KEY POINTS:
Ez Eldin Abu Sereai is sitting up in bed, gasping for breath. The 19-year-old's eyes are closed and he leans forward clutching a cushion.
His head is tipped backwards and he makes a rasping noise as his body rocks back and forward.
"Can you hear me, Ez?" Dr Fawzi Nabulsy says, trying to get a response from his patient. Ez's eyelids flicker for a second but no words come.
His mouth is wide open beneath an oxygen mask but he is barely conscious. Dr Nabulsy, a consultant in charge of the intensive care unit at Al Shifa Hospital in Gaza City, explains that Ez is suffering from renal failure and that his lungs are congested. "He needs dialysis or his chances of survival are not good. We cannot treat him here properly."
Later, we drive to the Rantissi Paediatric Hospital for Children, a facility with acute shortages of drugs and equipment. Atif Zourep has heart disease and we are told by staff that this 3-month-old Palestinian baby will die unless he is given permission for treatment in Israel. Consent, they say, could take anything from one week to two months, if a travel permit is granted at all.
Here, in Gaza, politics are being played with people's lives. According to medical staff, more than 200 people have died because of an Israeli economic blockade imposed since 2006.
The policy has impacted everywhere but effects have been felt most at Gaza's 13 hospitals where ambulances stand stationary and some operations are cancelled.
Staff claim that cancer patients have died because of a shortage of drugs for chemotherapy and because travel permits to leave Gaza for treatment have been refused.
It's a man-made humanitarian crisis that Nobel peace laureate Desmond Tutu recently described as an "abomination".
"My message to the international community," he added, "is that our silence and complicity, shames us all."
On 7 June 2007, a battle erupted in the Gaza Strip. A conflict fought between the political factions Hamas and Fatah, it pitched Palestinian against Palestinian to wrest control of probably the world's most volatile strip of coastal territory. Gaza, a densely populated sliver of land that is home to 1.5 million Palestinians, had been simmering with tension since the Islamist organisation, Hamas, won an astonishing victory in the January, 2006, parliamentary elections to usurp the ruling party Fatah.
Hamas - a legitimate resistance opposing a brutal military occupation to its supporters, but a group branded terrorists by opponents - said the election win was the people of Gaza's response to years of corruption by Fatah.
Hamas' success provided a political earthquake, but its ascendancy to power was anathema to many nations, not least Israel and the United States, which boycotted the Government and supported Palestinian Authority President Mahmoud Abbas and his Fatah faction with a view to ostracising the new regime.
But in a defeat for American interests in the Middle East, Hamas took control of Gaza in just over a week last summer to pre-empt a Fatah coup. During eight days of fighting the International Committee of the Red Cross estimated that more than 118 people were killed and 550 more injured.
The outcome was Israel's worst nightmare. Hamas - democratically elected and with the long-term aim of establishing an Islamic state in historic Palestine - was now in control of the Gaza Strip. Israel's response was swift and an economic blockade was tightened in an attempt to weaken and isolate its nemesis. One year on, and the pillars of Gaza's economy are crumbling, the effects of the blockade having proved catastrophic for the population. According to the United Nations, the unemployment rate in Gaza now stands at 45 per cent, one of the highest in the world. Moreover, it is claimed that people are dying unneccesarily. Cut off by land, sea and air, with no reliable power and little water, Gaza, according to its inhabitants, is being slowly strangled to death.
Driving through the Gaza Strip, it is clear this land is in economic meltdown. In many areas rubbish is piled high at the sides of roads due to collections being stopped, and the streets are largely deserted of cars. The odd donkey plods along pulling a cart, and the occasional melon stall is open, but bored men sit around on chairs on corners drinking tea and coffee for hours. Gaza, in many areas, has an empty feeling.
According to Oxfam, 150,000 workers have been laid off since the blockade began and 80 per cent of households now depend on food aid. One third of the population only has access to water for three to four hours every five days and meat is so scarce that rabbits are being smuggled in through tunnels at the Egyptian border.
In the Jabalia refugee camp, one of the poorest areas of Gaza, we meet 68-year-old Fatima Abu Jalhom and her family. There are 14 people living in three rooms and they survive on aid from the UN.
"We rarely get meat and things are getting worse," Fatima says wearily.
The fishing industry is one area of industry that is suffering terribly as Israel has imposed a six-mile limit for fishermen, as opposed to the 20 nautical miles set by the 1993 Oslo Accords. Israel says the limit is vital to stop weapons being smuggled into Gaza, but the fishermen claim it is a deliberate attempt to destroy their livelihoods.
