Trauma Under Eight Years of Armed Attacks Directed at Civilians

Sderot Media Center Report to the United Nations Fact Finding Mission on the Gaza Conflict

“I expect basic international humanitarian law to protect the civilians to be respected and restored, not repeatedly violated as Hamas has done. I expect there to be accountability. Hamas must cease firing these rockets and I have always insisted on this.”

Ban Ki-moon, UN Secretary General, speaking in Sderot

“If somebody was sending rockets into my house where my two daughters sleep at night, I’m going to do everything in my power to stop that, and would expect Israel to do the same thing.”

U.S. President Barak Obama during a visit to Sderot

“The attacks against civilians by Palestinian armed groups are widespread, systematic and in pursuit of an explicit policy to attack civilians. They therefore constitute crimes against humanity under international law. They may also constitute war crimes”

Amnesty International

Palestinian armed groups routinely violate international humanitarian law when using Qassam-type rockets to attack Israel. They are unlawfully launching strikes that either are directed against civilians or are indiscriminate because they are not directed at a specific military objective. In addition, some statements of the groups responsible for carrying out rocket attacks indicate an intent to use the weapons primarily to spread terror among Israeli civilians, which is also prohibited under international humanitarian law.

Human Rights Watch

Prepared by Noam Bedein June 30, 2009

Sderot Media Center

Table of Contents

Introduction. 3

Statistics of Attacks against Civilians. 3

Confirmation of Violations. 4

Psycho-Social Effects. 4

Economic Impact. 6

Case Studies. 6

Conclusions. 7

Appendix 1 – Expert describes how babies remember traumatic events for years. 8

*Letter to Sderot Media Center Director Noam Bedein requesting report on the affect of rocket fire on citizens of southern Israel.
Click to Read Letter


The Israeli town of Sderot was subject to repeated rocket attacks during the period the commission has chosen for its mandate: June 2008 through January 2009. These attacks constituted the indiscriminate firing of anti-personnel missiles aimed at civilian targets.

By all definitions, these attacks were clear and repeated violations of International Human Rights Law and International Humanitarian Law.

The direct consequences of these attacks included negative psycho-social and economic affects on the entire population, but it must be noted and emphasized that the population of Sderot was already in a state of trauma as a direct result of seven consecutive years of previous rocket attacks.

While the commission has arbitrarily mandated itself to a restricted timeframe, the traumatic effects as a result of the Gaza Conflict are seen by the residents of Sderot to have a real timeframe of March 5, 2002 through to and including 2009 to the present.

In 2008, over 3200 Palestinian rockets were fired from the Gaza Strip, the largest number of rockets fired at Israel (per year) since 2001.

Statistics of Attacks against Civilians

During the Gaza Conflict, Palestinians fired 84 rockets that exploded within the municipal boundaries of Sderot. The residents of Sderot were subjected to 140 warning sirens during the three weeks of fighting. There were thus an average of 7 alerts and 4 actual explosions every day.

Given the average Qassam rocket warhead is 20 kg, a total of 840kg of explosives detonated in Sderot during this period.

Each time the alert siren is sounded, all residents have a maximum of 15 seconds to seek shelter before the missile explodes. The rockets are non-discriminatory to age or infirmity, so that babies and the elderly all have 15 seconds maximum to reach cover before an explosion.

We note for the Commission that there were three times of “tahdiya”, the Arabic word for “calming” or “quieting” and these were not ceasefires, as Hamas would not agree to the term. The “tahdiya” was a tacit agreement between the two sides for a calming of hostilities. Despite the “tahdiya”, there were serious rights violations of Sderot and surrounding residents during these times:

In the first “tahdiya” November 26, 2006 until the May 15, 2007 there were more than 315 rocket attacks on Israel.

In the second “tahdiya” June 19, 2008 until December 19, 2008 there were 538 rocket towards attacks on Israel.

