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
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
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
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
• 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
The Establishment of Treatment and Rehabilitation
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.
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.
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