The grim reality in Gaza

Mohammed Omer reports on shortages in Gaza from crucial medical supplies through children's winter c

Traffic in the Gaza Strip slowed to a trickle last week, and this week medical centres have scaled back treatment in the medicines and sustenance-destitute Strip.

"Israel’s decision is a death penalty: our reserve of fuel is almost zero and it may very likely run out by the end of today," said Khaled Radi, Ministry of Health spokesman for the dismissed Hamas government.

Radi spoke in reference to the 30 November Israeli Supreme Court decision to allow further fuel cutbacks, severe reductions which are crippling Gaza’s residents in all aspects of life. Prior to that ruling, as early as October Israel decided to begin limiting fuel, with Gaza soon after enduring serious cuts of over 50% of fuel needs, a dire statistic confirmed by the UN body OCHA.

At the Nahal Oz crossing, through which all fuel enters Gaza, the Palestinian petrol authority reported that Israel has delivered around only 190,000 litres of diesel a day since late October, falling short of the 350,000 litres needed by the Gaza Strip. This number plummeted on 29 November, with Israel delivering a scanty 60,000 litres, only marginally improving three days later, 2 December, with a delivery of 90,000 litres.

This week’s increased cutbacks resulted in a several day closure of Gaza’s petrol stations, owners striking in protest to the pittance of fuel allowed in–just one quarter of that normally received.

Gaza’s Association for Fuel Station Owners commented: "Petrol firms considered the amount negligible and so, in protest over the Israeli blockade, refused to accept the paltry offering which does not come close to meeting the essential needs of Gaza’s civilians."

A Gaza taxi driver related his concern: "Cutting off fuel means cutting off our lives. We use it for everything, in the place of wood or coal. It’s tragic not only that Israel is imposing this siege on Gaza, but also that some Palestinians are supporting this cruel embargo, with the naïve idea of causing the people turn against Hamas in Gaza."

Shortages of fuel have greatly affected the public transportation system, leaving students from universities in Gaza City delayed for hours standing in wait for transportation back to Khan Younies and Rafah in the south.

Trickle Effect

The fuel cuts in turn impede water access: with diesel-run pumps unable to function, leaving over 77,000 without fresh drinking water, according to Gaza’s water utility. Oxfam International has warned that soon 225,000 Gazans could suffer from inadequate water supplies, raising concerns for public health.

Ambulances and clinics suffer too, a fact reiterated by Khaled Radi, who related how fuel shortages have already brought some ambulances to a standstill: "This has affected the mobility of ambulances which are especially vital during on-going Israeli air strikes such as that of this morning."

He added that shortages further threatened to close essential clinics, which rely on back-up generators during the frequent electricity shortages in the Strip. Two first aid health centres have already been forced to suspend treatment during electricity cuts. Those that remain open suffer from want of medical supplies, with 91 of 416 essential medicines depleted, according to the WHO.

Even basic things are scarce. Residents are hard-pressed to find a piece of glass to repair a broken window, imperative in December’s cold weather, particularly in a time when electricity and gas are scarce-to-absent.

Eyad Yousef, a 31-year-old Palestinian teacher, has been waiting for cement, unavailable for the last many months, to enter Gaza. Concurrently, prices of building materials have skyrocketed, more than tripled in the worst cases. Yousef waits for any sort of building material, but he knows that will not find anything, as he has looked all over the picked-clean area. "I have a floor of my home to finish, but can’t do so yet as no sort of building materials are available in Gaza," he said. "I'm using pieces of nylon to cover my windows at home, but I can’t go on like this for long," he added, saying he hopes that the international community will put pressure on Israel to open borders and let vital products into Gaza.

Death Penalty

Yousef, at least, is luckier than the newly dead: since last month at least 31 medical patients have died in Gaza, a result of Israel’s lockdown on borders and preventing of medical access to Israeli, Egyptian and Jordanian hospitals, as well as West Bank hospitals.

Since Hamas took over power in June, this subsequent Israeli lockdown has made it virtually impossible for Palestinians to get out of Gaza. The situation then deteriorated with the closing of Karni crossing, Gaza’s only commercial crossing, only opened for the most basic food essentials. Coupled with Israel’s ground and air attacks, the situation for Palestinians worsened yet further still when Israel last October announced Gaza as a "hostile entity", further allowing Israel to justify its closed-borders policy to the international arena.

In the densely-populated region starved of medical supplies, and now facing the shutdown of clinics, Gazan citizens have been given a death sentence with Israel’s control over borders. Yahya Al Jamal 53, one case among hundreds of people, has cancer and is in serious need of medical care at well-equipped hospitals. For more than two months now he has been refused entry to Israel for treatment. His agonized father reported that his son will die in the coming days if he does not get the medication he needs, an outcome of Israel’s mass denial of the luxury of critical healthcare.

