For the past six months, I have been travelling, photographing people and recording stories for Legacy of War, a two-year project documenting the long-term impact of conflict on communities and individuals around the world. Lebanon, Jordan, Northern Ireland, the United States, Cambodia, Vietnam, Laos and Gaza are just some of the places I’ve visited, with many more to come.
My work is not focused on the histories of war, the facts and figures; the political rhetoric and diatribes that fuel them; the divides, fears or greed that start them. Those are important to understand the causes, but my interests lie in the consequences and legacies. The commonalities that often scar those who have lived through conflict. There are few places that have seen more conflict in recent years than Gaza and the resulting psychological impact on the civilian population, especially on the young, has been well recorded. Less well covered, though, are the effects on the estimated 3,000 children with autism living in the region. There are also many others with learning disabilities and mental health issues. The war and ongoing embargo have affected support networks of schools and outreach programmes for these children. This has put extra strain not just on those living with disabilities, but also on their families.
I had worked for five years as a carer for children with autism and so I’ve been particularly interested in seeing how those who see the world differently cope with the incredible challenges of living in a war zone. The collapse of routine, loss of familiar settings and the death of loved ones sadly cause many children to suffer from mental health issues; for those with already heightened sensitivities, the effects can be far more acute.
Some have been shaped by the conflict in Gaza before they were even born. On 21 November 2006, as Asma and her family sheltered together in a downstairs room of their house, they listened to the familiar sounds of fighting around them. The family lived near Beit Lahia, a small town in Gaza, just a few miles from the Israeli border; a proximity that meant their home was always in the front line when war broke out. That summer, their house had been in the middle of some of the fiercest fighting between the Israel Defence Forces and Hamas. Now, after a period of relative calm, Israeli troops had once more crossed the border and fighting had resumed. The day before, the IDF entered Asma’s home, occupying it and forcing the family into a single room. Israeli snipers had taken up positions on the roof, meaning Hamas was now targeting them with rocket-propelled grenades.
Maryam, with her grandmother, Manzuma. The family of six live in one small room. The rest of the house was badly damaged by rockets during last year’s fighting. Photograph: Giles Duley
All the family could do was huddle together and wait, but for Asma it was particularly stressful – she was seven months pregnant. As the family listened to the blasts of gunfire and rockets outside, they heard a different noise. It was the sound of somebody knocking and the voice of an elderly woman calling their name, asking to be let in. The family, confused and fearful of moving, stayed put. They heard Israeli voices shouting from the roof, a small explosion and then the woman’s voice asking once more to be let in. Before they could reply, a huge blast ripped through the house. Smoke and gas filled the air; Asma was choking, struggling to breathe. She remembers the sense of suffocating, then nothing.
The woman outside had been Fatima Omar Mahmud al-Najar, a 64-year-old grandmother and suicide bomber. She had been sent by Hamas’s military wing to kill the snipers on the roof. Before she could enter the house to carry out her attack, the Israelis saw her and threw a stun grenade, so she detonated at the door, saving the family from the full impact.
The blast had, however, starved Asma of air and, struggling to breathe, she was rushed to Dar Al Shifa hospital where the decision was made to induce her child. Maryam was born that evening and stayed in hospital for a week.
When she came home, the family knew something was wrong: Maryam would scream constantly, slept for no more than an hour and seemed unresponsive. Then her epileptic fits started. Finally, a year later, Maryam was diagnosed as having severe hypotonic cerebral palsy, caused by the lack of oxygen when she was born. Asma was told her daughter would never walk, talk or even be able to feed herself – she would need constant care for the rest of her life. Maryam, who was born in the midst of war, would always live with its legacy.
Visiting Maryam is a difficult experience. She sits in the arms of her grandmother Manzuma, unable to hold up her head or control her limbs, she is like a rag doll with painfully sad eyes. Her brothers Muhammed and Juma sit on the floor, bathed in the flickering light of the television. Asma prepares coffee and cuts cake in the makeshift kitchen.
The family is living in one, sparsely furnished, room, forced there after their house was hit once more during the July 2014 Israeli offensive, Operation Protective Edge. Eight rockets were fired at the house; one hit the upstairs floor, setting it on fire, a piece of shrapnel injuring Maryam. The wound has healed, but her condition has worsened. Her father, Farah, tells me that since the night of the rocket attack her screaming has grown worse, her crying abnormal.
