actually become dysregulated. So because of that, one has quite different responses to what one would ordinarily expect. And I've been reading somewhere somewhere that in Gaza, it's this constant buzzing of the drones that is happening almost 24 hours a day that people are having to sort of deal with. It's the constant drones and on top of the drones, it's the bombardments that also are taking place. So we're really looking at multiple layers of stimuli exposure at varied frequencies and varied levels, which really results in a complete dysregulated emotional response that the person becomes adjusted to. And as a result of that, can really experience a whole multitude of different emotions, avoidance behaviors, heightened responses, physiological responses, like heart rate, racing, pulse rate, up, sweating. And at the same time, with ongoing exposure, as you said, you can become quite desensitized to it after a while, because the heightened cortisol levels at one ordinarily with trauma gets released and rises with chronic exposure, they actually become quite dampened. And as a result of that, you can also become quite desensitized at times to what is going on around you. Well, I'm not so sure in this particular, because it is so unique in Gaza that there is just so much going on at the same time from multiple. It's not just the direct trauma that's taking place, but it's also the indirect effects of the trauma. So the displacement and the lack of food and the lack of water for children, it's the lack of the routine of being at school on a daily basis, schools that were the shelter, that were the places of safety for most of the children in Gaza. So as a result of that, we're looking at a generation of children that are really been subjected to such magnitude of violence that I think the intergenerational consequences, we are not going to really know what's going to be the outcome for quite a long time. And quite a bit has been written about this, obviously, because professionals have had enough time to look at it and it's still a life, a war theater right now. And again, we don't know when it's going to stop. But there's been quite a few things written on it. We've got one article, we'll put up on screen here. This is an article by Dignity, really trying to break down the levels of psychological trauma in Gaza. Many experts, of course, are saying this is unlike anything they have seen in their lifetime. And these are people that specialize in this field. They actively go out to study and look at the aftermath and do clinical work in these types of areas. And this is basically on another level. And we're seeing a lot of these reports, and I think it really speaks to what you're talking about. The other problem here, though, Dr. Fernandez, is that most children generally will not see or witness a dead body other than maybe an open casket at a funeral, depending on what culture you're from. But it's not something that you wouldn't see until you're well into your adult life, normally, unless you served maybe in the military. And even then, only if you were deployed in theater, or if you work in a medical theater, or ICU, or emergency theater for a hospital or something. Other than that, the average person, it's not something they're exposed to. And more than once, let's say, on an unusual circumstance. But here, it's a daily diet of death for these children. And in some cases, it's their own family, or their extended family, and not just hearing about it, which is bad enough, but also seeing it as well. And I can't even comprehend what that does to the worldview of a young child, your thoughts on this. Yeah. And I think also, maybe, Patrick, just to bear in mind that although we are seeing this intensity of this trauma, is that the children of Gaza and the population of Gaza, actually, this is not a first for them. So I think the severity since October the 7th is quite unique. But it is something that they've been subjected to for a significant period of time, for at least the last 17 years since the siege. So the population has been dealt with multiple times over the last 17 years, where there are periods of intense trauma that they have been subjected to. So the children of Gaza, there's been a lot of work that's been done and published in medical journals where between the period of around 2005, up until about two years ago, about 49% of children actually had moderate symptoms of post-traumatic stress disorder. And that's all pre-October the 7th, actually. So we're actually looking at a quite a unique population that's been subjected to multiple levels of intensity of trauma for prolonged period of time for a number of years. And as a result of October the 7th now, we're looking at an ongoing, traumatic ongoing violent exposure that's sustained, and that is happening on a daily basis. Raising the post, they might have had periods where there was intense traumatic experiences, they underwent, and then there would be pauses. And you almost get a sense that you're able to have a little bit of a safe space in being able to make sense and process the traumatic experience you've undergone. But that has not happened now since October the 7th. So I think this population of children have really been dealt such a deathly blow and the impact on their psyches, I think it's almost incomprehensible going forward. I mean, just think if you're living in a stable country, if someone your family passes away or friend, there is a period of mourning. And if it's not an Islamic country, there might be a week, maybe longer, before you have the funeral processions and so forth. And then you get that sense of closure and then at time to mourn. Those are luxuries that these people do not have. In fact, just having burial space or the ability to do that in a safe manner under these circumstances, they don't have those luxuries either. So that's a really massive part too, in terms of not being able to go through that process. Go ahead. Yeah. And I'm read somewhere that about 17,000 children have actually been orphaned. So we're looking at huge numbers of children that some of whom don't even have an immediate family member left and most likely have just been taken in by random sort of people within the community in order to have someone around them. We're looking at about over 1000 children that have amputations, sometimes multiple amputations. So the level of trauma that the children have undergone has really been something that is unimaginable. Many have lost not just one parent, but both parents or multiple members of the family. So this is something that is definitely quite unique. No, indeed. Indeed, I remember just when this fighting broke out after October 7th, I phoned a close friend of mine who comes from a very large family in Gaza. And just to see how his family was. And he regretted to inform me that their house was one of the first targeted in the initial raids and lost a whole line of the family