If you still don't know what the siege is like, read this:
Gaza: abandoned, embattled and divided
GAZA is like a melancholy reflection of Monaco. An enclave of misery and isolation on sparkling Mediterranean shores.
Wedged between Israel, Egypt and the sea, the territory is home to 1.5 million Palestinians who are unable to leave its 360 square kilometres. At war with Israel, forsaken by Egypt, abandoned by the rest of the Arab world that had promised succour, Gaza is now implacably divided.
On one side are the Gazans aligned with Fatah, the political faction of Yasser Arafat and the only internationally recognised voice of the Palestinian people. On the other side are the supporters of Hamas, the Iranian-backed Islamic movement that won control of Gaza in May 2007.
Since then, the world has looked on as all those who oppose Hamas have played a role in sealing Gaza off from the outside. With no commercial imports or exports allowed by either Egypt or Israel, the Gazan economy has been virtually destroyed. Unemployment stands at about 60 per cent, and 70 per cent of the population depend on handouts from the United Nations for their daily food requirements.
As fighting between the Palestinians and Israelis has resumed over the past six weeks, leading to the collapse of the fragile ceasefire that had been in place since June, the situation inside Gaza has deteriorated even further.
With not enough diesel to run the power stations, electricity supply is fickle. Most homes get power for only a few hours a day.
Without fuel to run the water treatment plants, raw sewage is being pumped directly into the sea and on open land.
"Everyone is haunted with despair, with the feeling that the place is going somewhere we don't know," says the psychiatrist Dr Eyad el-Sarraj, founder and president of the Gaza Community Mental Health Program and a commissioner of the Palestinian Independent Commission for Human Rights. He estimates
a third of Gaza residents are showing signs of deterioration in their mental health that requires medical intervention.
"Lack of sleep, aggressive behaviour, intense anxiety, loss of appetite, mood swings, depression - the psychological impact of the siege is massive," he says. "The first question from people, whether they are patients or they are counsellors, is: 'What is going to happen to us? Where are we going, where are we heading? You must know better than we do."'
He adds: "Of course I do not know, and I have the same questions."
Because there are no emaciated bodies in Gaza, or people dying of malnutrition, the humanitarian crisis here can appear less compelling than others around the world.
But the longevity of the conflict and its relentless impact on people's daily lives make it no less harrowing, and not just for the people living inside Gaza.
The Israelis who live in the towns and farmlands that surround Gaza have been terrorised by the launch of about 3000 homemade Qassam rockets fired at them by Palestinian militants over the past 12 months.
"What I am trying to deal with here is the consequences of political failure," says John Ging, the director of operations for the UN Relief and Works Agency for Palestine Refugees in Gaza. "It's a massive humanitarian problem that is growing every day.
"Whoever you want to blame, the ordinary people are the ones who are paying a very heavy humanitarian price, by being stripped of their human dignity and their very survival here being reduced to a subsistence level."
Apart from the private homes of a wealthy few, or inside the few hotels frequented by non-government aid workers or foreign media who are allowed to enter Gaza, almost every aspect of life in Gaza appears to be in disrepair.
The roads are mostly ruined and strewn with refuse, half-completed buildings stand frozen in time, office buildings are empty and on most corners groups of men stand idle.
Perhaps the most acute area of disrepair is Shifa Hospital, the largest health provider in Gaza. In some cases, the Israeli and Egyptian authorities will allow patients through their borders to receive specialist medical treatment. But
many who apply to leave for medical reasons have their requests denied for security reasons.
Dr Faouzi Nabulsi, who heads the hospital's intensive care unit, estimates that
since May last year there have been about 300 deaths that could have been avoided if the borders were open.
Dr Nabulsi led the Herald to the bed of 20-year-old Hamza Shahien, a cameraman for the Hamas-run television station Al-Aqsa TV. On December 9, Shahien was injured by a shell fired from an Israeli drone that was targeting militants who had fired Qassam rockets into Israel. He had both legs amputated below the knee.
"The problem we face now is septicaemia," Dr Nabulsi said. "
We don't have the drugs to treat him here and without those drugs he will die. The infection will kill him. We have tried to get him out to an Israeli hospital, but he has been refused because they say he is a security risk."
At the hospital's nephrology department, which treats kidney disease, Dr Nafez Eneim says he has 28 kidney dialysis machines operating for 16 hours a day.
Another 12 machines cannot be used because the spare parts to repair them cannot be brought in.
"They tell us that the electronic plates we need to repair the machines and other spare parts could be used for other things, that they are a security risk," he says.
Daily power cuts at the hospital present other challenges. After each, the dialysis machines have to be reprogrammed, taking about five minutes each - and any blood in them has to be drained because of clotting risks. Tubes then have to be changed, the machine sterilised, doubling the running costs and using supplies twice as fast.
"No one is dying in my ward because I cannot give them care," he says. "But their lives are being shortened, and the quality of their life is reduced."
Life in the commercial world is equally fraught by the closure of the borders.
Faysal Shawa, the secretary-general of the Palestinian Businessmen Association, and from a prominent Palestinian business family, owns several factories and once employed several hundred workers.
When Israel ended its occupation of Gaza in 2005, Shawa says there was a mood of great optimism on all sides and he invested about $US1.5 million in an asphalt factory. "
You know how long it operated? About 50 hours. I finished the factory in early 2006 and already things had got so bad I could never get the raw materials in. Without raw materials, I cannot make asphalt. So I close the factory.
"This is the story all over Gaza. Since last year, we estimate
around 4000 factories and businesses have closed for this reason. One hundred thousand jobs have been lost."
Chronic shortages of items such as cooking gas mean that Gazans face major challenges just to heat their food.
For Rabah Kahlout, an unemployed metalworker who lives in the Jabaliya Refugee camp, a 1.4 square kilometre area that houses about 100,000 people, one solution was to modify an old LPG cylinder and fill it with kerosene.
By attaching a bicycle pump to a valve he drilled into to the cylinder, he can create enough pressure inside to produce a jet strong enough to cook on.
So what keeps Gaza from disintegrating completely?
First, the Palestinian Authority, in the West Bank capital of Ramallah, has continued to pay the salaries of public servants, guaranteeing a trickle of money into Gaza. Other sources of income include the likes of the Red Cross and other aid organisations, and the large United Nations missions.
Second, the black market, which is supplied by a network of tunnels under the border with Egypt, delivers all kinds of food, fuel, electronic equipment and other goods. Operated in open view of the Egyptian authorities despite an official ban, the tunnels have created a new class of corruption.
"At first, the smuggling was good. We got food, of poor quality, but better than nothing," el-Sarraj says.
"But now we have new warlords. People die digging tunnels and smuggling in these goods, and if Egypt wanted to, they could shut them down tomorrow. So why can't we trade openly? This is all about politics, nothing else."
There are some islands of creativity and relief. Foreign aid has helped start programs such as the Qattam Music Foundation, which began in October to teach 35 children the violin, piano, guitar and Arabic string instruments, the qanoon and oud.
"Our biggest concern at first was Hamas, who worried that other Islamic nations would disapprove of allowing music programs," says the program's director, Ibrahim al-Najjar. "But Palestinians have always been a musical people so we have started and we will continue, God willing."
If there is any chance of peace or of ending the relentlessly debilitating humanitarian situation in Gaza, the rhetoric of both sides is not encouraging.
Dr Ahmed Youssef, a political adviser to the Hamas Prime Minister, Ismail Haniyeh, told the Herald that unless Israel was prepared to open the borders, then Hamas was prepared for an intensive military campaign.
"
History tells us that without you standing and defending yourself nobody will come to save you." Militants declare early end to truce agreement
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