Canadian doctor calls for permanent ceasefire in Gaza after witnessing children's unprecedented trauma: 'Very long and slow healing'

After her latest mission in the region with Doctors Without Borders/Médecins Sans Frontières, Dr. Audrey Mc Mahon says "there's no safety anywhere" to offer support to the children of Gaza.

Youssef Al-Khishawi, an MSF water and sanitation agent, helps children carry water to their tent in the Tal Al-Sultan area of the southern Gaza town of Rafah, on January 27, 2024.
He says: “In a normal situation, one person needs two to three litres of drinking water per day. Now, with the current shortage, the average for one family of six is one gallon of water (3.8 litres).

Health-care workers in Gaza have been working around the clock since October, using limited resources to provide care to thousands while also trying to survive themselves. Meanwhile, emergency medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) has been offering support through medical and mental health staff, including 300 Palestinian health-care workers, many of whom have fled hospitals that were forcibly evacuated or attacked by Israeli forces, and have lost their homes and family members.

Still, for people like MSF psychiatrist Dr. Audrey Mc Mahon, the overarching goal remains to provide as much aid as possible. Mc Mahon recently returned from Gaza to her home in Sherbrooke, Quebec, where she works as a child psychiatrist, specifically providing mental-health care for refugee and migrant families and children. She was previously based in Jerusalem for 14 months with past stints in Sudan, Iraq, Democratic Republic of Congo, Colombia, Philippines, Senegal, and Haiti. She oversaw mental-health projects in Gaza and the West Bank, and has seen firsthand the “collective trauma” that Gazans are living with — particularly the city’s children.

Dr. Audrey Mc Mahon with Médecins Sans Frontières/Doctors Without Borders
Dr. Audrey Mc Mahon with Médecins Sans Frontières/Doctors Without Borders

As of April 22, more than 34,000 Palestinians have been killed in Gaza, including 14,685 children and 9,670 women. UNICEF reports that one child is killed or injured every 10 minutes in the ravaged city.

Mc Mahon spoke with Yahoo Canada about how MSF has been able provide help in Palestine, how Gaza’s children are set to experience life-long trauma, and why they are in need of healing “yesterday.”

MSF midwife activity manager Rita Botelho de Costa checking on a newborn in the Emirati post-delivery ward supported by MSF. To reduce the risk of morbidity and mortality among mothers and newborns, MSF is supporting the Emirati hospital with postpartum care. An addition of 12 beds to the ward, allowing more patients to receive proper post-delivery monitoring.
MSF midwife activity manager Rita Botelho de Costa checking on a newborn in the Emirati post-delivery ward supported by MSF.

Why did you want to travel to Gaza, and did you feel any fear or trepidation ahead of your visit?

It's important to support Palestine in any way that we can, and I know that — through my profession — I could do that. I did a lot of teaching and capacity-building to make sure that whatever we do is sustainable. And no, I wasn't scared to go into Gaza. I have been there many times before October, and I know people inside; colleagues, friends, which I think changes the way we relate.

Can you detail what sort of mental health projects you were working on while you were there on behalf of MSF?

In the West Bank, we have a full mental health clinic in Nablus. We have social workers, psychologists, we have a doctor that works specifically with mental health, and we offer community-based care and more specialized care. In Gaza, before October, we specialized in burn clinics. We were supporting [the since-destroyed] Al-Shifa and Nasser Hospitals’ burn unit and surgery care. And through those programs, we had a lot of children that were coming in who were hurt or burned. We had a psychosocial team offering counseling to them, their mothers, and any adults that would come.

Is it possible to describe what the situation was like when you were there this time, particularly in regards to the collective mental state of the region’s children?

I think we are coming to a time where it's hard to find words to describe what we're seeing and hearing. It's completely devastating to see how this war has impacted the children of Gaza. We needed to create a new acronym — WCNSF, meaning “wounded child, no surviving family” — which is extremely brutal. We've seen so many of them at our clinic after surviving bombardments. In the first few weeks of the war, our staff had to amputate children without sedation. This in itself for medical stuff is traumatic, but you have to do it. And these children have not only lost limbs, but members of their families and their homes. We are at the point where 100 per cent of Gazan children haven't been to school in six months. It's a complete breach of childhood.

Do you get the sense that these children truly understand what's happening, not just in terms of the sheer loss they’re experiencing, but what the meaning behind the conflict is?

They understand way more than we think. These children have seen the destruction of their world, the destruction of their city, the destruction of their neighbourhoods. They've seen people lying in the street with limbs missing. [It’s all] very intrusive and brutal.