Those who are ill suffer most and applications for medical help in Israel - funded by the Palestinian Authority - have increased sharply since the siege began jumping from about 600 a month at the beginning of 2007 to about 1000 a month by the end of the year. The Israeli human rights organisation, Physicians for Human Rights, says in a report that Israel's secret police are pressuring Palestinians in Gaza to spy on their community in exchange for urgent medical treatment.
For its part, Israel strenuously denies that it is involved in collective punishment against the people of Gaza and says the sole purpose of the blockade is to stop rockets being fired from Gaza into border towns such as Sderot.
Lior Ben Dor, a spokesman for the Israeli Embassy in London says that since September 2000, Hamas has perpetrated 425 terrorist attacks in which 377 Israelis have died and 2076 people have been wounded. These included 52 suicide attacks, in which 288 Israelis were murdered.
Despite a ceasefire being in place since June 19, 2008, 11 rockets and 15 mortars have been fired at Israel and between January and June 2008, 1075 rockets and more than 1204 mortar bombs have been fired at Israel from the Gaza Strip.
As a result of this, Israel says, it is faced with a dilemma in that it must protect its civilians from rockets while not being disproportionate with retaliation.
Sderot is said to be a town that never sleeps out of fear. A study last October of families living there reveals an epidemic of stress.
Twenty-eight per cent of adults suffer from post-traumatic stress disorder, while 57 per cent of children endure nightmares and other sleeping disorders. 92 per cent have experienced a rocket falling nearby, 56 per cent have experienced shrapnel hitting their home, and 65 per cent know someone who has been injured.
Dr Ronny Berger, who conducted the study for the Israel Trauma Centre for the Victims of Terror and War, says the statistics fail to show the true extent of the damage.
"Kids wake up in the middle of the night because of sirens and can't be calmed down," he says.
"The only Israeli soldier in Gaza today is Gilad Shalit, who was taken hostage two years ago," Ben Dor says, adding that the humanitarian problems in Gaza are the sole responsibility of Hamas, and nothing to do with Israel, which completely disengaged from the Strip three years ago.
"Israel has been supplying fuel, food, medical supplies and other humanitarian assistance in spite of incessant attacks carried out by Hamas and other organisations on the border crossings.
"It is apparent that Hamas is targeting the crossings in order to prevent the transfer of humanitarian aid to the civilian population, thus cynically depriving its own population and causing an artificial crisis in the Gaza Strip.
"Recent reports indicate that Hamas is allocating these supplies for its own use, thus deepening the deprivation of the public. Clearly, Hamas wants to create a crisis in order that international pressure will be placed on Israel," Ben Dor adds.
IT'S an impossible situation. Most people in Gaza tell us that Israel's siege is only entrenching attitudes and building more support for a military response. And these include children who grow up to believe they must fight Israel because of the suffering they endure.
On our way to interview a fighter with the Izz ad-Din al-Qassam Brigades, Hamas's military wing, we are joined in the car by the son of our driver. Majed, 14, is wearing a dark blue balaclava and a white scarf which shows an image of Yasser Arafat. The logo on his T-shirt shows a grenade, two M16 rifles and the Al Aqsa Mosque's Dome on the Rock.
We alight the car and are taken to a room to have five minutes with an armed man who is about to begin a night-shift patrolling the town of Beit Hanoun. His head is swathed in a keffiyah and he fidgets while holding a Kalashnikov rifle.
"You've to hurry," says the translator.
"Will the current ceasefire hold?" I ask.
"I can never see any peace with Israel. They are our enemies," he says.
"Are Jewish women and children legitimate targets?"
He shakes his head vigorously and wags his finger at me. "No, no, no. Only the Israeli soldiers who attack us. We are not terrorists. We are only defending ourselves," he says.
"Why not stop the rocket attacks?"
"We have stopped in the past few weeks but nothing changes for us in Gaza. We have home-made rockets and they have jet fighters, apache helicopters and tanks. No one cares about a Palestinian death. Why are Israeli lives worth more in the eyes of the world?"
"But is the human suffering worth it?"
"If they keep hitting us, we'll keep hitting them."
Human rights groups such as Amnesty International and Human Rights Watch have criticised both the Israeli Defence Force and Hamas for their roles in this crisis, but as the blockade continues, time is running out for patients such as Ez and Atif.
