Children in Gaza are developing severe trauma symptoms alongside the risk of death and injury, according to a Palestinian psychiatrist. On Sunday, the Hamas-run health ministry in Gaza said 1,750 children had been killed in the 16 days of bombardment by Israeli forces since Hamas’s murderous onslaught on 7 October. That is an average of almost 110 children a day. Thousands more have been injured. The psychological impact of the war on children was showing, said Fadel Abu Heen, a psychiatrist in Gaza. Children had “started to develop serious trauma symptoms such as convulsions, bed-wetting, fear, aggressive behaviour, nervousness, and not leaving their parents’ sides.” The “lack of any safe place has created a general sense of fear and horror among the entire population and children are most impacted,” he said. “Some of them reacted directly and expressed their fears. Although they may need immediate intervention, they may be in a better state than the other kids who kept the horror and trauma inside them.” About half of Gaza’s 2.3 million population are children. Since 7 October, they have lived under near constant bombardment, with many packed into temporary shelters in UN-run schools after fleeing their homes with little access to food or clean water. Tahreer Tabash, a mother of six children sheltering in a school, said: “Our children suffer a lot at night. They cry all night, they pee themselves without meaning to.” Israeli children have also shown increasing signs of trauma since 7 October, according to Zachi Grossman, the chair of the Israeli Paediatric Association. “We’re witnessing a tsunami of anxiety symptoms among children” and the issue was “not being adequately addressed”, he told Ynet, an Israeli news website. “Around 90% of children visiting paediatric hospitals complain of anxiety. Many are suffering from anxiety, and it’s certainly something we haven’t seen in the past. The recognition is beginning to dawn that this issue will be much more prolonged than before,” Grossman said. In Gaza, a child aged 15 has experienced five periods of intense bombardment in their life: 2008-9, 2012, 2014, 2021 and now 2023. Studies conducted after earlier conflicts have shown a majority of children in Gaza exhibiting symptoms of post-traumatic stress disorder (PTSD). After Operation Pillar of Defence in 2012, Unicef, the UN children’s agency, found that 82% of children were either continuously or usually in fear of imminent death. Among Unicef’s other findings were: 91% of children reported sleeping disturbances during the conflict; 94% said they slept with their parents; 85% reported appetite changes; 82% felt angry; 97% felt insecure; 38% felt guilty; 47% were biting their nails; 76% reported itching or feeling ill. After Operation Cast Lead, the three-week war in 2008-09, a study by the Gaza community mental health programme (GCMHP) found that 75% of children over the age of six were suffering from one or more symptoms of post-traumatic stress disorder, with almost one in 10 ticking off every criterion. At the time, Hasan Zeyada, a psychologist with the GCMHP, told the Guardian: “The majority of children suffer many psychological and social consequences. Insecurity and feelings of helplessness and powerlessness are overwhelming. “We observed children becoming more anxious – sleep disturbances, nightmares, night terror, regressive behaviour such as clinging to parents, bed wetting, becoming more restless and hyperactive, refusal to sleep alone, all the time wanting to be with their parents, overwhelmed by fears and worries. Some start to be more aggressive.” Experts also noted a spike in psychosomatic symptoms, such as a high fever without a biological reason, or a rash over the body. A report last year by Save the Children on the impact of 15 years of blockade and repeated conflicts on the mental health of children in Gaza found their psycho-social wellbeing had “declined dramatically to alarming levels”. Children that the aid agency interviewed “spoke of fear, nervousness, anxiety, stress and anger, and listed family problems, violence, death, nightmares, poverty, war and the occupation, including the blockade, as the things they liked least in their lives”. The report quoted António Guterres, the secretary general of the UN, describing the lives of children in Gaza as “hell on earth”.