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Humiliation takes harsh health toll, report says

June 20, 2007
Special to World Science  

Re­peat­ed hu­milia­t­ion can take a steep health toll, ac­cord­ing to a group of sci­en­tists who stud­ied the ef­fects what they called the hu­milia­t­ions of liv­ing un­der mil­i­tary oc­cupa­t­ion. 

But some oth­er re­search­ers ques­tioned the stu­dy’s meth­od­ol­o­gy and called for fur­ther in­ves­ti­ga­t­ion.

In this im­age cap­tured by a hu­man rights group in 2005, Is­rae­li sol­diers al­leg­ed­ly mal­treat a Pal­es­tin­ian ac­cused of graz­ing sheep on land re­served for mil­i­tary use on­ly. The man and ac­tivists main­tained that that the ar­ea had not been de­clared off lim­its. (Cour­te­sy operationdove.org)
The study was con­ducted in the West Bank, a Pal­es­tin­ian land un­der Is­rae­li oc­cupa­t­ion and plagued by al­most cease­less low-grade war and spi­ral­ling pov­er­ty.

Gun­men and su­i­cide bombers from Pal­es­tin­ian ter­ri­to­ries reg­u­larly try to slip in­to bor­der­ing Is­ra­el to at­tack their oc­cupiers. 

To count­er this, the U.S.-backed Is­rae­li mil­i­tary oc­ca­sion­ally at­tacks al­leged ter­ror­ist cells in Pal­es­tine. On a more eve­ry­day ba­sis, it op­er­ates a per­va­sive net­work of bar­ri­ers and check­points both on its bor­der and in­side Pal­es­tin­ian lands, os­ten­sibly to catch ter­ror­ists.

These and oth­er con­trol meas­ures, such as de­clar­ing some roads and lands off-lim­its to the lo­cals, trig­ger reg­u­lar com­plaints of frus­t­ra­t­ion and hu­milia­t­ion from the popula­t­ion. Typ­i­cal sto­ries in­clude “wom­en in la­bor who are made to wait end­less­ly… wom­en who are forced to tell sol­diers that they are bleed­ing so their hearts will soft­en… the boy who tries to per­suade a sol­dier to let him pass so he can vis­it his grand­fa­ther,” Is­rae­li jour­nal­ist Gid­e­on Le­vi wrote in the Jan. 18, 2004 is­sue of the Is­rae­li news­pa­per Haa­retz.

In the stu­dy, Rita Gi­a­ca­man and col­leagues at Birzeit Un­ivers­ity in Ra­mal­lah, The West Bank, ques­tioned 3,415 high school cit­ies from their dis­trict. “Hu­milia­t­ion was sig­nif­i­cantly as­so­ci­at­ed with a high num­ber of sub­jec­tive health com­plaints, even af­ter ad­just­ing for sex, res­i­dence and oth­er meas­ures of ex­po­sure to vi­o­lent events,” they wrote in a pa­per de­scrib­ing their stu­dy, pub­lished in the June 11 ad­vance on­line is­sue of the re­search jour­nal Pub­lic Health.

Al­though pre­vi­ous stud­ies have found ill health ef­fects re­sult­ing from so­cial isola­t­ion or mar­gin­al­iz­a­tion or prej­u­dice, very lit­tle re­search has stud­ied the ef­fects of out­right hu­milia­t­ion, ac­cord­ing to the re­search­ers.

“The au­thors of this re­port de­serve spe­cial praise for in­ves­ti­gat­ing these ques­tions un­der the haz­ard­ous con­di­tions” of the Pal­es­tin­ian ter­ri­to­ries, wrote re­search­ers with Co­lum­bia Un­ivers­ity in New York in a com­men­tary in the same is­sue of the jour­nal. 

But the com­men­ta­tors, Yu­val Ne­ria and Rich­ard Neuge­bauer, ques­tioned some of the meth­ods used. For in­stance, they said, re­search­ers asked chil­dren wheth­er they or their rel­a­tives had been “hu­miliated,” but nev­er of­fered a very pre­cise def­i­ni­tion of hu­milia­t­ion. Hu­milia­t­ion is largely in the eye of the be­hold­er, the Co­lum­bia pair not­ed, so it’s not clear that one per­son’s ac­count of be­ing “hu­miliated” cor­re­sponds to any clear, ob­jec­tive def­i­ni­tion of what hu­milia­t­ion is.

