Imagine that you are 18 years old. You have just completed high school and in a few months you will enter the army. In the meantime, you spend your time going out with friends and working to save some money – like any other typical teenager in Israel.

One afternoon, you come home exhausted from work and collapse into bed for a nap. Suddenly, in the middle of your nap you find yourself waking up to the sound of glass shattering – all over your back.

It takes you a moment to realize that the window above your bed has exploded and that shards of glass lie everywhere. Your dad comes racing in, picks you up and carries you outside to safety.

Welcome to a moment in the life of Ilan Dahan, a Sderot 18-year-old who slept through the siren warning of the impending Kassam, only to wake up to the rocket explosion in his backyard on Tuesday evening, May 19.

“It’s a miracle that all I got was this scratch,” Ilan says, dazedly pointing to a red mark on his back, where a piece of glass cut through.

Ilan’s family stands around in shock. His mother Shula looks at her son tearfully. “I never expected this to happen to us during the ceasefire,” she says.

The back of the Dahan’s home is covered in debris and glass, while rocket shrapnel marks the walls and ceiling of the home. An evening breeze blows through the windowless windows. Ilan’s father, Avi, stands by his son. “I was terrified that something had happened to him,” Avi says in a quiet voice.

Now imagine that, after such a rocket attack, the kind of therapy needed to get shock victims back on track is no longer available. Due to significant budget cuts, 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.

Those who will be affected most by this recent development are Sderot’s children. The Sderot Trauma Center, which caters mostly to children and teenagers – ages 17 and below – is on its way out. Fifty percent of the center’s funding comes from the International Fellowship of Christians and Jews, also known as Keren LeYedidut. The organization can no longer provide the funds to keep the center going.

The trauma center treats 620 patients, of whom 80 percent are children, says Daliah Yosef, the center’s director. “I’ve already handed out dismissal letters to the staff at the center,” she said two days after the rocket attack.

The other fifty percent of the trauma center’s funding is provided by the Israeli Ministries of Health, Finance and Pensioners – not nearly enough to keep the center open.

“The harshest part of this reality is that hundreds of Sderot children will be left with no place to go for treatment,” says Yosef.

Ilan is fortunate that he is 18 and can therefore receive treatment at the Sderot Mental Health Center, which caters to adult victims. However, the Mental Health Center’s director, Dr. Adrianna Katz, says that although her center is in no danger of closing, she does not have enough staff to deal with over 6,000 trauma victim files – which continue to grow every day.

In addition to Yosef’s Trauma Center, the Sderot Shock Treatment Center, which operates under the trauma center, is also in danger of shutting down. The Shock Treatment Center opened three years ago, alongside the trauma center, to provide immediate treatment to shock victims after rocket attacks. Before then, 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,” she added.

“Going back to the original way – transporting Sderot trauma victims by ambulance to hospitals outside the area is absolutely ridiculous,” Katz said. “The cost of transporting patients 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.”

Indeed, in the recent rocket attack, the Sderot Shock Treatment Center treated all eight victims of shock, including a woman injured by rocket shrapnel. Since the Qassam attack on May 19, Dr. Katz reported to Sderot Media Center that 60 new patients have arrived to the Sderot Mental Health Center therapy treatment.

Sderot’s trauma facilities remain 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 within range of Kassam fire, it is the therapy and care that Dr. Katz and Daliah Yosef provide which helps residents return to a semblance of normal life.

Photo Credit: Anav Silverman

In the meantime, Ilan Dahan continues to hope that someday he can wake up to a rocket-free sky.

Photo: Anav Silverman, Sderot Media Center

There have been many questions bouncing around in the media this week. Why is Israel at war? Why are there so many Hamas men dead? Why are Hamas firing rockets at Israel? A war of resistance, some say. Israel is holding a siege against Gaza. Palestinians are starving and suffering.

And who is to blame?

Israel of course. At least that is the conclusion that emerges within the headlines of AP and Reuters news reports, European news media, and countless Internet blogs on the current fighting.

For those who seek objective answers to those questions, the unfolding tragedy of Sderot and the western Negev must be taken into account.

There has been a war of terror on Sderot from more than eight years now. During this time period, an estimated 8,000-10,000 Palestinian rockets have been fired at Sderot and the western Negev from the Gaza Strip. There was not one serious long-term military response from Israel to the rocket attacks during that time besides the closing of crossings and checkpoints.

In the meantime, hundreds of Israelis homes and properties have been destroyed, over 700 Israelis wounded, and thousands psychologically traumatized by Palestinian rocket fire. Periodically, schools in Sderot and the western Negev have been forced to close, as normal life cruelly transforms into a marathon of 15 seconds, (the number of seconds one has to escape to shelter when the Tzeva Adom, or Red Color alert is set off by an impending Palestinian rocket).

