Palestinian Children’s Experiences of Drug Abuse in the Home in the Occupied Territories of Palestine: a Scoping Review of Extant Literature

Abstract

The Occupied Territories of Palestine (OtP) consists of the non-contiguous West Bank including East Jerusalem, and the Gaza Strip. Its dense population with political and economic tensions is affected by a rise in drug trafficking, abuse and addiction. A scoping review mapped what is known about Palestinian children's experiences of drug abuse in the home. Following application of exclusion measures, six records remained. Charting and analysis resulted in three themes; The consequences of being a child with a drug using parent; Causal factors of drug use in Palestinian families; and Prevalence rates of parental drug use are unknown. The review paints a concerning picture of stigma, family dysfunction, school drop-out, child and family isolation and maladaptive child development. Exposure to drugs, trauma and abuse contributes to strong potential for Palestinian child drug use, sexual exploitation, overdose, psychiatric illness, and infectious diseases acquisition. The review will inform the urgent strategic response. Abstract 3 The Occupied Territories of Palestine (OtP) consists of the non-contiguous West Bank including 4 East Jerusalem, and the Gaza Strip. Its dense population with political and economic tensions is 5 affected by a rise in drug trafficking, abuse and addiction. A scoping review mapped what is known 6 about Palestinian children's experiences of drug abuse in the home. Following application of 7 exclusion measures, six records remained. Charting and analysis resulted in three themes; The 8 consequences of being a child with a drug using parent; Causal factors of drug use in Palestinian 9 families; and Prevalence rates of parental drug use are unknown. The review paints a concerning 10 picture of stigma, family dysfunction, school drop-out, child and family isolation and maladaptive 11 child development. Exposure to drugs, trauma and abuse contributes to strong potential for 12 Palestinian child drug use, sexual exploitation, overdose, psychiatric illness, and infectious 13 diseases acquisition. The review will inform the urgent strategic response.14

Perspectives of Frontline Professionals on Palestinian Children Living with Sibling and Parental Drug Use in the UNRWA Camps, Jordan

“…Research on health risk behaviours relating to substance/drug use and injecting use of drugs in the Middle East and North Africa (MENA) region remains scant, with little early warning data to inform government responses to emerging public health threats (Arfken & Ahmed, 2016;Glick et al, 2018). A reported rise in substance/drug use, injecting use and drug use disorder in the oPt (West Bank and Gaza) has been observed in recent times and related to exposure to trauma, poverty, unemployment, fragmentation of Palestinian families and community stress (Sweileh et al, 2004;Al-Afifi et al, 2015;Massad et al, 2016;Palestinian National Institute of Public Health, 2017a;Damiri at al., 2018a;Van Hout et al, 2019). These observed increases have occurred despite religious, legal, and cultural constraints .…”

“…-Introduction: The effect of drug use on Palestinian refugee children needs to be more clarified and linking within the existing literature. >>> This paragraph has been added as requested in pages 4-5: "The effect of drug use on children and their families living in the Palestinian refugee camps is far -reaching and includes familial stigma and community isolation, dysfunction, early school leaving and maladaptive child development (Van Hout et al, 2019). Research conducted by the team in 2019 in the oPt has underscored how they are vulnerable of children and young people at risk of substance use (including drugs), and are vulnerable to physical and sexual abuse, exploitation in drug trafficking, and at risk of becoming dependent users themselves (Al-Afifi et al, 2015;Van Hout et al, 2019;(Al-Afifi et al, 2019; United Nations Office on Drugs and Crime (UNODC), 2019).…”

Public health imperatives in countering drug related health threats and vulnerabilities in contemporary Palestinian refugee camps

“…are generally denied full rights to political, economic and societal integration (employment, property ownership), are restricted access to public education, public health care and social services, and consequently experience acute socio-economic deprivation ( Habib et al., 2012 ; Kitamura et al., 2018 ). Further to the political insecurity, complicated by the impending angst around the ‘right to return’, Palestinian refugee communities in the drug transit and drug production countries of Lebanon, Jordan, Syria, West Bank and Gaza are reported to increasingly experience camp insecurity and drug related health threats and vulnerabilities ( Thabet & Dajani, 2012 ; UNRWA/UNICEF, 2018 ; Massad et al., 2016 ; Al-Afifi et al., 2019 ; Damiri, 2019 ; Syam et al., 2019 ; Van Hout et al., 2019 ; Wazaify et al., 2020 ). These conditions inside camps, along with tensions with the outside or host communities collectively increase their risk of substance use and high-risk drug use ( Afifi et al., 2019 ; Anera, 2019 ).…”

“…Limited access to safety and justice, lack of governance and infiltration by radical Islamist groups and criminal networks in some camps has played a vital role in the targeting of youth by drug dealers, the spread of drug abuse, trafficking and violence ( Damiri et al., 2018 ; UNHCR, 2016 ; Yamout et al., 2012 ). Young disenfranchised Palestinian refugees, particularly males, and those living with the trauma of displacement and conflict, are extremely vulnerable to drug related risk behaviours including exploitation in drug trafficking by cross border criminal networks ( Al-Afifi et al., 2019 ; Al-ghzawi et al., 2014 ; Elbedour et al., 2007 ; Van Hout et al., 2019 ; Wazaify et al., 2020 ). Internal efforts by Palestinian communities, NGOs, and CSOs strive to counteract this threat to communal existence and safety in the refugee camps.…”

“…In contrast, whilst both Syria and Jordan note PWID as a key population in their National AIDS planning, there is no operationalization of harm reduction in Syria, and whilst NSP was provided on a small scale in Jordan, there has been a decline in the important of some health programmes, particularly the national AIDs programme, with domestic resources are currently diverted to refugee support initiatives. Community groups continue to report concern around the hidden nature of drug use, the stigmatising treatment of drug users as criminals by law enforcement, and lack of harm reduction and drug treatment provision accessible near to the camps ( Al-Afifi et al., 2019 ; Glick et al., 2018 ; MENAHRA, 2020 ; Van Hout et al., 2019 ; Wazaify et al., 2020 ). Efforts are also reported to be coming from within, for example in Lebanon where in 2014, a group of young people living in Burj Barajneh camp converted an old prison building into a drug rehabilitation centre.…”