Israel prohibits construction material imports, including cement, gravel, wood, pipes, glass, steel bars, and more compared to an average of 7,400 monthly truckloads pre-siege. Israel calls them "dual use" items that Hamas can use for military purposes. Their ban, in fact, is to harass, hold 1.5 million Gazans hostage, break their will to resist, hope many will give up and leave, and for those who stay destroy them by slow-motion genocide.
Besides essential food and medical care, Gazans' most urgent need is for construction materials to repair and rebuild homes and other structures now in ruin. A joint UNWRA - UNDP survey showed that 3,540 homes were totally destroyed, 6,400 heavily damaged, and another 52,900 less so. As of July 2009, many thousands are still displaced, their lives severely disrupted, especially for those living in tents.
"Anecdotal evidence suggests that children are among the worst affected by displacement, including many who were relocated to alternative schools closer to their place of alternative accommodation."
Besides homes, many thousands of other structures need to be rebuilt or repaired, including many with major damage. But without construction materials, it's impossible except for rudimentary, make-do ingenuity such as efforts getting the most out of whatever materials are available.
In other ways, humanitarian agencies help out by supplying blankets, tents, mattresses, clothing kits, kitchen sets, and other items Israel lets in. Some families also get small cash assistance through UNWRA for refugees and UNDP for others, but serving the needs of 1.5 million people means precious little gets done overall.
Despite the obstacles and Israel's hostility, a number of organizations, including UN agencies, are actively seeking ways to help, including initiating vitally needed reconstruction. The UN Special Coordinator for the Occupied Palestinian Territory asked Israel's Defense Minister to open border crossings and let in construction materials to begin work on housing, health and education facilities, suspended for over two years. Thus far, no response was received, but not enough pressure is put on for it, nor does any come from nations mattering most like America.
A Protracted Energy Crisis
After Gaza was declared a "hostile entity" in September 2007, Israel cut the amount and types of fuel let in, including benzene, diesel, cooking gas, and industrial fuel. A protracted crisis followed affecting key services gravely and Gazans' ability to run their households.
Electricity is the main problem because Gaza's sole power plant can't supply enough of it. Production levels were previously cut after Israel destroyed six electric transformers in June 2006 during Operation Summer Rain in Gaza and Operation Change of Direction against Hezbollah in Lebanon during which vast amounts of carnage were inflicted and many hundreds of lives lost in both conflicts combined.
At full capacity, Gaza's power plant supplies less than one-third of the Strip's needs. Lacking enough fuel, it's operating at three-fourths capacity at best. When available, the rest is bought mainly from Israel plus smaller amounts from Egypt. As a result, public institutions rely heavily on backup generators and other devices that are extremely dependent on a spotty availability of spare parts, so are very vulnerable to breakdowns.
A Challenged Health System
Gaza's ability to deliver proper health care is severely compromised by a lack of virtually everything, including building materials to expand for a growing population. Power shortages force suspension or postponement of vital surgeries because of the risk to patients. Proper medical equipment is in short supply, and what's available is hampered by a lack of spare parts and the ability to get them. Inadequate amounts of pharmaceuticals and other supplies are a constant problem. As of July 2009, 77 essential drugs and 140 disposable items were out of stock with no easy way to replace them due to blockage restrictions.
In addition, few patients can leave Gaza for vital treatment elsewhere. Getting approval is time consuming, arduous and uncertain, thus compounding a dire situation, even for the severely ill who without access to a full-functioning facility have little chance to survive. Some give up after trying. Others die awaiting approval that doesn't come. The Gaza Ministry of Interior estimates that hundreds of patients can't travel due to the lack of a passport alone and no simple way to get one.
During and in the aftermath of Operation Cast Lead, Gazan medical teams were severely challenged to work around the clock under dangerous conditions to provide care for the hundreds of patients in need, many with very severe injuries. They performed courageously and tirelessly treating an estimated 5,300 injured, many with multiple and complex wounds. They also treated hundreds with chronic illnesses, but not optimally given the lack of vital resources.
Psychological trauma also proved challenging, especially for children given the lack of safe havens and almost constant bombardments and ground attacks. As a result, people lost "the most basic sense of security, which is one of the foundations of overall psychological well-being." WHO estimates that from 20,000 - 50,000 will suffer long-term consequences, and for some it will be permanent.
Problems, especially for children, are sleeping disorders, loss of appetite, difficulty concentrating, inability to conduct normal activities like dressing, washing, household chores, and for about one-fourth of them repeated bed-wetting.