Israel has seen remarkable growth in the past fifty years. The most recent global financial crisis in 2009 produced a brief period of recession in the country. Still, their prudent fiscal policies and regulations, combined with a particularly robust banking sector, allowed the economy to recover quickly. Israel is now considered one of the most resilient and technologically advanced market economies in the world. Its skilled workforce and concentration of venture capital allow the country to lead in innovative industries such as high tech, cleantech, and the life sciences.[i] But this economic boom did not affect all people and geographic regions in Israel the same. Israel is the picture of a global power that we expect for a country with arguably one of the strongest economies in the world. But the occupied Palestinian territory tells a much different story.
The occupied Palestinian territory can seem like a different world, let alone a different country, from Israel. Palestine looks like a developing country, whereas the surrounding Israel does not. Millions of people still live below the poverty line in Palestine, and basic needs such as clean water and accessible transportation are not being met.[ii] There is also a substantial income gap between residents of Israel and Palestine, with the income of residents of Palestine less than a third of that of residents in Israel. Millions of Palestinian citizens live as farmers in Israel’s economic centers and live below the poverty line even there.[iii] As a result, many international agencies, including the United States Agency for International Development (USAID), are trying to solve a range of development issues in Palestine.
In this paper, I will focus on two development issues in Palestine: education and healthcare. First, I will discuss Palestine’s educational system and how the declining mental health of Palestinians due to the Israeli occupation of Palestine hinders educational outcomes.
Second, I will address the disparities between Israel and Palestine’s healthcare systems, focusing specifically on the prevalence of Israeli blockade in Palestine’s healthcare system.
Looking at a mix of randomized control trials and other research, I was better able to see the negative effect of the Israeli occupation of Palestine on Palestinians’ mental health and how this has affected education outcomes. Because Palestine lacks specific policies regarding education and mental health, I found that implementing mental health programs in Palestine is the most effective tool for alleviating PTSD/depression symptoms and improving performance in school. I also found that the Israeli blockade has had a drastic negative effect on the healthcare system in Palestine, which has given rise to many health issues like malnutrition. Unfortunately, Palestine lacks any policy regarding these health issues as well. A step forward could be through implementing nutritional programs that have been shown through randomized control trials to be the most effective at improving citizens’ health.
Education has been a source of both hope and transformation for the Palestinian people under Israeli occupation. After 1948, when most Palestinians fled or were forced to leave their homeland—an event known as the Nakba (the catastrophe)—students and teachers played a critical role in rebuilding Palestinian society. Palestinian schools, universities, and informal institutions have all contributed personal development and growth skills to a geographically fragmented people whether they were in exile or under occupation. Education is valued by families across Palestine, with 95.4% of children enrolled in primary education.[iv] But these impressive rates of enrollment mask the challenges of mental health that cause many adolescent boys and children with mental health issues to drop out of school.
Unlike Israel and many other developed countries, Palestine’s education has had to contend with the oppressive and often violent conditions of occupation and exile over the past seven decades. While most neighboring Arab states provide Palestinian refugees with access to education, in some countries such as Lebanon, Palestinians are dependent on the United Nations Relief and Works Agency for Palestine Refugees for access to education. Additionally, Palestinians experience many other restrictions in these countries as a result of their political status or financial situation. The protracted conflict and violent episodes that have escalated in the West Bank, including East Jerusalem, the closure of the Gaza Strip, and physical access restrictions, pose daily challenges and threats to children’s rights.
Violence against children in all its forms is of grave concern, as it compromises children’s learning and future potential. Children experience distress, fear, and intimidation traveling to and from school in high-risk locations where they frequently pass through checkpoints or walk by settlements. Constant exposure to conflict, economic hardship, and increased poverty contribute to the acceptance of violence as a social norm, affecting children’s motivation to learn.
I have firsthand experience of Palestine’s education. I am a Palestinian who used to live in Jerusalem. I moved to the U.S. three years ago for college and have since realized the enormous education gap between Palestine and other countries. The schooling system in Palestine focuses only on scientific disciplines, which were not interesting to me. Consequently, my grades suffered. Moreover, the Palestine’s education system values memorization and lacks appreciation for creativity and analytical thinking. There are also no internships or job opportunities in Palestine. In Israel, however, the case is different. The classes offered are flexible, and there are plenty of research and internship opportunities. Unfortunately, fluency in Hebrew is required to study in Israel, and most Palestinian schools do not teach Hebrew. Another obstacle to accessing education in Israel is that a lot of Palestinians cannot even cross the border into Israel without a permit, and once they are in, Israeli companies and professors prefer to hire Israeli students over Palestinians.