Sderot and western Negev residents have been forced to sit and endure Palestinian rocket terror to the point that there is now a generation of Sderot children who are showing signs of post traumatic stress disorder (PTSD) as early as age three.

In a recent report in the major Israeli newspaper, Ma’ariv, Yaron Sasson writes of children in Sderot being born into a period of siren alerts, or Tzeva Adoms and the sound of Kassam explosions. These sounds of war have become part of the psychological makeup of Sderot children. It is not surprising then that psychological research conducted among Sderot residents has produced some very disturbing findings.

According to research done by Sderot’s Hosen Center, a treatment center that offers support and counseling to Sderot residents during times of emergency, there is a major problem appearing in young Sderot children, the generation born into Kassams.

Clinical psychologists working at the center discovered that many Sderot children are not developing speaking skills at a rate appropriate to their age. A normal child learns to speak around the age of one. But many children in Sderot have not even begun to speak by the age of three or even four. Those who are able to speak, stutter and cannot complete words.

Dalia Yosef, director of the Sderot Hosen Center, explains that the constant rocket fire upon Sderot has created a state of stress and panic that has dramatically impacted the development of young Sderot children.

Yosef and the clinical psychologists who work with her, counsel Sderot children from the ages of one to 18, offering treatment for a wide variety of issues.

“It is important to note,” says Yosef, “that these Sderot children have been born into a reality of constant rocket fire. The world, as it appears to them, is unsafe and scary, full of insecurity and chaos. Their sense of security has been shattered by the continuous rocket attacks.”

“These children develop symptoms of PTSD early on, suffering from sleeping disorders, nightmares and anxiety attacks. Many experience regression, going back to wetting their beds,” says Yosef.

Those children whose parents suffer from signs of post traumatic stress disorder, have even more complicated issues. According to Yosef, children of parents diagnosed with PTSD sense that their parents cannot protect them. “These kids’ problems are even more severe than kids whose parents are more psychologically stable,” says Youssef. In Sderot, 30% of adults have been diagnosed with PTSD.

Yosef explains that a young child hears the rapid breathing of his parent, when the Tzeva Adom sound and understands that his parent is frightened. “Once the child understands this, then he perceives that the world is unsafe and that his parent is unable to properly protect him,” adds Yosef. “The parent feels threatened and so does the child. Later on, this feeling of insecurity and stress affects the child in areas like speech, hindering normal speech development.”

Younger children go back to the bottle, to the pacifier, and have extreme difficulty separating from the parents. “Kids are scared to go to the bathroom or to the shower by themselves, because of the fear of a rocket strike,” says Yosef. “The situation has created unhealthy relationships within the family unit. Children as old as 12 sleep with their parents.”

Even during the recent ceasefire or days where Kassams don’t fall regularly on Sderot, the trauma and stress continue because people continue to anticipate rocket attacks. “Only a permanent long term quiet will help these children and their parents recover,” says Yosef. “The moment there is a siren alert and a rocket explosion, all the progress we have made in the treatment is destroyed.”

The Sderot Hosen Center offers treatment for children and parents together. “We give parents the tools and skills need to maintain a sense of calm in situations of terror,” explains Yosef. “Because parents are the authority figures in the family, we focus on them and try to identify ways in which they can be more relaxed in this tense environment.”

Livnat Shaubi, a lifelong resident of Sderot and the oldest in a family of 11 children, recently spent an entire day with her younger siblings, helping them find ways to cope with the Hamas war on southern Israel. After spending four days at home, exhausting Lego, board games, and playing balls, the Shaubi boy–Hananel, David, and Yehuda, ages 5, 7 and 11, respectively, created Kassam rockets from plastic bottles they found lying in the house.

“Like other Sderot kids, my mom cannot allow my younger siblings to play outside during these periods of rocket attacks. “My brothers are cooped up all day and therefore these art projects, an important outlet for their creativity, simply reflects the reality around them” says Shaubi

Shaubi told Sderot Media Center that the first words her five-year-old brother, Hananel learned to say, along with Daddy and Mommy, were ‘Tzeva Adom’ (Red Color, the name for the siren alert).

“These kids know war,” she adds. “Soon it will be the children in Be’er Sheva, Ashkelon and Ashdod, who will join them.”

And this is exactly why Israel is currently engaged in this war–to prevent the tragedy of Sderot from spreading to one million other Israelis who are currently experiencing for their first time the impact of Palestinian rocket fire in some of Israel’s major cities. Israel’s children and Gaza’s children deserve a quiet future, one with normal childhood experiences, where threats in the form of Palestinian rockets are finally laid to rest.