Insult upon injuries, cement – already scarce for building – is no longer available even for graves of the many recently dead.

Empty Stocks

Aid agencies like the World Food Program (WFP) reporting that food imports are only enough to meet 41 per cent of demand in the Gaza Strip.

As winter progresses, resilient citizens desperately seek to survive. In Rafah’s Saturday market, Umm Mohammed Zourub scours the stalls yet again: "I've been looking for new winter clothes for my children, but I haven't been able to find any because no materials are coming into Gaza with the closed borders," the 43 year old mother lamented.

Indeed, the cold weather has fallen quickly on an internationally-isolated and starved population. From the intense heat of summer months, where water was scarce and air conditioning a fantasy, Gazans now experience the bitter cold in the same homes unprepared for extremes, and the bitter realization that, once again, they have been left to the whims of imprisonment, Israeli air and ground attacks, and a staggering invisibility in the international realm.

Mohammed Omer
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“I felt so frantic I couldn’t see my screen”: why aren’t we taking mental health sick days?

Some employees with mental health problems fake reasons for taking days off, or struggle in regardless. What should companies be doing differently?

“I would go to the loo and just cry my eyes out. And sometimes colleagues could hear me. Then I would just go back to my desk as if nothing had happened. And, of course, no one would say anything because I would hide it as well as I could.”

How many times have you heard sobbing through a work toilet door – or been the person in the cubicle?

Jaabir Ramlugon is a 31-year-old living in north London. He worked in IT for four years, and began having to take time off for depressive episodes after starting at his company in 2012. He was eventually diagnosed with borderline personality disorder last January.

At first, he would not tell his employers or colleagues why he was taking time off.

“I was at the point where I was in tears going to work on the train, and in tears coming back,” he recalls. “Some days, I just felt such a feeling of dread about going into work that I just physically couldn’t get up ... I wouldn’t mention my mental health; I would just say that my asthma was flaring up initially.”

It wasn’t until Ramlugon was signed off for a couple of months after a suicide attempt that he told his company what he was going through. Before that, a “culture of presenteeism” at his work – and his feeling that he was “bunking off” because there was “nothing physically wrong” – made him reluctant to tell the truth about his condition.

“I already felt pretty low in my self-esteem; the way they treated me amplified that”

Eventually, he was dismissed by his company via a letter describing him as a “huge burden” and accusing him of “affecting” its business. He was given a dismissal package, but feels an alternative role or working hours – a plan for a gradual return to work – would have been more supportive.

“I already felt pretty low in my self-esteem. The way they treated me definitely amplified that, especially with the language that they used. The letter was quite nasty because it talked about me being a huge burden to the company.”

Ramlugon is not alone. Over three in ten employees say they have experienced mental health problems while in employment, according to the Chartered Institute of Personnel and Development. Under half (43 per cent) disclose their problem to their employer, and under half (46 per cent) say their organisation supports staff with mental health problems well.

I’ve spoken to a number of employees in different workplaces who have had varying experiences of suffering from mental ill health at work.

***

Taking mental health days off sick hit the headlines after an encouraging message from a CEO to his employee went viral. Madalyn Parker, a web developer, informed her colleagues in an out-of-office message that she would be taking “today and tomorrow to focus on my mental health – hopefully I’ll be back next week refreshed and back to 100 per cent”.

Her boss Ben Congleton’s reply, which was shared tens of thousands of times, personally thanked her – saying it’s “an example to us all” to “cut through the stigma so we can bring our whole selves to work”.

“Thank you for sending emails like this,” he wrote. “Every time you do, I use it as a reminder of the importance of using sick days for mental health – I can’t believe this is not standard practice at all organisations.”


Congleton went on to to write an article entitled “It’s 2017 and Mental Health is still an issue in the workplace”, arguing that organisations need to catch up:

“It’s 2017. We are in a knowledge economy. Our jobs require us to execute at peak mental performance. When an athlete is injured they sit on the bench and recover. Let’s get rid of the idea that somehow the brain is different.”

But not all companies are as understanding.

In an investigation published last week, Channel 5 News found that the number of police officers taking sick days for poor mental health has doubled in six years. “When I did disclose that I was unwell, I had some dreadful experiences,” one retired detective constable said in the report. “On one occasion, I was told, ‘When you’re feeling down, just think of your daughters’. My colleagues were brilliant; the force was not.”

“One day I felt so frantic I couldn’t see my screen”

One twenty-something who works at a newspaper echoes this frustration at the lack of support from the top. “There is absolutely no mental health provision here,” they tell me. “HR are worse than useless. It all depends on your personal relationships with colleagues.”

