Specialists treating children who were held hostage by Hamas have expressed concern about the long-term effects their ordeal may have on them.

“I don’t think that in the Western world 30 children were ever abducted and kept in captivity for over 50 days,” former Israeli Justice Minister Ayelet Shaked told the JC.

Shaked is chair of the Association of Friends of Schneider Children’s Hospital, which supports the Israeli medical centre in Petach Tikvah that has been treating returned hostages.

The children underwent a battery of medical tests at the hospital after their release before returning home. The centre’s psychiatric team is continuing to treat them remotely.

Accounts by relatives of freed hostages paint a bleak picture of children marked with exhaust pipes, drugged or held at gunpoint for crying or speaking too loudly. Some have reported being beaten by Gaza residents; others were forced to watch footage of Hamas’s October 7 massacre; still others returned home communicating only in whispers.

“Children were so malnourished that they have to learn how to eat again. They slept on the floor with no mattress or blanket and will have to readjust to being in a bed,” said Shaked. She hailed the medical centre’s staff as the best in the world, giving the freed young people the best chance of fully recovering.

Prof Rivka Tuval-Mashiach, head of the community services unit at NATAL-Israel Trauma and Resiliency Centre in Tel Aviv, says captives’ perception of time is also often distorted, resulting in longer healing periods.

“Emily Hand, one of the children hostages, thought she was held in Gaza for a full year. When you spend your time waiting in fear, wondering if you’ll still be alive at the end of the day, each one can feel like weeks or even months,” Tuval-Mashiach, who is also a clinical psychologist and senior lecturer at Bar-Ilan University, told the JC.

“Loneliness makes the hostage experience much more frightening. Children held with a parent would usually cope better. Their age also matters. While there are reports of teens being beaten by terrorists, I’m hoping that the very young children were less exposed to cruelty and violence.

“Regardless, all former captives will go through a long and difficult recovery process even if they weren’t tortured. They all went through the traumatic experience of living in captivity with no access to their loved ones or the outside world for over 50 days. Some even witnessed their parents being murdered by Hamas prior to their abduction and have not yet processed the event.”

Dr Ofrit Shapira-Berman, a psychoanalyst and lecturer at the Hebrew University of Jerusalem, has been working with the relatives of Israeli captives for more than eight weeks. “Children who knew how to use the toilet may not know how to any more. They may not want to be touched and this could be very difficult for parents,” she said. “They may be scared to sleep in their own beds. Some unfortunately have become orphans.”

Shapira-Berman warned that some of the children could eventually engage in self-destructive behaviour such as self-medicating with drugs and alcohol. “We know that children who are physically and sexually abused usually carry that with them for ever. We have no reason to think these children won’t,” she said.

But she remains optimistic that the children will be able to fully recover from their ordeal. “We all are weaker than we hope, but stronger than we believe,” she said.