I’ve visited the Gaza Strip for each of the past six years, including in 2014 a few months after Israel’s devastating military assault. And yet, I’ve never seen Gaza like I did when I had the privilege of visiting this summer.

I call it a privilege because, due to the blockade of Gaza imposed by Israel (with the support of Egypt), which is part of Israel’s now 50-year-old military rule over Palestinians in the occupied territories, internationals allowed in and out of Gaza are few, and Palestinians even fewer. This illegal land, air, and sea blockade, which has just entered its tenth year and amounts to collective punishment, as has been noted by the UN and human rights groups, has decimated the economy of Gaza and allowed for the near complete destruction of critical infrastructure. Experts use the term “de-development” to describe this once-bustling Mediterranean coastal enclave of two million Palestinians.

Nearly half the population are now unemployed and 80% rely on humanitarian assistance from organizations like UNRWA, the United Nations Relief and Works Agency for Palestine Refugees in the Near East. Nearly one million refugees require UNRWA food assistance now, up from 80,000 people in 2000, before the blockade was in place. At its heart, UNRWA is a human development agency, running the largest and one of the best performing public school system in the entire Middle East, 10 times the size of DC Public Schools. But due to decades of Israel’s dispossession, occupation, and systematic oppression of Palestinians, UNRWA is forced to prioritize emergency interventions like food assistance and emergency protection. It’s an affront to humanity.

Upon arriving in Gaza, which requires a permit from Israel and extensive humanitarian coordination, I immediately saw the crippling effects of the ongoing electricity crisis which has been wreaking havoc since March. Electricity is now only available for 2-4 hours a day, a situation that has been exacerbated by internal Palestinian political divides. This has brought life to a near complete stop for many in Gaza, and has enormous public health and environmental implications. In 2012, the UN determined that if trends continued, Gaza wouldn’t be liveable in 2020. Today, the effects of the blockade, recurring violence, and now the electricity crisis have led the UN to conclude that Gaza is basically already unlivable.

The first day of my visit, I visited a water pumping station at Al-Shati refugee camp by the coast. There, I witnessed raw sewage pumping directly into the water. The sewage would normally flow to a treatment plant, but without electricity, that’s not an option. Instead, it pumps directly into the sea, not far from where people swim and fish. Their fish will be contaminated, just like their water. The sea, which is at the heart of Gazan culture, now poisons them. Despite more than 65% of the shoreline being unsafe for humans, people continue to go to the beach because it’s the only source of relief left during the sweltering summer.

At an UNRWA health clinic, I met with doctors and nurses who are facing the challenges of the electricity crisis both at work and home. A nurse shared with me that she wakes up at 2 am to do her family’s laundry because that’s usually when she has electricity. A doctor told me that he only gets 3-4 hours of rest each night because the heat keeps him awake. Regardless of their personal struggles, they both come to the clinic every day committed to providing quality healthcare for their fellow Palestine refugees.

Because the medical equipment runs on a different current than the clinic’s back-up generator, x-ray, ultrasound, lab testing machines and others aren’t able to run at full capacity, and the machines will break down much sooner than they should. The World Health Organization warns that at least 30 hospitals, 70 primary health care centers, and a blood blank in Gaza are at severe risk of full or partial closure due to continued power outages and not enough fuel or spare parts for back-up generators. It’s a health catastrophe in the making.

Skin rashes from heat and bacterial infections, potentially from direct exposure to sewage, are on the rise. In August, it was reported that a five-year-old boy in Gaza died from a brain disease caused by bacteria in the contaminated sea. Cases of psychosomatic illnesses and psychological stress continue to increase too, particularly among children.

An UNRWA counselor I met shared the story of an 11-year-old girl who had recently attempted suicide. One man told me they continue to swim and fish despite the dangers because death would be a relief at this point.

With the stress of simply surviving as great as it is, it’s not surprising that many have little energy left to have hope for the future. The two million people in Gaza are the victims of cruel politics — collateral damage in a cynical political game.

Palestinians in the besieged Gaza Strip deserve humanitarian support, but no amount of assistance will ever substitute for the necessary political action, including that of the US, to stop the violation of human rights that Palestinians face on a daily basis. Lifting the blockade on Gaza would be a start.

About Abby Smardon

Abby Smardon is Executive Director of the United Nations Relief and Works Agency (UNRWA) USA National Committee