Groundbreaking study of 26 former Hamas hostages charts physical, psychological trauma
Researchers find that the 19 children and 7 women faced poor sanitation, hunger and darkness; lead researcher worries about the hostages still held in Gaza
Reporter at The Times of Israel
Released after about 50 days in Hamas captivity, 19 children and 7 women exhibited the effects of psychological terror due to warfare strategies that included isolation, intimidation, lack of food and water, and emotional abuse.
The findings were published last week in a groundbreaking study that is the first to collect research data on hostage children immediately following their release. The children were examined and treated at Schneider Children’s Medical Center at the end of November and early December.
“As soon as we knew that children were taken hostages, we did an extensive search, but found no research data on children who’d been captives,” said Dr. Noa Ziv, senior physician in the hospital’s pediatrics department, who led the study with hospital staff members Dr. Yael Mozer-Glassberg and Dr. Havatzelet Yarden-Bilavsky.
In the study, published in the prestigious journal Acta Pædiatrica, the researchers describe how among other symptoms the patients had significant weight loss, emotional trauma and complications caused by poor hygiene and lack of proper medical care.
The participating women and children were among the 251 kidnapped on October 7, when 3,000 Hamas terrorists stormed Israel and killed 1,200 people amid acts of brutality and sexual violence. About 115 of the hostages are still being held in Gaza.
Hamas released 105 civilians during a weeklong truce in late November. Upon their release, the hostages went to one of six Israeli hospitals: Soroka Medical Center, Sheba Medical Center, Wolfson Medical Center, Ichilov Hospital, Shamir Medical Center, and Schneider Children’s Medical Center.
All the children and women examined at Schneider Children’s Medical Center were forcefully taken from their homes. Twenty-four of the former hostages had witnessed the murder or kidnapping of other family members during the attack.
Among them were six nuclear families abducted as family units (children, parents, and grandparents) and seven children who were kidnapped alone and held separately. The children were between the ages of 2 and 18; the women were between 34 and 78.
The first study of its kind
After admission, the patients underwent a medical evaluation that included a basic physical examination, blood tests, stool tests, and urine tests.
“As of now, most research [on hostages] focuses mainly on the mental and psychological consequences of adult men and soldiers in captivity,” Ziv said. “To the best of our knowledge, this is the first study on the medical and physical impact on captured children during the immediate post-captivity period.”
Once at the hospital, a multidisciplinary team, consisting of medical professionals, dietitians, and psychological staff carried out the assessment and treatment of the returnees. The medical files on each hostage were compiled using information collected from Israel’s health maintenance organizations.
Significant attention was paid to anticipating potential medical problems and consideration of the patients’ medical history, while maintaining medical confidentiality.
The returnees stayed in the hospital for about four days. Of the 26 participating former hostages, 18 individuals (70 percent) did not have a home to return to because their houses were burned during the attack or the houses were in evacuated zones.
Underground and dark conditions
All 26 patients reported a lack of sanitation and hygiene.
Two women and six children were kept underground for most of their time in captivity; as a result, some of them also suffered from a lack of vitamin D, which is crucial for the body.
Most abductees reported limited access to running water throughout their captivity, resulting in lice in six patients.
Blood tests showed that about half of the captives had unusual infections; some suffered from tick-borne fever and others from Q fever, transmitted by inhaling dust or contact with sick animals. Some suffered from multiple insect bites and intense skin irritation.
Ziv said that because the hostages sat in the same position for lengthy periods in captivity, their lab tests showed high levels of the CPK enzyme indicating significant muscle damage.
“They didn’t move,” she said, ” and once they were released, they complained of muscle aches.”
During the attack and kidnapping, 14 hostages were injured, including nine with shrapnel injuries that remained in their bodies. One of them had a fractured seventh rib and a lung injury with bleeding. Another suffered a gunshot wound to the lower abdominal wall.
Hunger and thirst
All the captives suffered from hunger; 15 of them showed a significant weight loss of up to 15% of their body mass.
According to the hostages’ reports, their diet consisted mostly of rice and white bread, without vegetables, protein, or fat.
In the hospital, the patients received a nutritional regimen to avoid the risk of Refeeding Syndrome, a potentially fatal condition, caused by giving an undernourished person too much food and fluids too quickly, leading to metabolic disorders and fluid and electrolyte imbalances.
Ziv said that three toddlers would not eat all their food at first and hoarded some “for later.”
The researchers found that weight loss was far more prevalent in adult women and adolescents than in young children.
They believe that the adults and adolescents in each group or family of hostages deprived themselves of food to feed the younger children.
Psychological traumas
All the children under 7 were withdrawn and suffered from repeated nightmares. One toddler who had been separated from her family and held alone for 10 days had “unprovoked crying.”
The children spoke in whispers, possibly out of fear or because of their captors’ instructions. Ziv said it took them a while to resume their normal volume of speech.
One toddler demonstrated trichotillomania, also known as hair-pulling disorder, caused by distress.
Ziv said that after their release, the women and children underwent continued care at local clinics.
“These were the effects after about 50 days in captivity,” Ziv said. “I am afraid of the fate of the other hostages because as more and more time goes by, their condition will only get worse.”
“Even a young and healthy person cannot survive hundreds of days of extreme hunger, thirst and dehydration, infections, injuries, abuse, and harsh environmental conditions,” public health professor Hagai Levine, head of the Hostages and Missing Families Forum told the Hebrew language newspaper, Maariv. “The abductees are in immediate danger of their lives.”
Ziv said that the results of the study were compatible with the researchers’ projections.
“But considering the present situation, having a study published about abducted Israeli children is an achievement,” she said, adding that the long-term effects of their captivity are not yet known.
The “immense magnitude of the psychological trauma of kidnapped victims cannot be properly assessed or treated in the immediate return phase,” the authors write in the study. They hope that the insights “will never again be clinically relevant in the future, as children and their mothers should be spared from these atrocious situations.”
