Dr. Efrat Bron-Harlev, CEO of Schneider Children’s Medical Center of Israel, recently addressed the United Nations about the plight of the children who were kidnapped from Israel by Hamas terrorists on Oct. 7, 2023.
She said that 38 of the 253 people who were abducted that day were children. The youngest was Kfir Bibas, just eight months old at the time.
The child is still in captivity, along with his parents, Yarden and Shiri Bibas, and his brother, Ariel, who turned five last month.
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Bron-Harlev, a pediatrician, said children released after 50 days in captivity are still, to this day, waking up terrified in the middle of the night.
"They were not allowed to cry, not allowed to laugh, not even allowed to stand up."
She said the children appeared "like shadows of children. No impressions on their faces. They were not happy. They were not crying. They were mostly very, very silent."
Dr. Hagai Levine, chair of the Israeli Association of Public Health and head physician of the Hostages and Missing Families Forum, also reported seeing children being afraid to speak.
"In captivity, they were told, ‘If you speak, you will be killed’ — that's very, very traumatizing," he told Fox News Digital.
In addition to psychological trauma, the hostages were also in extreme physical danger.
Levine, who is also an epidemiologist, said the risks to the hostages’ lives ranged from the threat of "being murdered to lack of food to lack of oxygen, lack of water (and) infectious diseases."
Referencing the recent polio outbreak in Gaza, Levine noted that he sent a letter to UNICEF and the World Health Organization reminding the organizations "that every child has a right to health — and this includes Kfir and Ariel Bibas."
Levine said he was on a bus this summer with children who were formerly hostages as well as children who are relatives of hostages.
The young ones attended a U.S. summer camp in July, he said.
"I saw songs and jokes," he said, recalling his observations. "I’m not saying they were happy, but they have the unique ability to cope."
The doctor said he knows these children have had to grow up quickly — but the "plasticity of the brain" helps children rehabilitate, he said.
He said he has encouraged them to play and dance.
However, "there is always a shadow" holding them back, he said — given that at this moment, there are still other hostages held captive.
Levine said these children grew up in a tight-knit community of a kibbutz — and seeing hostage posters everywhere of their neighbors is very real to them.
"It’s really difficult for them to really recover," he said.
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It is a long process to get these children to be able to trust again, Levine said, and they need someone who is a constant in their lives, especially if their parents were murdered.
He said physical, psychological and educational rehabilitation, such as speech therapy and equine therapy, can help them to regain trust and feel in control.
He also noted that relatives of the hostages are experiencing survivor guilt, severe depression, anxiety, insomnia and physical symptoms such as tremors.
They are traumatized because they don’t know what happened to their loved ones, and they "have been in this horrible nightmare" for nearly a year at this point, he said.
Roxanne Saar, the aunt of released hostage Gali Tarshansky, age 13, told Fox News Digital, "I feel like it could have been me."
Saar had been staying at her father-in-law’s home at Kibbutz Be’eri on Oct. 6, 2023, when she decided to return home that night.
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The next day, 101 civilians at Be’eri were killed by Hamas terrorists and 32 people were kidnapped, according to JNS (Jewish News Syndicate).
Gali Tarshansky's brother, Lior, 15, and her uncle, Noy Shosh, 36, were among the murdered victims.
Saar said that the first question the young teenager asked when she was released from captivity after 54 days was, "Where is Lior?"
It was not until after she returned to Israel that she discovered her brother and uncle had been killed, along with her dog, Mocha, as well as friends she grew up with from her kibbutz.
She was held hostage in homes in Gaza with Nova festival survivors and a couple from Kibbutz Be’eri. The husband, Ohad Ben Ami, is still a hostage, Saar said.
Saar said that in Gaza, "there was not enough food, there was not enough medicine, there was no showering, there was no water … There was psychological terror."
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She said the young woman's captors, some of whom were armed, told her, "Israel does not exist. Your family doesn't want you anymore.’"
Saar added, "I'm not sure if we know everything … I don't have any expectations from terrorists who are capable of kidnapping a 13-year-old girl."
It is crucial, she said, for the remaining hostages to be freed in order for the released hostages to heal.
Saar said Gali Tarshansky is living in a different area of Israel today, attending a new school. She is in therapy.
Said Saar, "I don't think there is anyone in the world who can understand the potential future impact of what happened … Everybody wants to help, but how can someone help with something that we never knew before?"
Professor Merev Roth, PhD, an analyst who works with the Hostages and Missing Families Forum, told Fox News Digital that therapists who are treating released hostages are in uncharted territory.
"All of this is new," she said. "There is not one case in history that so many kids and families were kidnapped from their houses for such a long time and in such a brutal massacre."
Roth is one of the founders of First Line Med (FLM), an organization that offers pro bono treatment to victims of Oct. 7.
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She supervises child therapists and treats adult family members of child hostages who were released after 50 or 54 days in captivity.
Roth said she had to treat some of the families in their homes or hotels initially, because they were afraid to go outside.
She recalled seeing how frightened a three-and-a-half-year old toddler was when the child heard a gardener working outside.
"I remember the girl running into her mother's body, and her mother immediately took her in her arms. The girl didn't say a word. She was white, she was shaking, she didn't even cry," Roth said.
Another time, when the little girl heard noises outside, Roth said the girl asked, "Are they coming for us again?"
Roth said another child released from captivity is unable to get through a full day of school in kindergarten.
Her father is still a hostage, and Roth said she knows he is in danger and asks her mother, "Is Father dead? Will he come back when I'm really old?"
Roth said the children who were separated from their parents in captivity, or witnessed family members being murdered or wounded, "shattered in the most extreme, brutal way" a child’s sense of safety and trust in the world.
Some children had captors who were abusive and threatening; other hostages experienced Stockholm Syndrome, where they identified with their captor, Roth said.
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Antisemitism spreading across the globe is "a big blow," said Roth. "It added to the feelings that the world went crazy, that everything is distorted."
She said these children are suffering from "trauma syndrome symptoms," such as anxiety, depression, sleeping disorders and social withdrawal.
They become easily frustrated, angry and disassociated, which means "you are disconnected from your emotional response … You become confused. You cannot concentrate and you don't react emotionally in your full scope. You are a bit numb," she said.
Dissociation can also be self-protective, Roth noted.
"It takes a long time until they come back into their senses, which is a good thing, because their psyche protects them from feeling all that they would feel if they were connected, and it would be overwhelming for them."
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The therapist said these children are struggling to feel normal.
"They do find any channel they can to be smiling and friendly and cooperative. They're really trying … They are amazing in their coping, but they are injured."
Play therapy, she said, enables children to reenact real experiences through imaginary scenarios, and gives therapists insight into their inner thoughts.
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"You can see the split of the world into total good and total bad creatures fighting each other … I see complete evil, revenge, abuse and angels," she said.
"You can also see the other side … life saviors that came from nowhere to save them."
A seven-year-old boy said he was the "cat hero," helping the cats he drew to fall asleep and feel less afraid.
He also wrote a touching story with his therapist about a family of kittens who had been kidnapped and were found. Roth said that the child told his therapist, "Now we can finish therapy, because the kitties are back home."