Quality of life, human insecurity, and distress among Palestinians in the Gaza Strip before and after the Winter 2008–2009 Israeli war

Abstract

Purpose This study investigates changes in the quality of life (QoL) of Gaza Palestinians before and after the Israeli winter 2008–2009 war using the World Health Organization’s WHOQOL-Bref; the extent to which this instrument adequately measures changing situations; and its responsiveness to locally developed human insecurity and distress measures appropriate for context. Methods Ordinary least squares regression analysis was performed to detect how demographic and socioeconomic variables usually associated with QoL were associated with human insecurity and distress. We estimated the usual baseline model for the three QoL domains, and a second set of models including these standard variables and human insecurity and distress to assess how personal exposure to political violence affects QoL. Results No difference between the quality of life scores in 2005 and 2009 was found, with results suggesting lack of sensitivity of WHOQOL-Bref in capturing changes resulting from intensification of preexisting political violence. Results show that human insecurity and individual distress significantly increased in 2009 compared to 2005. Conclusion Results indicate that a political domain may provide further understanding of and possibly increase the sensitivity of the instrument to detect changes in the Qol of Palestinians and possibly other populations experiencing intensified political violence.

Reframing Public Health in Wartime: From the Biomedical Model to the “Wounds Inside”

“…52 It is interesting to note that a comparison of Gazans' QOL before and after the winter 2008-9 attack revealed that the standardized WHOQOL-BREF instrument could not detect significant changes in QOL scores. 53 In contrast, our locally developed measures of human insecurity and distress detected important increases in these two measures of suffering and reported health before and after the war, confirming the need to supplement or replace standardized international instruments with context-specific measures. This study also confirmed the importance of introducing a political domain into QOL instruments, that is, uncovering the political determinants of health.…”

Community Work in the Ongoing Crisis Context of Gaza: Integrating a Public Health and Human Rights Approach

“…Every dimension of daily life reminds Palestinians that they cannot control their own destiny. Lack of freedom and security, impossibility to access clean water and electricity or a decent educational and health system, unemployment, systematic harassment and violence, inability to move and leave the strip, contribute to an increasing sense of hopelessness and impotence (see Hammoudeh, Hogan, & Giacaman, ).…”

Quality of Life and Determinants of Parents’ School Satisfaction in War Contexts

“…Although Palestinians continue to be among the besteducated peoples in war and poverty affected zones (Høigilt, 2013;Nasser, Berlin, & Wong, 2011), the ongoing disruption of general economic, environmental, health, and living conditions also affects the education domain, contributing to further undermining opportunities for improvements in subjective well-being and familial QoL (Batniji, 2013;Hammoudeh, Hogan, & Giacaman, 2013). Families are forced into a paradox: on the one hand, they identify education as the one of the few opportunities for their children to cope with adversity and daily suffering; on the other, they see excellent educational opportunities as an extremely remote prospect for the children of Gaza (Khamis, 2013).…”