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GENEVA —The United Nations Children's Fund, UNICEF, is warning that children in Gaza are facing a mental health crisis and are in desperate need of psychosocial support, which is largely unavailable under the security and humanitarian conditions prevailing in the war-torn enclave.
"The only way to have this mental health and psychosocial support delivered at scale is with a cease-fire," said Jonathan Crickx, who is UNICEF's chief of Communication and Advocacy-State of Palestine.
"Palestinian children's mental health is severely impacted," he said. "They present symptoms like extremely high levels of persistent anxiety, loss of appetite. They cannot sleep. They have emotional outbursts or panic every time they hear the bombings."
Speaking from Jerusalem, Crickx told journalists in Geneva Friday that UNICEF estimates at least 17,000 children, or 1% of the 1.7 million displaced population in the Gaza Strip, are unaccompanied or separated.
"Each one, a heartbreaking story of loss and grief," he said.
While he was in Gaza this week, he said he met many children, each one with her or his own devastating story to tell.
"Of 12 children I met or interviewed, more than half of them had lost a family member in this war. Three had lost a parent, of which two had lost both their mother and their father," he said. "Behind each of these statistics is a child who is coming to terms with this horrible new reality."
He noted that in the middle of a conflict, it is common for extended families to care for children who lost their parents. But this is not happening in Gaza, he said, because "extended families are distressed and ... are struggling to cater for their own children and family."
Before the war began, UNICEF reported, more than 500,000 children already needed mental health and psychosocial support in the Gaza Strip. It now estimates this number has risen to more than a million.
UNICEF and its partners have provided support for 40,000 children and 10,000 caregivers since Israel began its offensive in Gaza following the brutal invasion of its territory by Hamas militants on October 7 that killed 1,200 people and resulted in 240 people taken hostage.
"This is far from sufficient when we see the scale of the needs. It is possible to scale up now," Crickx said. "We have done it before. But it is not possible under the current security and humanitarian conditions."
Richard Peeperkorn, World Health Organization representative for the Palestinian territory, confirms that the large number of Gazans affected by mental health problems before the war has now "massively increased."
"It should be something to focus on as soon as we can focus on regular health care, primary health care, including mental health and psychosocial support," he said, adding that many health care workers who are dealing with trauma each day also suffer from mental health issues and need help.
But for now, he said, the WHO is not able to give this issue the attention it deserves because of its focus on some 27,000 fatalities and 67,000 injured.
"When we go around the hospitals, we talk a lot about trauma, spinal injuries, burns, et cetera," he said. "I have never seen so many amputees in my life, including among children. And if you also think about all those injured people ... [you can't help but think about] the impact it has and will have, not only on themselves, but their families and communities."
Peeperkorn said the focus is now mostly on converting the majority of the "partly functional hospitals ... into trauma centers."
"And what is important there is basic health services, primary health care, a whole range of mother and child health, reproductive health services, including noncommunicable diseases," he said, adding that access for patients and health partners who resupply hospitals remains "extremely challenging."
OCHA, the U.N.s Organization for the Coordination of Humanitarian Affairs, is reporting that thousands of Palestinians in Gaza continue fleeing to the southern town of Rafah, whose population has increased from 200,000 to more than a million people - most living in makeshift structures, tents or out in the open.
"Rafah is a pressure cooker of despair, and we fear for what comes next," said OCHA spokesperson Jens Laerke. "As we have heard, [Khan Younis] has also come increasingly under attack, and it has been shocking to hear about the heavy fighting in the vicinity of the hospitals."
Laerke also said that there was no safe place in Gaza, and further fighting in Rafah would make the situation even worse.
"There is not enough food, there is not enough clean drinking water, and there is no protection. Nobody is guaranteed [to be safe] from the next wave of fighting that we fear is coming on," he said. "It is, like, every week; we think it cannot get any worse. Well, go figure. It gets worse."