Figure 1
Mental Health and Educational Outcomes
The Palestinian population has been exposed to a series of traumatic events that have had a tremendous effect on education in Palestine. Land confiscation in particular is a source of much frustration and tension for Palestinians. The Israeli army frequently uses house demolition as a punishment against Palestinians, which has had an immense psychological impact on them. The home is not just a shelter, but the heart of family life. Losing one’s home is more than a physical disaster because it evokes the traumatic experiences associated with being a refugee. Israel occupying more Palestinian areas and demolishing Palestinian homes also brings back memories of Palestinian losses in the 1948 war, a particularly acute and deep-seated source of fear and insecurity for Palestinians. As men lose faith and confidence in the face of their traumatic experiences, women often bear the brunt of physical abuse. Up to a quarter of Palestinian women in the Gaza Strip have been exposed to domestic violence and abuse at some point in their lives, mainly from their blood relatives.[v] Exposure to distressing events increases the likelihood of developing PTSD symptoms and other mental health disorders, which when developed in children, can adversely affect their motivation to learn.
Depression impairs one’s ability to reason clearly by interfering with healthy thought processes, impacting a person’s ability to concentrate and make decisions. Many people who are depressed have memory problems and have trouble remembering events or facts.[vi] Other depression symptoms
exacerbate learning difficulties. Some people with depression become irritable, nervous, and unable to concentrate. Others discover that they have lost interest in hobbies, sports, and new skills.[vii] In addition to that, mood swings can make it difficult to pay attention, and feelings of despair or low self-esteem can lead people to think they shouldn’t bother learning new things or that they simply are not capable. Unfortunately, Palestinians cannot get the help they need because Palestine has a fragmented mental health system with inconsistent medications and counselling availability.
I also have firsthand experience on how mental health can affect education outcomes in Palestine. For example, during the Gaza war in 2014, the situation in Jerusalem was deemed dangerous. Consequently, there were school closures for three months and limited freedom to go out, which affected students’ motivation to learn and hope for a better future. As a result, many of them decided to drop out of school or repeat their grade. These students used most of their mental ability to process unsettling thoughts and events, which caused difficulty concentrating on school.
Because PTSD and depression can have such a large effect on education, scholars have sought to study the impact of counselling on students’ educational outcomes. In an experiment done by Stanford scholars from the Rural Education Action Program, researchers examined the effects of providing school counselling intervention on student dropout behavior and learning anxiety.[viii] They analyzed data from a randomized controlled trial involving seventy-four junior high schools and 7,495 students in China and found that school counselling reduces dropout and decreases learning anxiety. The findings were highly significant. Unfortunately, we do not see evidence that this kind of policy exists in Palestinian schools. This data and the scholarly research I have discussed before suggests that Palestine should implement mental health programs and other counselling interventions in schools to improve children’s mental health, which can in turn improve educational outcomes.[ix]
In another study conducted by scholars at the University of Tampere and Islamic University Gaza, scholars studied the effect of psychological treatment for war-affected youth in Palestine. The researchers cluster-randomized 428 Palestinian children into the treatment and control groups. They reported the quality of peer (friendship and loneliness) and sibling (intimacy, warmth, conflict, and rivalry) relations, post-traumatic stress, depressive symptoms, and psychological distress symptoms before and after treatment. The results showed that psychological counseling had mixed effects on children who had experienced war. While many relationships with children had improved due to the counseling, most improvements were not significant. Although this study doesn’t directly examine the effect of psychological treatment on educational outcomes, the alleviation in symptoms (while not substantial), along with the previously discussed research, should be adequate evidence to prove that mental health programs will improve educational outcomes in Palestine.
Figure 2
Healthcare in Palestine
Though it is caring and educated, the healthcare system in Palestine struggles to provide adequate services for the population due to the Israeli blockade. The World Bank reports a poverty level of 26% in the area, with an unemployment rate of 15% in the West Bank and 47% in Gaza.[x] The difficult conditions in which many Palestinians live exacerbate the health care system’s shortcomings and make it more challenging for Palestinians to access quality healthcare when they need it.
These conditions are made even worse by the presence of permit restrictions that limit Palestinian access to healthcare. Restrictions on who can travel where in Palestine are common, and these restrictions make it even more difficult to access healthcare. For example, many specialized hospitals are located in East Jerusalem, but Palestinians are often denied permission to travel there, even to receive desperately needed medical care. Availability of healthcare in Gaza is particularly affected since Gaza is subject to heavier restrictions. These restrictions on travel have a crippling effect on patient care. Nearly one out of every five Gaza patients who apply for a visa to get medical care in East Jerusalem, Jordan, Israel, or even the West Bank receives a denial or experiences a significant delay.[xi] Some of the restrictions—the Israeli and Egyptian blockade of Gaza in particular—have left the Palestinian hospital system with critical shortages of supplies like medical equipment, prescription drugs, over-the-counter medications, and protective gear.