In a recent study conducted by NATAL (Israel Trauma Center for Victims of Terror and War), researchers discovered that close to 56% of Sderot residents have suffered in some way from Palestinian rocket attacks. According to the report, presented by Natal Community Staff Director, Dr. Roni Berger in Beersheva on November 24, nearly half of Sderot’s population has been either physically or emotionally damaged by Palestinian rocket fire.

Over 4, 000 Sderot residents are suffering from symptoms of post-traumatic-stress disorder (PTSD) while one third of Sderot children, ages 13 to 18, have trauma-related learning disorders.

PTSD is a severe and ongoing reaction to a terrifying ordeal that involved physical harm or the threat of physical harm to the person, according to the National Institute for Mental Health. People who develop PTSD may have witnessed a loved one who was harmed in a traumatic event or were victims themselves.

Symptoms of PTSD usually begin three months after the ordeal but can also emerge years afterward. Some people can recover within 6 months while others have symptoms that last for much longer. For some people, the condition becomes chronic.

“The initial symptoms of shock include an accelerated heart rate, dry mouth, limbs ‘falling asleep,’ a sense of fainting, seeming paralyzed or even emotionally detached,” says Gabi Schreiber chief of psychiatry at Ashkelon’s Barzilai hospital.

Dr. Adrianne Katz, head of the Sderot Mental Health Center says that the shock impacts the victim’s ability to function for months after the experiencing a Palestinian rocket explosion. “Many rocket terror victims suffer from depression, sleepless nights, severe anxiety, and have trouble going back to a regular routine,” she says.

The NATAL study showed that almost 50% of Sderot residents know someone who has been killed in a Palestinian rocket attack, while 65% personally know someone wounded in an attack. Over 90% of Sderot residents have experienced a Palestinian Qassam explosion at some point-whether it be in a neighborhood, home, school, business or other residential setting.

Dr. Mina Zemach and the Dahaf Polling Institute conducted the research in order to compare Sderot to other communities outside of Palestinian missile range. Sderot residents made up the test group, while residents of Ofakim, a town of similar socio-economic makeup to Sderot but not under rocket attack, served as the control group.
The study revealed that three times as many Sderot residents had gone to a spiritual counselor (such as a rabbi), and a family doctor than did Ofakim residents.

Dr. Roni Berger explained that there were several reasons why Sderot residents suffered from higher degrees of trauma than residents other Israeli communities within rocket range. “The fortifications in Sderot are poorer, and the population is weaker as well. The social unity is smaller. It’s a population who felt, and still feels, abandoned.”

In addition, 45% of the Qassam rockets fired from the Gaza Strip target Sderot according to IDF intelligence.

Although adults in Sderot showed significantly higher levels of trauma and stress in the study than adults living in other Gaza vicinity communities, children of Gaza vicinity communities did not fair so differently from Sderot children. Close to 75% of children living in Gaza vicinity communities, ages 12-14 suffer from symptoms of PTSD compared to 86.6% of Sderot children.

“Only a minority of those suffering from PTSD actually seek help,” Dr. Roni Berger told Sderot Media Center. NATAL, a non-government organization seeks to reach out those Sderot residents who otherwise would receive help. “NATAL’s staff has been going door to door for the past two years in our mobile units, visiting Sderot families and offering them social support,” says Dr. Berger. “We teach these families how to cope with the stress and panic that result with each rocket attack.”

“In a way, this is much more effective then simply providing residents with a psychological diagnosis,” adds Dr. Berger. “NATAL health professionals give Sderot residents the skills to relax. One of the most important things is for the residents to learn to talk about their experiences [with rocket attacks].”

“Unfortunately those residents who don’t know how to cope, become worse,” says Dr. Berger. “Those who do cope ‘well’ are also not immune to trauma symptoms-they also pay some sort of psychological price for living under Palestinian rockets and it may manifest itself in strained family relationships or tension at work.”

The constant downplay of the psychological impact of Palestinian rocket fire in the international and Israeli media has unfortunately shifted important focus from the reality on the ground–Sderot residents after eight years of Qassam fire are gradually becoming psychologically crippled by the constant trauma of Palestinan rocket attacks. One of the most ironic phenomenas is that the concept, post trauma is not even relevant to Sderot residents. The constant renewal of rocket attacks has not allowed Sderot children and families to recover from past Qassam barrages. This constant state panic and stress that plagues Sderot residents is a continuing ordeal that remains theirs alone.