Palestinians in Gaza are largely forgotten. They are an invisible people inhabiting a world without rights and possibilities. Over Israel’s near 50-year occupation, Gaza and the West Bank were reduced from a lower middle-income economy to a dysfunctional economy disproportionately dependent on foreign assistance. Gaza is under immense pressure from a continued blockade, now in its tenth year. Egyptian restrictions on the movement of people through Rafah, “which has remained largely closed... since October 2014, including for humanitarian assistance”  increased internal discord and hindered intra-Palestinian reconciliation.
There are stunningly high levels of unemployment and poverty. According to the World Bank, unemployment currently stands at 43 percent and in excess of 60 percent for Gazan youth. Yet, while Gaza’s economic demise is well documented, the blockade’s societal impact is often neglected. The blockade created a series of long-term, chronic conditions in Palestinian society,  including the destruction of civilian space, changes to social structure and health status, widespread trauma, a dramatic change in popular attitudes, and finally, a widening generational divide.
As United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) Spokesman Chris Gunness notes: “The juxtaposition of hopelessness and despair, contrasted with the transformational potential of Gazan society, has never been so palpable.”  According to the World Bank, the Israeli blockade alone—which has severed almost all of the territory’s ties to the outside world, virtually terminating Gaza’s critically needed export trade—decreased Gaza’s GDP by at least 50 percent since 2007.  Egypt’s near total termination of Gaza’s tunnel trade—a vital, albeit underground economic lifeline—dealt an additional and extremely damaging blow. On top of this, the 2014 Israel–Gaza conflict, or Operation Protective Edge (OPE), worsened an already bleak situation by reducing Gaza’s economy by an additional $460 million.
This set in motion what one local analyst called a “dynamic of disintegration" that produced a range of unprecedented socioeconomic changes. Combined with the ruinous impact of the blockade, OPE was resulted in extensive damage to or destruction of homes, schools, health facilities, factories, businesses, sewage and water treatment infrastructure, and agriculture — effectively resulting in the destruction of civilian space. At least 100,000 people found themselves homeless, resulting in an estimated 75,000 being displaced, 11,200 being injured, at least 1,000 becoming permanently disabled, and 1,500 children becoming orphaned. 
Gaza’s society was radically leveled, particularly with the virtual destruction of its middle class and the emergence of an unprecedentedly new class of “poor.” Perhaps emblematic of the damage done to society, particularly since the imposition of the blockade, is Gaza’s rising infant mortality rate (IMR). IMR not only measures the health status of children, but also of the whole population. For the first time in more than 50 years, the IMR in Gaza increased from 20.2 per 1,000 live births in 2008 to 22.4 in 2013. Neonatal mortality rates, or the number of children who die within four weeks of birth, experienced a dramatic increase from 12.0 in 2008 to 20.3 in 2013, an uptick of nearly 70 percent. In Gaza, there is also a documented rise in domestic violence and child labor, as well as considerable anecdotal evidence for an increase in prostitution. No doubt the blockade, coupled with the last three wars in Gaza, is a contributing factor.
According to local health officials, 80 percent of adults in Gaza suffer from some form of post-traumatic stress disorder. During OPE, all sectors of the Strip were subject to or threatened with some kind of attack. According to Yale Professor Brian Barber, “OPE was uniquely crippling because no one was free of risk, and no place was safe to find refuge. It was, in a sense, universally and inescapably terrorizing.” Every child over the age of six has seen three wars, and at least 400,000 children are in need of immediate psychological intervention, according to the UN. As a result, OPE has created a profound sense of collective dread and desperation that has less to do with the war than the inhuman conditions left unchanged since the war. People have never felt less safe and secure or more devoid of hope.
The people of Gaza once maintained more nuanced views of Israel, but now see little possibility for peace. There appears to be a greater generational divide between the “older” Oslo generation (and earlier cohorts), who had some insight into Israel and the world beyond, and those born since Oslo, who have little insight, if any. Gaza’s population is very young, with nearly half of the population being 14 years of age and younger. This is extremely dangerous, especially in the absence of effective leadership and in an environment that offers so little. Furthermore, the generational divide appears to be shifting. Young people, some reportedly as young as 10-12 years, are assuming responsibilities reserved for individuals far older. Children are forced out of school to work and help support their families; in some cases, they even head households.  Even before OPE, almost 30 percent of all young people aged 16-17 were out of school in Gaza and the West Bank. People, especially the young, are acutely aware of what they are being denied. How long can they be expected to accept their own deprivation?
