Understanding the psychosocial environment of children displaced from Gaza to Egypt: a qualitative parent perspective

BACKGROUND AND OBJECTIVES

Prior to October 2023, 80% of Palestinian children exhibited at least one symptom of post-traumatic stress disorder (PTSD), and 88% reported witnessing violent property bombing. Since October 2023, it is estimated that every child in Gaza has experienced psychological trauma. Intergenerational trauma, severe food insecurity, repeated displacement, and acute grief among Palestinian children demonstrate an urgent need for child-focused mental health services.

Between October 2023 and May 2024, approximately 115,000 Palestinians fled from Gaza to Egypt. Palestinian children in Egypt are not permitted to attend school due to a lack of legal residency status, further disrupting cognitive development. Despite this, there is little to no literature examining the psychosocial environment of children displaced from Gaza to Egypt. By May 2025, more than 150,000 Palestinians had been displaced from Gaza to Egypt, including thousands of children facing compounded effects of trauma, displacement, and educational disruption.

This project aims to:

(1) understand the needs of Palestinian children displaced from Gaza and residing in Egypt, and

(2) identify the psychosocial environment shaping their experiences in Egypt, including legal barriers, loss of education, and access to care.

METHODS/STUDY DESIGN

Twelve semi-structured qualitative interviews were conducted with parents displaced from Gaza to Egypt after October 2023 and with experts who have worked extensively with this population. Parents were recruited from a community mental health clinic in Egypt, the Gaza Emotional and Mental Support Initiative (GEMs), and experts were recruited through snowball sampling. Verbal consent was obtained via WhatsApp. A psychologist from GEMs was available on call during parent interviews, and all participants received follow-up psychosocial resources and a delivery of selected grocery items in recognition of their time.

Inductive thematic analysis was conducted using NVivo to identify shared patterns and challenges across key domains in Egypt, including displacement experiences, living conditions, finances, education, healthcare, and mental health. Intervention recommendations were also collected. The study received institutional review board approval from the University of California, San Francisco, and ethics approval from Al Quds University.

RESULTS

Findings highlighted overcrowded and unsanitary living conditions unsuitable for children, characterized by a lack of privacy and appropriate spaces for play and learning. Restrictions on movement due to security measures in Egyptian public hospitals, combined with high transportation costs, led to prolonged child confinement, sometimes limiting children to a single room for months. Parents expressed concern about their children’s lack of intellectual stimulation, exacerbated by limited access to education.

Across all interviews, the absence of legal refugee or residency status in Egypt emerged as a major challenge, preventing families from earning income to meet basic nutritional and developmental needs and barring children from accessing in-person education. Family separation during displacement contributed to emotional distress and strained family dynamics. Psychologically, parents reported increased aggression, withdrawal, and behavioral changes in their children following trauma. Overall, displacement to Egypt was described as a “tragic” experience marked by disempowerment, fear, and reliance on inconsistent donations for survival.

CONCLUSION

Participants emphasized the urgent need to establish educational opportunities for Palestinian children in Egypt, improve coordination among NGO services, and provide legal refugee status to enable families to earn income and meet basic food, medical, and livelihood needs. To safeguard children’s rights and well-being, interventions must prioritize stable living conditions with safe spaces for play and learning, address trauma, and support cognitive and psychosocial development.