Maryam holds on to her father’s finger. ‘It was not until my final visit to Maryam’s family that I saw the photograph I had been looking for.’ Photograph: Giles Duley
“She is having more fits since the attack. After the crisis and her last injury, she screams all night. Before she was moving around a bit, but now she doesn’t move at all.” As I sit there drinking my coffee, I find it hard to imagine what life is like for Maryam. Her situation is desperate: the family home nearly destroyed; their income as farmers gone; a lack of psychological or physical support; and, hardest of all, no escape from the home that they know will be caught in the crossfire when war returns. Due to the lack of freedom of movement and financial constraints the family has no choice but to stay.
Later, Farah takes me on to the roof to show me where the rockets hit. “The problem,” he says pointing in one direction, “is that when those over there fire on those over there”, his arm swinging to point the opposite way, “then those over there fire back. We are in the middle.” It’s a simple illustration of the fate of so many families caught in conflicts around the world, though here in Gaza the situation is made worse by the Israeli blockade. There simply is no way to escape.
As a father, he says, he wants just one thing: to protect his family; to take them somewhere safe, somewhere where Maryam won’t be injured again. But he can’t.
As my photography matures, I find I spend more time with people and take fewer photographs. In a world where speed and efficiency seem valued above all else, I’ve made the conscious effort to slow down. Spending time with people, observing their daily life, sharing food and coffee, watching for small gestures and, most importantly, listening to their stories. Only then does the photography start.
Sitting with Maryam and her family, I’m struggling to find that moment. I can’t “see” the image that does justice to her story, it’s not coming to me. That day, I leave without having taken a single photograph. The evening is spent struggling with how to do the story justice, to retain the dignity of those I’m photographing.
The next day, I visit the offices of Handicap International, a charity that works to provide support for children with disabilities throughout Gaza, including those with intellectual impairments. Huha Skeikh is a Palestinian psychologist who has written extensively on how the conflict has affected those with learning disabilities and other disorders such as autism.
She takes me to meet a 14-year-old girl, Islam, who lives with her father and sister in Gaza City. When Islam was one and a half, she fell from the fourth story of her building and suffered a serious head injury that left her with learning disabilities. She struggled to concentrate at school, was aggressive and suffered from panic attacks. Eventually, her headmaster excluded her from school and she spent many months shut at home where her sense of isolation and anxiety grew.
Finally, when she was 11, Islam was enrolled in a specialised school and started seeing Huha for psychological support. “The reason for the psychological sessions was the increased anxiety she was facing because she had difficulty communicating with people and was used to staying at home, so school was a strange environment. She was very aggressive and could hit people, so we were trying to work with her and include her in the community.”
Working with Islam’s mother as well, Huha could see the progress she was making. Then on 21 July last year, as the war intensified, a shell hit Islam’s house. She was hit in the leg with shrapnel, but survived. However, four siblings, her grandmother and mother didn’t. She saw their bodies all around her.
“I was not able to reach Islam until the war was over,” recalls Huha. “[By then she had] developed a speech impediment as a result of the trauma. She has constant nerves and had constant voices, thoughts and pictures coming to her in a very insistent way. She used to have bad dreams and nightmares and would often wake up and go and stand behind the door, just waiting for her mother. She hears voices and has hallucinations. She would smell things that her mother used to do, like baking, but it doesn’t exist.”
Some of Islam’s drawings showing the trauma of losing her family members in an Israeli attack. Giles Duley decided not to photograph Islam herself, owing to the sensitive nature of her condition.
Before we leave, I witness one of Huha’s sessions with Islam and one of her surviving sisters, Ruda. The pair are incredibly close. They have decorated a box with stickers of sunflowers and, as part of Islam’s therapy, they are placing their mother’s possessions in it.
“This is my mother’s scarf. She used to wear it when she went out,” Islam quietly says as she places a red scarf in the box. Outside it’s starting to rain heavily. There is no electricity and the room has grown dark.
“My mother used to wear this blouse and now I am wearing it.” She places more objects gently in the box. “This is my late sister Yasmin’s. These are pictures of my mother and two of my sisters.”
“Islam,” Huha says reassuringly, “you can keep this box with you all the time. Whenever you want to talk to your mother you can open it and take out the things that remind you of her, so your mother can always be around you. Islam, what would you like to say to your mother?”
There is a pause before Islam answers. “I love you, I miss you and please keep coming so we can remember you.”
Later, I speak to Rawya Hamam, a psychiatric nurse, and psychologist Dr Hasan Zeyada, who work at the Gaza Community Mental Health Programme, a charity that provides support across Gaza City.
“It’s not just children with special needs,” Rawya explains. “In the war, around one-third of those killed were children (561 children) and around 110,000 families were displaced from their homes. The basic psychological need for children everywhere is to feel secure but in this war, insecurity prevails.
“Trauma affects children on so many levels – cognitive, emotional