In the post-Operation Cast Lead period from January 18 2009 until June 2009, more than 215 rockets attacks on Israel.

Confirmation of Violations

The indiscriminate firing of anti-personnel missiles at civilian populations is by definition a violation of international law. It is assumed that the Commission shares the view of the major human rights organizations Human Rights Watch and Amnesty International that the firing of rockets at Sderot are factual and self-evident violations of International Human Rights Law and International Humanitarian Law.

Psycho-Social Effects

Unlike other Israeli population centers that had not received repeated missile attacks, the population of Sderot did not have to learn new tactics to deal with the attacks during the Gaza Conflict. Rather, the population was already used to being attacked on a regular basis over a prolonged period of time. However, the frequency of attacks was on a higher, sustained basis than the population was used to.

A study released June 29, 2009 by The Israel Center for the Treatment of Psychotrauma at Herzog Hospital in Jerusalem discovered that 60% of the children in the Israeli towns near Gaza, including Sderot, who have been in the area for the past nine years under constant missile attack refuse to go to sleep alone. The study found that according to the parents, 45% of children under age six suffer from post-trauma syndrome.

The same study also found that parents suffering post trauma stress disorder affect and influence the distress of their children. The authors discovered that 41% of mothers and 33% of fathers reported they suffer post trauma distress disorder. “For parents who suffer from symptoms of fears and post-trauma, their children have more distress and developmental problems and therefore the most important mission is to strengthen the parents who struggle with this constant threat and build strength for them and their children. There is no doubt that the most effective way to help toddlers is by strengthening their parents,” said report author Dr. Ruth Pat-Horenczyk.

There is no defensive system installed to counter rockets fired at Sderot. There is warning system (named “Colour Red”) that during normal weather conditions sounds a loud audible alert on loudspeakers distributed throughout the town. The system has limited or no functionality in inclement weather when no warning is received before a rocket explodes. Rockets are fired at Sderot from only a few kilometers away in Gaza, and the warning system gives a maximum of 15 seconds for the residents to seek cover.

It is significant to note that because of this small window of opportunity to seek cover, residents actually respond to the initial electronic “click” heard when the alert sirens are turned on, and are already in motion to the nearest shelter or cover when the actual siren is heard a split second later. Trauma psychologists note an increased level of tension in almost all residents due to the necessity of being able to reach cover within 15 seconds or be unprotected during an explosion.

Unlike other civilian population centers in Israel, Sderot had been subjected to thousands of missile and mortar attacks before the Gaza Conflict. Millions of dollars had been spent to fortify schools and public institutions against rocket warheads, hundreds of small concrete bunkers had been installed throughout the town, and residents had had literally thousands of previous live drills over many years. Thus, the psychological trauma was not new to the residents, but just a continuation of the same suffering.

As well, Sderot residents had before the Gaza Conflict suffered hundreds of casualties from missile attacks including 13 killed including 3 infants, and millions of dollars in property damage.

The psycho-traumatic affects on the population had already been documented before the Gaza Conflict, and as a result of the conflict the population was simply subjected to a more concentrated form of the same trauma. Specific studies have shown the trauma affects even young infants (Appendix 1).

Due to significant budget cuts following Operation Cast Lead, trauma therapy facilities in Sderot, which have played a valuable role in rehabilitating residents of the rocket-torn community, are now in danger of closing down.

The Sderot Trauma Center caters mostly to Sderot children and teenagers – ages 17 and below. The trauma center last year treated 620 trauma patients, of whom 80% are children.

Adults receive treatment at the Sderot Mental Health Center, which ministers to adult victims from ages 18 and up. The Mental Health Center’s director Dr. Adrianna Katz reports that she does not have enough staff to deal with over 6,000 trauma victim files.

The Sderot Shock Treatment Center operated under the Trauma Center and provided immediate treatment to shock victims after rocket attacks. Before it opened in 2006, Sderot residents had to be transported 20 minutes away to Ashkelon’s Barzilai Hospital or to Be’er Sheva’s Soroka Hospital.

