"Silent Suffering": Why Children in Gaza Are Losing the Ability to Speak

An estimated 1.1 million children in Gaza are in need of mental health and psychosocial support, while a growing number are losing their ability to speak as a result of trauma and injuries from Israeli attacks. This worrying phenomenon is increasingly being observed by doctors and specialists, who report cases of children who suddenly stop speaking after violent experiences. In many cases, the loss of speech is not only related to physical injuries, but also to deep emotional trauma that directly affects their development. Without ongoing intervention and support, the consequences can be long-lasting and affect their lives well into the future.

After a powerful bombardment that hit near his home, five-year-old Yad Zohud suddenly lost the ability to speak, no longer able to produce sounds or words. 

He is not alone, as throughout Gaza specialists are reporting an increase in the number of children who can no longer speak as a result of war injuries or severe psychological trauma.

For some, the cause is physical, such as head injuries, neurological damage, or trauma from explosions, while for others there are no visible wounds and the silence comes as a result of constant exposure to violence that exceeds their ability to process or express the experience.

Child psychotherapist Katrin Glatz Brubakk, who has worked in Gaza with Doctors Without Borders (MSF), describes this as a “silent suffering” that often remains hidden in the face of the scale of the destruction.

How is the problem manifesting?

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At Hamad Hospital in Gaza City, doctors report that cases of speech loss in children are on the rise, while Dr. Musa al-Khorti, head of the speech therapy department, points out that in some cases a child can completely lose the ability to speak, referring to conditions such as selective mutism (where a child is able to speak normally in some situations, for example at home, but does not speak at all in other situations such as at school or in public), or hysterical aphonia (loss of voice without a physical cause), which are associated with functional loss of the voice as a result of extreme psychological stress. The cases vary from one to another, but many of them follow a similar pattern, where the loss of speech occurs suddenly after a violent event or a serious injury.

Five-year-old Jad, who had never had speech problems before, according to his mother, woke up unable to speak after the bombing near his home. Meanwhile, four-year-old Lucine Tamboura lost her voice after falling from the third floor of her home when a staircase damaged by an air raid collapsed under her feet. Her mother explains that the fall affected her speech and caused partial paralysis in her arms and legs; although these have improved, she still has difficulty speaking and is undergoing treatment.

Doctors warn that without ongoing care, these conditions can have long-term consequences on children's development, especially when associated with psychological trauma.

Why is this happening?

Psychotherapist Katrin Glatz Brubakk explains that the loss of speech in children is a reaction to extreme trauma, emphasizing that these are children who, even without an obvious medical cause, stop speaking due to severe experiences. 

She describes cases of children who have lost family members, witnessed death, been injured, or lived under constant violence, where silence becomes the only way to cope with reality.

According to her, at some point the world becomes unpredictable and the child is in immediate danger, so this is not a conscious decision, but a physical reaction of the body. Many of them go into what she calls the “freeze response,” where the body freezes because it can’t fight or run away from the danger. The body, in a way, “chooses” to remain still until the environment seems safe again.

However, the consequences go beyond the loss of speech, as if children stop playing and interacting, they also stop learning and developing. Prolonged trauma keeps the brain in a survival mode, where the amygdala (a small almond-shaped structure in the brain) remains constantly active (meaning the brain behaves as if danger is always present, even when it is not) while functions related to learning and emotional regulation are suppressed, meaning that even when a child seems withdrawn, their nervous system is still on high alert, with serious long-term consequences for development.

Is Gaza different from other conflict zones?

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According to psychotherapist Katrin Glatz Brubakk, the scale and completeness of the trauma in Gaza is unmatched by anything she has seen in more than a decade of fieldwork, noting that in 12 years of experience she has never encountered anything like it and that today there is almost no one in Gaza who has not been affected in one way or another. She describes Gaza as a place characterized by a total lack of security, where bombs are everywhere, everyone is affected and in constant danger, and where the concept of security almost no longer exists.

This situation is further aggravated by the collapse of the health system and basic services, as people cannot receive the necessary help, neither physical nor psychological, while at the same time they do not even have the opportunity to leave, creating a combination that makes the impact of the trauma much more severe.

For Brubakk, the most neglected consequence is not just the visible injuries, but what she calls a "long-term silent consequence" that develops beneath the surface, adding that it is easy to point out amputations or bandages, but silent suffering is everywhere and much less visible.
She also emphasizes that in Gaza even the most basic assumption of security no longer exists, as no one can be considered truly safe, given that even during a supposed ceasefire people continue to be killed and no one knows when their turn might come.

How does recovery begin in children?

According to Brubakk, recovery from trauma-related mutism is a slow and very fragile process that requires time and constant care. She cites the example of a five-year-old boy, Adam, who developed selective mutism after witnessing the death of his father in an air raid, stopping talking to everyone except his mother, with whom he communicated only in soft whispers and withdrawing almost completely from interaction.

At first he refused all contact, but over time small signs of recovery began to appear, such as the moment when he whispered to his mother that he didn't like the therapist, which for Brubakk was a positive sign because it showed that he was responding again. From there, recovery took place in a fragmented manner, through brief eye contact, small moments of curiosity, and small steps towards interaction, until he gradually began to regain his voice.

She stresses that this kind of progress depends on structured and ongoing care, which is becoming increasingly difficult to provide, while doctors at Hamad Hospital warn that children with such conditions need specialized equipment and long-term rehabilitation, many of which were damaged or lost during the war.

However, Brubakk explains that recovery can begin in the simplest of ways, such as through what she calls “hope bubbles,” which are soap bubbles used in therapy with withdrawn children. She explains that these bubbles, in addition to being beautiful and soothing, help children take their attention away from fear and focus it on something gentle and controllable.

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The process of blowing bubbles also becomes a way to regulate breathing and calm the nervous system, as creating large bubbles requires slow, controlled breathing, thus turning the game into a calming mechanism for the body. This transition from fear to curiosity helps children to re-engage and relax, sleep better, and regulate their nervous system, gradually returning them to a normal developmental path.

Ultimately, Brubakk reminds us that recovery does not come through a single big moment, but through many small and often invisible steps, emphasizing that patience is essential, as every small step counts. In a place like Gaza, even the smallest moments of security carry extraordinary weight precisely because they are so rare.