A friend and colleague of mine, she has a three-year-old and a five-year-old, and at the beginning of the war, the five-year-old was crying and frightened by the bombings. She told him, “Don't worry, they're huge birds and they make a lot of noise. But they will stop soon.” A couple of weeks ago, she was exhausted, she’d kept working in the hospital. Later, she was crying at home. Her five-year-old went to her and said, “Mama, why are you crying?” She said, “Because I'm exhausted by the bombings. I just want to get back to our life.” And he said, “Mama, don't worry, they're just big birds and they make a lot of noise. But soon they will stop.”

Damaged walls at the entrance of MSF office in Gaza city on April 1, 2024.
Damaged walls at the entrance of MSF office in Gaza city on April 1, 2024.

That’s incredibly moving and tragic. Touching on that, I’ve read reports coming out of Gaza of some Palestinian children saying, amid all the loss, grief, and devastation, that they don't want to live anymore, which feels unprecedented. Is that fair to say?

It speaks to them understanding what is happening. This is something that they can't make sense of. These children will ask, “Why is this happening to us? What did we, as Palestinians, do?” And there's just no sensical answer. It's true that it's rare that a five-year-old or six-year-old will want to die, but we do see it sometimes. When a child that young says this, it's truly because living has become so massively painful that they don't want to feel it anymore. Maybe they lost their parents, maybe they are orphans, maybe they've lost people they love and they want to join them and be with them again.

Dr. Audrey Mc Mahon with Médecins Sans Frontières/Doctors Without Borders
Dr. Audrey Mc Mahon with Médecins Sans Frontières/Doctors Without Borders

We know resources are incredibly limited in Gaza right now. What, then, does treatment look like when it comes to mental health? What are the supports that are available to them?

It's extremely difficult to offer mental health support under active bombardments; there's no safety anywhere. That means there is no real therapy possible in this environment. The first thing that needs to happen is a ceasefire. [In the meantime,] the best thing we can do is continue supporting their resilience, and what they need to survive at the moment. What our teams can offer is limited, but we do storytelling with the children, activities, listen to them, their stories, we do drawings with them to let them express what they're going through. But while they're still in the midst of destruction, it isn’t healing.

What long-term mental health impacts do you see these children experiencing?

I think they're going to be very long lasting, across generations; it’s a collective trauma. I don't think you heal completely from something like this. But they need healing now, they needed it yesterday, and they'll need it tomorrow. They need the support of the international community, from civilians across the world, to remind them that they are human, that they belong.

They need healing now, they needed it yesterday, and they'll need it tomorrow.

How has seeing this first-hand impacted you? It can’t be easy.

I get asked this question a lot and, every time, I want to talk about my colleagues in Gaza who have been living under the bombings for six months, who struggle to have their basic needs met, and still wake up in the morning and go to work. This is superhuman strength, it's survival. When you look at what they are doing and what they are going through, you go on and you talk about the truth.

Is there a moment or dialogue that has particularly stayed with you?

I have a colleague and friend who made the hard decision to leave Gaza. Hard because for those who leave, Gaza is still their home, their land, and they are all very afraid and aware that they might never go back, which is the scariest and saddest thing. When my friend left, she was sharing how difficult that was. As she was leaving me a message about this, I could hear one of her children talking to her. So, she stopped and she left another message later, saying, “Sorry, my little one came to ask me what was going on and why I was crying.” She explained to her daughter, who is six, that she was crying because she missed Gaza, her home, her friends, her colleagues. She missed the sea. She missed everything. Her daughter then told her, “Mama, remember we didn't leave Gaza because we wanted to leave. We left to survive and to avoid death.” She’s six years old and saying this!

Dr. Audrey Mc Mahon with Médecins Sans Frontières/Doctors Without Borders
Dr. Audrey Mc Mahon with Médecins Sans Frontières/Doctors Without Borders

It's unfathomable. In sharing all of this, what do you hope people will learn or take away?

Gaza is not a terrible place. It's a nightmare right now, but it used to be like any other place on Earth. It used to be a home, it used to be beautiful. I hope to rehumanize the story and rehumanize Palestinians. I hope people remember our shared humanity, and that this goes beyond political considerations.

I think I know the answer, but I have to ask: Will you go back, and keeping working and helping?

Without hesitation.

And when you do go back, what do you hope you will see?

I sincerely hope there will be a permanent ceasefire. I hope that those who have the power make that happen because that's what Palestinians need, to go from survival to rebuilding to a very long and slow healing.