When the Shock Treatment Center opened in Sderot, it made treatment for Sderot residents much more efficient and easier, as they received help on the spot said Dr. Katz, who also heads the shock center. Sderot residents feel more at home being treated at the center. The cost of transporting patients to distant hospitals is more expensive and many times there are not enough ambulances to transport all victims, especially during episodes when there are a series of rocket attacks on the city. Due to budget cutbacks the Shock Center closed after Operation Cast Lead.

Sderot’s remaining trauma facility remains a vital part of the Sderot community, which for eight years has been under Gaza rocket attack. As the city’s residents continue to live under the range of Qassam fire, these center provides the only local therapy and care which helps residents return to a semblance of normal life.

Because of the constant threat and deaths of several children, several playgrounds have been retrofitted with reinforced concrete play areas that double as bomb shelters. This allows children to play outside in designated areas that have quick access to shelter during a missile attack.

Economic Impact

Before Operation Cast Lead, real estate and small businesses had suffered most from the rocket fire. According to Yakov Levy, a Sderot realtor, prices of homes fell by 50%. Housing prices were nearly double in 2000 before the rocket fire began. Between 20 to 30 percent of businesses in Sderot and surrounding areas have shut down since 2001. Sales at stores in general have dropped by nearly 50 percent. During the intense rocket fire of May 2007, 350 small businesses were forced to close down. In January 2008, Hollandia, a major international mattress factory, employing close to 100 local residents in and around Sderot, shut the factory in Sderot and relocate to central Israel because of the rocket fire.

During Operation Cast Lead, all local schools were closed as well as non-essential businesses and factories. Parents had to stay at home with their children, and in families with two working parents (most instances), at least one income earner was off work in order to care for the children during the war. Stress levels rose as the operation continued, with children being unable to play outdoors and parents being unable to work, coupled with daily stress of alerts and explosions causing all residents to seek shelter an average of 7 times each day.

National Insurance payments covered some of the lost wages, but not all of them.

Close to 1,900 cases were filed with the Israeli government for damages done to homes and property by Hamas rocket attacks during the three weeks of war. Palestinian rockets directly hit more than 1,500 Israeli homes and buildings in the south, and caused heavy damage to 327 vehicles. The 84 rockets that exploded in Sderot during this period caused damage to several dozen homes and businesses, but no dollar figure was available at the time of writing of this submission.

Case Studies

There are dozens of case studies available, but the following two are chosen as typical examples of psycho-trauma.

1. May 19, 2008. 35-year-old, Shir-El Friedman was killed and two others wounded when a Qassam rocket struck a car in Sderot. According to the IDF, a total of 15 rockets were fired at the area during the day. Hamas, Islamic Jihad, and the Popular Resistance Committees claimed responsibility. This fatality is listed despite occurring before June 18, because the regularity of rocket attacks before the alleged “calming” agreement with Hamas were identical to the attacks that occurred during Operation Cast Lead.

2. December 17, 2008. A Qassam rocket struck the parking lot of a shopping center in Sderot, injuring three Israelis. Hundreds of shoppers were in the area when the rocket exploded Wednesday afternoon. The explosion caused serious damage to a supermarket and cars. At least 18 rockets and 6 mortar shells were fired this day on southern Israel, 48 hours before the “calming” between Israel and the Hamas expired.


From the definition of International Human Rights Law and International Humanitarian Law, there were clear violations of these laws perpetrated on the residents of Sderot during the Gaza Conflict. This is clearly stated in previous conclusions by Human Rights Watch:

Palestinian armed groups routinely violate international humanitarian law when using Qassam-type rockets to attack Israel. They are unlawfully launching strikes that either are directed against civilians or are indiscriminate because they are not directed at a specific military objective. In addition, some statements of the groups responsible for carrying out rocket attacks indicate an intent to use the weapons primarily to spread terror among Israeli civilians, which is also prohibited under international humanitarian law.