“I was friends with my boss so I felt I could tell him,” they add. “I took a day off because of anxiety and explained what it was to my boss afterwards. But that wouldn’t be my blanket approach to it – I don’t think I’d tell my new boss [at the same company], for instance. I have definitely been to work feeling awful because if I didn’t, it wouldn’t get done.”

Presenteeism is a rising problem in the UK. Last year, British workers took an average of 4.3 days off work due to illness – the lowest number since records began. I hear from many interviewees that they feel guilty taking a day off for a physical illness, which makes it much harder to take a mental health day off.

“I felt a definite pressure to be always keen as a young high-flyer and there were a lot of big personalities and a lot of bitchiness about colleagues,” one woman in her twenties who works in media tells me. “We were only a small team and my colleague was always being reprimanded for being workshy and late, so I didn’t want to drag the side down.”

Diagnosed with borderline personality disorder, which was then changed to anxiety and depression, she didn’t tell her work about her illness. “Sometimes I struggled to go to work when I was really sick. And my performance was fine. I remember constantly sitting there sort of eyeballing everyone in mild amusement that I was hiding in plain sight. This was, at the time, vaguely funny for me. Not much else was.

“One day I just felt so frantic I couldn’t see my screen so I locked myself in the bathroom for a bit then went home, telling everyone I had a stomach bug so had to miss half the day,” she tells me. “I didn’t go in the next day either and concocted some elaborate story when I came back.”

Although she has had treatment and moved jobs successfully since, she has never told her work the real reason for her time off.

“In a small company you don’t have a confidential person to turn to; everyone knows everyone.”

“We want employers to treat physical and mental health problems as equally valid reasons for time off sick,” says Emma Mamo, head of workplace wellbeing at the mental health charity Mind. “Staff who need to take time off work because of stress and depression should be treated the same as those who take days off for physical health problems, such as back or neck pain.”

She says that categorising a day off as a “mental health sick day” is unhelpful, because it could “undermine the severity and impact a mental health problem can have on someone’s day-to-day activities, and creates an artificial separation between mental and physical health.”

Instead, employers should take advice from charities like Mind on how to make the mental health of their employees an organisational priority. They can offer workplace initiatives like Employee Assistance Programmes (which help staff with personal and work-related problems affecting their wellbeing), flexible working hours, and clear and supportive line management.

“I returned to work gradually, under the guidance of my head of department, doctors and HR,” one journalist from Hertfordshire, who had to take three months off for her second anorexia inpatient admission, tells me. “I was immensely lucky in that my line manager, head of department and HR department were extremely understanding and told me to take as much time as I needed.”

“They didnt make me feel embarrassed or ashamed – such feelings came from myself”

“They knew that mental health – along with my anorexia I had severe depression – was the real reason I was off work ... I felt that my workplace handled my case in an exemplary manner. It was organised and professional and I wasn’t made to feel embarrassed or ashamed from them – such feelings came from myself.”

But she still at times felt “flaky”, “pathetic” and “inefficient”, despite her organisation’s good attitude. Indeed, many I speak to say general attitudes have to change in order for people to feel comfortable about disclosing conditions to even the closest friends and family, let alone a boss.

“There are levels of pride,” says one man in his thirties who hid his addiction while at work. “You know you’re a mess, but society dictates you should be functioning.” He says this makes it hard to have “the mental courage” to broach this with your employer. “Especially in a small company – you don’t have a confidential person to turn to. Everyone knows everyone.”

“But you can’t expect companies to deal with it properly when it’s dealt with so poorly in society as it is,” he adds. “It’s massively stigmatised, so of course it’s going to be within companies as well. I think there has to be a lot more done generally to make it not seem like it’s such a big personal failing to become mentally ill. Companies need direction; it’s not an easy thing to deal with.”

Until we live in a society where it feels as natural taking a day off for feeling mentally unwell as it does for the flu, companies will have to step up. It is, after all, in their interest to have their staff performing well. When around one in four people in Britain experience mental ill health each year, it’s not a problem they can afford to ignore.

If your manager doesn’t create the space for you to be able to talk about wellbeing, it can be more difficult to start this dialogue. It depends on the relationship you have with your manager, but if you have a good relationship and trust them, then you could meet them one-to-one to discuss what’s going on.

Having someone from HR present will make the meeting more formal, and normally wouldn’t be necessary in the first instance. But if you didn’t get anywhere with the first meeting then it might be a sensible next step.

If you still feel as though you’re not getting the support you need, contact Acas or Mind's legal line on 0300 466 6463.

Anoosh Chakelian is senior writer at the New Statesman.