was killed instantly. In fact, 12 members of the family and living on farmland as well, not even in the city. But it's really, it was hard for me to respond to him telling me that. It's just incomprehensible by normal standards of what you're used to in terms of, you know, getting bad news from friends and, you know, being able to console them as well. But that's just that was a basically a preamble to much, much worse. We saw unfold and continues to unfold to this day. I don't know how many total families someone's done a study on this. I've seen some journalistic work that there are a whole, I don't know how many dozens, how many hundreds of, I don't know, family lines have been completely erased. If that's extraordinary. I mean, they've even come up with that term, which I'm sure you're well aware of, wind of child, no surviving family. That is, that's now, you know, many of the children in Gaza have, you know, are known as the wind of child, no surviving family. So yes, definitely, there are multiple lineage, lineages of families that have been completely wiped out. And, you know, I've also seen somewhere in the media where the families and parents will write the children's names on multiple limbs. So that if, you know, they are bombed, that if, you know, the body is somehow putting to shreds that they're able to sort of identify multiple parts of the person. It's just quite horrific to think about these things that are happening that we are also experiencing on a day-to-day basis. I think it's also to think about the trauma that everybody in the world that are not in Gaza, that we too are having to experience on a daily basis. And then of course, the health care workers too, the ones that in Gaza have to deal with us on a constant basis, not just having to look after their patients, but then having to look after themselves and their own families. Many doctors, you know, have had contact with some mental health professionals from Gaza where they themselves on a daily basis are filled with the need to look for food and water for their own families. They don't even have the space to really have to completely focus on their patients. So it's this duel, this kind of almost alternate reality that people are having to live in, where they have been subjected and mental health professionals or all health professionals in Gaza have been subjected to so much trauma both for themselves and the actual people that they're having to help as well. Yeah, not to mention that the many instances where, you know, frontline health care workers, whatever's left of them, by the way, in Gaza, all of the hospitals have been targeted by the Israelis systematically, but they're actually having to receive family members coming into A&E, a makeshift A&E department, and in some cases, you know, having to work on people in their own family. And on top of that, just what you said about the writing, the names of the children on their limbs and, you know, permanent marker as well. And the fact that some families have been forced to split up the family so they don't have the entire line of the family in one location. I spoke to one resident. This was three about two months ago. And he said that four different parts of the family had been targeted and had taken losses in their family. And the surviving members of the family from those four different residence blocks came to southern or came to Rafa for safety. So you have the remainder of the entire family in one building. And we were talking to him on the phone and he's saying, well, you know, this is it. And now they're targeting Rafa, the Israelis. This is where we were told to go for safety. I'm here with my whole family, but you know, we could be finished in a split second. We don't know. And also the stress of speaking to a journalist on the phone, knowing that that could be tracked or traced by the Israelis and then targeted in a vindictive way. We've seen reports of this with journalists and their families being targeted by the Israelis. So I mean, it really is quite an extraordinary situation by anyone's measure. And you know, before we break and appreciate you joining us, Dr. Fernandez, there's also a lot of calls at the at the UN level, the human rights council level, to try to address so many situations. But just finally, in your opinion, what do you see? What can happen to try to deal with this, this, this wide ranging problem? I think that's such a difficult question. I, you know, every time I watch on the TV and listen to all these high profile United Nations folks, people and Antonio Gutierrez and everyone, it just doesn't seem like there's light at the end of the tunnel. Because at the end of the day, what we need is a political solution so that this just comes to an end completely. And it just doesn't seem to be happening. I think it's important all the processes that have been happening, the most recent the United Nations Commission report has come out just a day ago and has confirmed that Israel, you are committing all these horrific things in Gaza and they've been responsible for the starvation and the, you know, inflicting all these violent acts and horrific acts on the population of Gaza. And also the ICC and the ICJ case that we can only just hope that things will, will come of it, that there will be some kind of a solution. Because I think it's really what hangs in the balance is just the, the mental health of an entire population. And the entire children that the children of Gaza is just that the whole mental health is going to be severely impacted going forwards because of the brain development, the horrific experiences have been subjected to the loss of their families, loss of limbs, continuous displacement, having no food, no water, no electricity. It is something that is just beyond what I think even a very resilient person can actually almost cope with. So I think it's really something that needs to come to an end. This, what needs to happen is a ceasefire so that these people can have a pause and just be able to breathe once again and, you know, get, get a sense of what's been happening and have to deal with, with the repercussions of this war. Thank you very much. And yes, you know, the world definitely owes a debt of gratitude to South Africa and their delegation for basically bringing this case to the international courts of justice and open the door for other countries to do the same. So that's definitely been a positive development on the international scene. But we want to thank you for joining us, Dr. Sandra Fernandez, neuropsychiatrist. We really appreciate your input on this very important issue. And we'll keep a line of communication open for the future for sure, but much appreciated. Thank you. Thank you. And then she goes, ladies and gentlemen, that is Dr. Sandra Fernandez. We're going to take a break right now though with the network TNT today's news talk will be right back in just a few minutes after these messages.