In addition to that, it’s important to note the difference in healthcare systems between Israel and Palestine. My experience as a Jerusalemite was a tale of two healthcare systems that live side by side. Israel has one of the world’s highest-performing healthcare systems as judged by national health statistics and health spending levels. It invests modestly in healthcare, spending about 7.3% of GDP in 2016, but has population health statistics as good as a 2015 infant mortality rate of 3.1 deaths per 1,000 births, and life expectancy at birth of 80.1 years for men and 84.1 years for women in 2015. Palestine’s healthcare system does not have the resources or results of its Israeli counterpart. Life expectancy at birth in 2015 was 70.7 years for men and 74.7 years for women, and infant mortality in 2014 was 12.6 deaths per 1,000 births.[xii] As a result, I never thought twice before going to an Israeli hospital. I knew I would be able to get the help I needed. In Palestinian hospitals however, I always doubted that. Hence, we cannot avoid the conclusion that Palestinian healthcare is vastly inferior to the Israelis’, and that the occupation has had a considerable influence on its value. Despite these setbacks, the Palestinian government could still implement initiatives to alleviate substantial issues affecting its citizens, like poor nutrition.
Conclusion
All things accounted for, there are vast disparities between Israel and Palestine. In many ways, the two areas can seem like different worlds. Unfortunately, Palestine’s current development policy and its economy appear to be trending negatively by lacking specific policies for nutrition and mental health. According to my research and the randomized control studies discussed in this paper, mental health programs can significantly alleviate PTSD and depression symptoms, improving educational outcomes. Nutritional programs that bring awareness to malnutrition and bad eating habits have also proved effective in improving health outcomes and decreasing malnutrition. There is much to be done to develop Palestine to the same level as Israel, but research has given us a good direction for where to start, and hopefully progress will be made soon.
[i] Pileggi, Tamar. “Israel’s Economy Contracts For First Time Since 2009”. Timesofisrael.Com, 2014, https://www.timesofisrael.com/israels-economy-contracts-for-first-time-since-2009/#:~:text=The%20Iast%20time%20Israel’s%20economy,but%20boosted%20exports%20by%2 02.8%25. Accessed 4 Aug 2021.
[ii] “A Question Of Security”. Human Rights Watch, 2021, https://www.hrw.org/ report/2006/11/06/question-security/violence-against-palestinian-women-and-girls.
[iii] “A Question Of Security”. Human Rights Watch, 2021, https://www.hrw.org/ report/2006/11/06/question-security/violence-against-palestinian-women-and-girls.
[iv] “Education And Adolescents”. Unicef.Org, 2021, https://www.unicef.org/sop/what-we-do/ education-and-adolescents. Accessed 4 Aug 2021.
[v] “A Threshold Crossed”. Human Rights Watch, 2021, https://www.hrw.org/report/202l/04/27/threshold-crossed/israeli-authorities-and-crimes-apartheid-and-persecution
[vi] Wetsman, Nicole. “Depression’s Impact On Memory”. Brainfacts.Org, 2019, https://www.brainfacts.org/diseases-and-disorders/menta1-health/2019/depressions-impact-onmemory-022119.
[vii] Wetsman, Nicole. “Depression’s Impact On Memory”. Brainfacts.Org, 2019, https://www.brainfacts.org/diseases-and-disorders/menta1-health/2019/depressions-impact-onmemory-022119.
[viii] Huan, Wang et al. “Can School Counseling Reduce School Dropout In Developing Countries?”. 2014, https://impactevidence.org/media/study_pdfs/31012.pdf. Accessed 4 Aug 2021.
[ix] Huan, Wang et al. “Can School Counseling Reduce School Dropout In Developing Countries?”. 2014, https://impactevidence.org/media/study_pdfs/31012.pdf. Accessed 4 Aug 2021.
[x] The World Bank. 2021, https://www.worldbank.org/en/news/feature/202l/06/27/the-toll-of war-on-palestinians-in-gaza. Accessed 4 Aug 2021.
[xi] Israel: Record-Low In Gaza Medical Permits”. Human Rights Watch, 2018, https:// www.hrw.org/news/2018/02/l3/israel-record-low-gaza-medical-permits.
[xii] “A Visit to Israel Sheds Light on Two Health Systems”, 2017, https:// www.com monwealthfund.org/blog/2017/visit-israel-sheds-Iight-two-heaIth-systems”