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Gazans are still coping with the trauma of the war with Israel in May

AUDIE CORNISH, HOST:

Imagine living through four wars before even graduating high school - wars that devastated neighborhoods and decimated families. That's what many young Palestinians have experienced in the Gaza Strip. NPR's Daniel Estrin returned to Gaza to see how they're coping after the war in May. And a warning - this story contains the sound of explosions.

DANIEL ESTRIN, BYLINE: Sama Ahel is 16 years old. And like a lot of kids, she takes videos of the things around her. This May, she captured seven horrific minutes of war, which she's about to show me.

Do you still watch it?

SAMA AHEL: Yes.

(SOUNDBITE OF ARCHIVED RECORDING)

S AHEL: (Speaking Arabic).

ESTRIN: She was caught in an 11-day conflict. Israel conducted airstrikes while Hamas fired rockets. Sama's video starts after an Israeli missile landed near the base of her apartment building, blowing glass through the window of the room where her family was huddled.

(SOUNDBITE OF ARCHIVED RECORDING)

S AHEL: (Speaking Arabic, crying).

ESTRIN: She's in socks, running down the stairwell and onto the street. You can see flames next to a Hamas government office on the ground floor. Her sister covers her bloody face with a scarf. Sama was bleeding, too.

(SOUNDBITE OF EXPLOSIVES BURSTING)

ESTRIN: There are more explosions. Her family takes cover behind a metal dumpster next to a United Nations compound across the street. Gaza doesn't have the bomb shelters and missile defense systems that protected Israel during the war.

(SOUNDBITE OF ARCHIVED RECORDING)

S AHEL: (Shouting in Arabic).

(SOUNDBITE OF SIREN BLARING)

ESTRIN: Finally, an ambulance. They pile in. And her father, who's a psychologist, says, stop filming.

(SOUNDBITE OF ARCHIVED RECORDING)

ISMAIL AHEL: (Speaking Arabic).

S AHEL: (Speaking Arabic).

ESTRIN: What's not on video is what he did for his family. He led them in a deep breathing exercise.

I AHEL: (Speaking Arabic).

ESTRIN: Dr. Ismail Ahel tells me the idea behind deep breathing is to take a moment to come back to reality, to realize the traumatic event is over. It's behind you. His daughter Sama demonstrates and explains through our interpreter.

S AHEL: (Through interpreter) You just need to close your eyes and to start inhale - (takes deep breath) - and exhale. Multiple inhale and exhale - you will just start to feel it going through you.

ESTRIN: Their entire apartment building needed help. A week after the war, he and a group of therapists went to all 120 apartments making house calls. They referred some to therapy. The rest they taught deep breathing and other coping mechanisms, like shaking out your whole body.

I AHEL: (Through interpreter) We have, like, a hard time treating those people. We can't just deal with the first trauma or the second trauma. It's a complexity of traumas together.

ESTRIN: He and his colleagues diagnose this as Gaza trauma, which means one trauma on top of the other - from living through four wars and other waves of violence over the last decade and a half. The war touched both sides of the conflict, but the injuries and deaths were of a far greater scale in Gaza. And in the last six months, many children have received mass therapy. The U.N. put 150,00 kids through counseling and summer activities. And a local mental health clinic has found another way to treat many kids at once - psychodrama role-playing workshops.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED CHILD: (Speaking Arabic).

AIDA KASSAB: (Howling).

ESTRIN: Psychologist Aida Kassab makes a howling sound and flaps a window drape like there's a storm as kids huddle in a plastic playhouse. She wants them to learn to find love and protection with others when their home feels threatened. But these kids act distant.

KASSAB: (Through interpreter) Those children are from the same school and the same neighborhood, but there is no communication between them - no collaboration, no teamwork. They have a behavior disorder and trauma.

ESTRIN: It's hard to treat trauma here because people don't feel the war is really behind them. Israel and Hamas are still negotiating the terms of their cease-fire. Most destroyed homes have not been rebuilt. Dr. Yasser Abu Jamei, who oversees the psychodrama workshops with the Gaza Community Mental Health Program, gives parents this advice.

YASSER ABU JAMEI: Sometimes the best thing which you can give the family is to make them identify the strength points in their life, you know. A strength point could be that you survived. A strength point could be that your home is still there. A strength point could be that your school is a good one.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED PERSON: (Speaking Arabic).

UNIDENTIFIED PERSON: The Ahel family does have these strength points. They survived the attack near their building. Their home is still there. Sama is back in school. But none of this brings her comfort. Her apartment building is now tilting a few degrees. When she looks out her school window, she sees a bombed building. But before she does her homework or has an exam, she takes five or six deep breaths and visualizes...

S AHEL: (Speaking Arabic).

ESTRIN: ...The sea, the mall, the library, her friend Yasmine's house. She has a few happy places to go to in her mind. Daniel Estrin, NPR News, Gaza City.

(SOUNDBITE OF EXPLOSIONS IN THE SKY'S "LOOK INTO THE AIR") Transcript provided by NPR, Copyright NPR.