Gi­a­ca­man’s team count­ered, in a pub­lished re­sponse, that pre­cisely be­cause it’s in the eye of the be­hold­er, the best per­son to ask about it is the be­hold­er—the tar­get or wit­ness of the al­leged hu­milia­t­ion. There can be no pre­cise def­i­ni­tion be­cause what con­sti­tutes de­base­ment varies by cul­ture and by in­di­vid­ual, they ar­gued.

Study par­ti­ci­pants were asked simply wheth­er they had been hu­miliated, seen a family mem­ber hu­miliated, seen a friend hu­miliated or seen a strang­er hu­miliated. There were few ques­tions about the ex­act cir­cum­stances of the al­leged vi­ola­t­ions of dign­ity. 

Par­ti­ci­pants re­porting four or more forms of hu­milia­t­ion were more than se­ven times likelier to suf­fer from a high num­ber of sub­jec­tive health com­plaints as people who re­ported no hu­mil­iat­ing in­ci­dents, Gi­a­ca­man and col­leagues wrote. Health com­plaints in­cluded head­ache, stom­ach ache, back­ache and sleep dif­fi­cul­ties. “What is hap­pen­ing here,” Gi­a­ca­man wrote in an e­mail, “is really trag­ic.”


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Repeated humiliation can take a steep health toll, according to a group of scientists who studied the effects what they called the humiliations of living under military occupation. But some other researchers questioned the study’s methodology and called for further investigation. The study was conducted in the West Bank, a Palestinian land under Israeli occupation and plagued by almost ceaseless low-grade war and spiralling poverty. Gunmen and suicide bombers from Palestinian territories regularly try to slip into bordering Israel to attack their occupiers. To counter this, the U.S.-backed Israeli military occasionally attacks alleged terrorist cells in Palestine. On a more everyday basis, it operates a pervasive network of barriers and checkpoints both on its border and inside Palestinian lands, ostensibly to catch terrorists. These and other control measures, such as declaring some roads and lands off-limits to the locals, trigger regular complaints of frustration and humiliation from the population. Typical stories include “women in labor who are made to wait endlessly… women who are forced to tell soldiers that they are bleeding so their hearts will soften… the boy who tries to persuade a soldier to let him pass so he can visit his grandfather,” Israeli journalist Gideon Levi wrote in the Jan. 18, 2004 issue of the Israeli newspaper Haaretz. In the study, Rita Giacaman and colleagues at Birzeit University in Ramallah, The West Bank, questioned 3,415 high school cities from their district. “Humiliation was significantly associated with a high number of subjective health complaints, even after adjusting for sex, residence and other measures of exposure to violent events,” they wrote in a paper describing their study, published in the June 11 advance online issue of Public Health. Although previous studies have found ill health effects resulting from social isolation or marginalization or prejudice, very little research has studied the effects of outright humiliation, according to the researchers. “The authors of this report deserve special praise for investigating these questions under the hazardous conditions” of the Palestinian territories, wrote researchers with Columbia University in New York in a commentary in the same issue of the journal. But the commentators, Yuval Neria and Richard Neugebauer, questioned some of the methods used. For instance, they said, researchers asked children whether they or their relatives had been “humiliated,” but never offered a very precise definition of humiliation. Humiliation is largely in the eye of the beholder, the Columbia pair noted, so it’s not clear that one person’s account of being “humiliated” corresponds to any clear, objective definition of what humiliation is. Giacaman’s team countered, in a published response, that precisely because it’s in the eye of the beholder, the best person to ask about it is the beholder—the target or witness of the alleged humiliation. There can be no precise definition because what constitutes debasement varies by culture and by individual, they argued. Study participants were asked simply whether they had been humiliated, seen a family member humiliated, seen a friend humiliated or seen a stranger humiliated. There were few questions about the exact circumstances of the alleged violations of dignity. Participants reporting four or more forms of humiliation were more than seven times as likely to suffer from a high number of subjective health complaints than those who reported no humiliating incidents, Giacaman and colleagues wrote. Health complaints included headache, stomach ache, backache and sleep difficulties. “What is happening here,” Giacaman wrote in an email, “is really tragic.”