As the sun rises over Gaza, it illuminates a landscape marked by devastation and despair. The wholesale destruction. The eradication of any sign that normal lives are being led. It is a scene few of us would recognize. It might as well be the far side of the moon. But this is not some distant planet. The narrow strip of land along the shores of the Mediterranean, on which tens of thousands of tons of bombs have been dropped, is one of the most densely populated areas on Earth. The impacts of conflict reverberate through what remains of every street and home, in every heart and mind. For more than 2 million people living in this landscape — and in similar settings in countries like Lebanon, Somalia, Sudan, the Syrian Arab Republic and Yemen — daily life is not just a struggle for survival against physical dangers. It is a battle against the overwhelming psychological toll that uncertainty and exposure to violence inflicts. My own part of the world, the Eastern Mediterranean region, is home to 40 percent of the world’s population in need of humanitarian assistance. It hosts 55 percent of the world’s refugees. Almost half the region’s countries are grappling with protracted emergencies, increasing the vulnerability of their populations to mental, neurological and substance use disorders. Amid these staggering statistics, it is vital we understand the human cost of conflict. The prevalence rate of mental disorders in the region is significantly higher than the global average Dr. Hanan Balkhy Individuals affected by emergencies experience profound distress, manifesting as anxiety, sadness, fatigue and irritability. More than one in five will experience mental health conditions, including post-traumatic stress disorder, depression and schizophrenia. One in 11 will develop conditions severe enough to impair their ability to function in these crisis environments. How do you manage when falling bombs replace the sounds of children playing in the street? When every day must be spent searching for the water and food necessary to eke out an existence. When you breathe the miasma of sewage that can no longer be treated but instead floods the streets. When medical care is impossible to access, leaving injuries untreated and illnesses to fester. And when you are forced to scrabble through tons of rubble to search for missing loved ones. When children are being orphaned and maimed every day. When childhood itself has been turned into a nightmarish struggle to survive. How can the experience of witnessing such destruction, of losing mothers, fathers, sisters and brothers, not leave a lasting imprint on developing minds? How will they recover? How might you cope? The prevalence rate of mental disorders in the Eastern Mediterranean region is significantly higher than the global average, with the difference almost wholly accounted for by prevailing emergencies. Yet, as the need for mental health and psychosocial support rises, the ability of overstretched health and social care systems to provide support is being eroded, leaving a yawning gap of as much as 90 percent for the treatment of mental, neurological and substance use disorders. In Lebanon, the situation is fast spiraling out of control. After years of profound economic stress — exacerbated by the devastating port explosion of 2020 and the arrival of 1 million Syrian refugees to live among Lebanon’s population of 4 million — it has been reported that more than 1,900 people have been killed and more than 9,000 injured since October 2023, while health facilities have again come under attack. Recognizing the urgent need for mental health services, the Lebanese government has worked to strengthen its mental health infrastructure and enhance services that benefit both refugees and the local population. This commitment to mental health is fostering community resilience. Amid the growing chaos, it offers a lifeline of hope. Residents of conflict-affected countries deserve more than the chance to survive; they deserve the opportunity to thrive Dr. Hanan Balkhy In Sudan, the simplest tasks — gathering food and water — are fraught with danger. For many, the world outside their door has been turned into a landscape of terror. The threat of gender-based violence has left millions of women and girls ensnared in a web of fear, creating an invisible prison. Not only must we recognize the deep psychological wounds inflicted by this relentless cycle of violence, we must act to restore freedom and agency to its victims. The psychological traumas and emotional distress that haunt Gaza, Lebanon and Sudan echo across Somalia, the Syrian Arab Republic and Yemen, impacting millions of innocent civilians. As we observe World Mental Health Day on Thursday, it is also crucial we acknowledge the dedication and professionalism of the health workforce across the region, the people at the forefront of delivering care. They risk their own well-being and, in far too many cases, their lives as they support the most vulnerable in their communities. Often lacking the resources they desperately need, they continue to battle the tides of despair. They deserve our heartfelt appreciation and unwavering support, including access to mental health resources that can help them maintain their own well-being. Investing in mental health is a strategic necessity. The World Health Organization is actively engaged in scaling up mental health and psychosocial support interventions and integrating them across all levels of health and social care. Our efforts range from building local capacities for low-intensity interventions like psychological first aid to providing services for those with severe mental health conditions and essential psychotropic medicines. But the scale of the problems is enormous. Much more needs to be done. Residents of conflict-affected countries deserve more than the chance to survive; they deserve the opportunity to thrive. By addressing their needs, we empower individuals and communities to reclaim their lives and contribute to building back better for us all. We cannot afford to wait until the dust has settled. We urgently need to develop innovative approaches to support populations and governments in need. But more than this, more than anything, we need peace to prevail. In our region, we have grown far too accustomed to the harsh realities of war and its profound impact on mental health, not only on those living through the nightmare but also those who witness it virtually through screens and mobile devices. The shared trauma has shaped our collective psyche, reminding us that the scars of conflict extend far beyond the battlefield. Let us act decisively and invest in the well-being of those affected by conflict and disaster. Only then can we create a future where every individual has the opportunity to heal, thrive and contribute to a more peaceful society. The time for action is now. The stakes could not be higher. Dr. Hanan Balkhy is the World Health Organization’s Regional Director for the Eastern Mediterranean.