Human Rights Watch

There is clear evidence that as a direct consequence of the Gaza Conflict Sderot residents where subjected to high levels of psycho-social stress, although these residents had suffered for several years under the same rights violations that lead to the Gaza Conflict.

There was significant economic stress to residents and businesses in Sderot as a direct consequence of the Gaza Conflict, and this was in addition to the previous hardships due to previous rights violations under the same circumstances.

Appendix 1 – Expert describes how babies remember traumatic events for years

Jun. 29, 2009

US psychiatrist: Babies remember traumatic events for years

By Judy Siegel-Itzkovich, THE JERUSALEM POST

The prevailing view among parents, the general public and mental health professionals that infants as young as six months old “do not remember” traumatic events that happen to them or to their loved ones has recently been disproved, a professor of infant mental health said at a Jerusalem conference on Sunday.

Prof. Alicia Lieberman of the psychiatry department at the University of California at San Francisco told an audience of 300 that young children, even babies, “remember traumatic events in their bodies” with increases in stress hormones such as cortisol and that the event makes a distinct impression on them.

Most professionals and parents have pooh-poohed this idea because infants and young toddlers do not have the verbal ability to describe the trauma, but it nevertheless is stored in their brains, she asserted.

The message was very relevant to an Israeli audience, as large numbers of infants have survived terrorist and missile attacks, family violence and other traumatic events, and most remain untreated.

Lieberman was speaking at the first session of the two-day International Conference on Trauma and Early Childhood, held at Truman Hall on the Hebrew University’s Mount Scopus campus and organized by the capital’s Herzog Hospital’s Israel Center for the Treatment of Psychotrauma, the HU’s Paul Baerwald School of Social Work, and the Jewish Family and Children’s Services of San Francisco. It is being chaired by trauma expert and clinical psychologist Dr. Danny Brom, who heads Herzog’s psychotrauma center.

The US psychiatrist said that infants who have been exposed to trauma – anything from witnessing or being hurt by a road accident and terrorist attacks and near drownings to seeing its mother murdered by its father – “always try to find the meaning of their experience and how to fit into the world.”

Lieberman, who was born in Paraguay and spent five years earning a degree at the HU, explained that the seat of verbalization in the brain is in the cortex, but the visceral responses to trauma are based elsewhere.

People are wrong to assume that when traumatized infants grow up and don’t speak about it, they weren’t influenced by it. Therapists often start their relationship with traumatized parents and children with mistaken idea that if the child did not discuss it, they should not bring it up, the California psychiatrist said.

“Basic research shows that young babies even five months old can remember that a stranger came into room and scared them three weeks before. Even though the babies were pre-verbal, they can later remember traumatic events that occurred to them,” said Lieberman.

One case was a girl named “Rachel, who around her first birthday was held by her mother when her angry and abusive father pushed his way through the door in their apartment and shot the mother. He father was jailed for life, and her grandmother raised her, but Rachel had serious behavior problems. One day, when she was four years old, the grandmother noted that she reacted badly to the noise of firecrackers.” The preschooler said: “Don’t kill me!”

Then, at the age of nine, she asked her grandmother how her mother died. The grandmother replied: “She fell off the roof.”

But, unsatisfied, the girl demanded to know “how my mother really died.”

That, said Lieberman, was “the last time she discussed” her memory of the traumatic event.

Among the negative behaviors caused by traumatic events in children are temper tantrums, developmental delays, regression, unsociability and violence. However, the good news is that post-traumatic stress symptoms can be treated by talk therapy, cognitive behavioral therapy and other means with help from a trained therapist, said Lieberman, and doing so as early as possible after the child is able to speak is best.

A feature on the two days of lectures will appear on the Health Page on Sunday, July 5.

This article can also be read at /servlet/Satellite?cid=1245924952462&pagename=JPArticle%2FShowFull


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