DevMode
In accordance with the Oslo agreement, signed between the PLO and Israel in 1993, around 7,500 Palestinian prisoners were released from Israeli jails. Statistics of the various human-rights organizations show that, between 1987 and 1993, at least 120,000 Palestinians were detained in Israeli prisons for more than three days. The majority had been tortured.
On their release, these prisoners found that no proper preparations had been made to deal with their special conditions, apart from the brief-lasting euphoric welcome they received. In fact, the Palestinian people, already too exhausted by over 30 years of Israeli occupation, were unable to shoulder the new and huge burden. They failed to offer these released prisoners full assistance or to help accommodate them properly, in order to allow them to resume their life outside prison bars.

Treatment and Rehabilitation Efforts

Some of the released prisoners sought assistance to their problems from human-rights organizations and doctors in private clinics. When we talk about problems of released prisoners, certain issues normally come to mind, like finding a job or living quarters, or even frustration with the disregard of one's political faction.
But the released Palestinian prisoners confronted the human-rights organizations with problems of a different nature. These prisoners talked about difficulties of reintegration into the bosom of their families. Others (mainly those who had served prolonged periods of time) were bothered by a severe discrepancy on the cognitive level between themselves and other members of the family, even with their grandchildren. For example, children would deride them for not knowing what traffic lights were. Some released prisoners painfully realized that they had lost their position as pater familias and that, to their children, the ultimate authority in the household was the mother. Others talked about a failure to resume their sexual life.
Human-rights organizations noticed that some released prisoners were using excessive force with their wives. Also, a good number of them had joined various Palestinian security organs, and proceeded to torture those in their custody, using the same methods of torture to which they, themselves, had been subjected in Israeli detention centers.
In general, the following facts were observed:
• Some released prisoners were suffering from a wide range of specific, trauma-related psychiatric problems.
• Given the stigma attached to mental illness, some patients among released prisoners were reluctant to seek help in the public sector.
• The only treatment available was of poor quality, sometimes exacerbating the released prisoners' condition. For example, the clinic environment and having to wait in crowded waiting rooms, reminded the prisoners of their original trauma.
• The existing private clinics are few and too expensive, far beyond the financial capacity of the released prisoners.
• Psychiatric treatment alone could not meet the released prisoners' needs. They required a treatment package consisting of different methods.

The Establishment of Treatment and Rehabilitation Centers

A treatment and rehabilitation center was established in Ramallah, in the West Bank, in addition to the already existing program in the Gaza Strip, the Gaza Mental Health Program. The center is composed of a multidisciplinary team, comprising a consultant psychiatrist, a clinical psychologist and a psychiatric social worker. All staff are highly qualified, with a long experience in the field of mental health, and with added training and supervision in the field of psychotherapy applied to victims of torture.
Patients are usually self-referred to the center, or they are referred by some human-rights organization. The consultant usually assesses and evaluates new cases and decides whether to include them in the treatment program. Inclusion or exclusion depends on admission criteria, which are, firstly, whether the patient is a survivor of torture, direct or indirect (like victims of organized violence). The treatment is offered to all victims of torture regardless of the identity of the perpetrators. The second criterion is whether a patient is assessed as suffering from a debilitating and/or a dysfunctional level of performance.

Treatment Procedures

After admission, a decision is made on a weekly basis regarding the tentative treatment procedures, and reevaluation and modifications to the treatment plan are made. The decision to treat a specific patient through medication, group psychotherapy, debriefing, or a more sophisticated treatment modality is taken collectively. Various treatment methods are used, mainly short-term dynamic psychotherapy, cognitive behavior therapy, and a social work intervention program - more of the human approach. The most common treatment procedure is to provide the patient with individual psychotherapy under the supervision of a therapist. Depending on the nature of their case, the patients are made to join group therapy. Nonetheless, each patient needs an individually tailored treatment plan. An outreach program includes visits to the family of the patients, as well as family therapy.
Parallel to the treatment process, all data are documented for research purposes. The aim is to identify the most common trauma among victims of torture in Palestine, to monitor the treatment and rehabilitation development, and to monitor the process of recovery of treated patients and their resumption of normal life.

Conclusion

It has been found that the level of trauma among Palestinian released prisoners is very high. The level becomes higher when the Palestinian prisoner is tortured by his own people (i.e., by the Palestinian National Authoritiy). In either case, these prisoners need special care and treatment.
To torture a person will, sometimes, take only minutes, but, for us psychiatrists, it takes years and years to assist the tortured persons to resume their normal life. Hence, we have to exert all our efforts to prevent all forms of torture on any level and in any context.

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