Reconstruction is so painfully slow that no one in Gaza, save international organizations, discusses it anymore. By November 2015, only 170 homes out of 18,000-19,000 destroyed or severely damaged were rebuilt.  By April 2016, according to the UN, nearly 3,000 homes were rebuilt or made livable. Not surprisingly, “an estimated 1.3 million people [out of a total population of 1.8 million] are in need of humanitarian assistance in the Gaza Strip in 2016.”  These people have a range of skills, but are deliberately denied the right to work by Israel, the United States. and the European Union. They are instead forced into a debilitating dependency on foreign aid. Foreign donors are almost non-existent in the context of reconstruction, because the majority of promised monies—approximately 65 percent--has yet to materialize.  Even if donations were waiting to be funneled in, longstanding Israeli restrictions obstruct the importation of needed construction materials, despite an easing of certain restrictions in recent months.
Because of security concerns, Israel prohibits the entry of a range of items into Gaza, , including wooden boards thicker than 1cm.  Thus, many Gazans must salvage building materials, yet another example of the normalization of violence and illegality, which the international community continues to accept. An official with the Israeli human rights organization, Gisha - Legal Center for Freedom of Movement, captured Gaza's situation, noting: “In the rest of the world we try to bring people up to the humanitarian standard. Gaza is the only place where we’re trying to push them down—to keep them at the lowest possible indicators.”  The assistance provided by international donors is not meant to raise people out of poverty, but to maintain their survival within it. It is not meant to alter the structures of unemployment and dependency, but to sustain and reinforce them. It is not meant to alleviate the causes of suffering but, simply, to manage them.
What will happen when Palestinian despair defines Palestinian identity?  Will Israel respond, as it long has, by building more barriers and inflicting more misery? Will the international community respond by providing more sacks of flour and bags of rice? Palestinians working in major media outlets were recently instructed by their home offices not to cover Gaza in depth. “Barring a major event” they were told, there were to be “no human interest stories, no day-to-day coverage, and no focus on suffering." This is, the media staff are told, in order “to diminish any linkage with the West Bank and any understanding of Gaza and what has happened to it. Gaza is abandoned in "the middle of nowhere.”  As long as occupation and colonization continue, there can be no resolution and no conclusion. What Gaza needs, what all Palestinians and Israelis need, is for the occupation to end and for liberation to begin.
 United Nations Office for the Coordination of Humanitarian Affairs OPT, Gaza: Internally Displaced Persons, April 2016, p. 4.
 For a more detailed discussion of social impacts, see Sara Roy, “Afterword – The Wars on Gaza: A Reflection;” in The Gaza Strip: The Political Economy of De-development, Third Edition (Washington, DC: Institute for Palestine Studies, 2016); and Sara Roy, UN Security Council Arria-Formula Presentation on Gaza, in Israel-Palestine Non-governmental Organization Working Group at the United Nations, Reflections One Year Later and Charting a New Course for Gaza—UN Security Council Arria-formula Meeting, United Nations, New York, July 20, 2015.
 “Interview: The UN in Gaza,” Middle East Policy, Vol. XXIII, No. 1, Spring 2016, p. 145.
 World Bank, Economic Monitoring Report to the Ad Hoc Liaison Committee (Washington, DC: World Bank, May 27, 2015), p. 6.
 See Roy, “Afterword – The Wars on Gaza: A Reflection,” pp. 398-399, 415-416; Human Rights Council, Report of the Independent Commission of Inquiry Established Pursuant to Human Rights Council Resolution S-21/1, Executive Summary, June 24, 2015, pp. 6-7; Human Rights Council, Report of the Detailed Findings of the Independent Commission of Inquiry Established Pursuant to Human Rights Council Resolution S-21/1, June 24, 2015, p. 154; and United Nations Office for the Coordination of Humanitarian Affairs OPT, Gaza: Internally Displaced Persons, April 2016, p. A.
 Email exchange.
 Sami Abdul Shafi, “Economic Shift in EU Policy in Palestine: Capturing Lost Opportunity; Restoring Dignity,” Chatham House, September 2015, Draft.
 Security analyst, Jerusalem, November 2015.
 United Nations Office for the Coordination of Humanitarian Affairs OPT, Gaza: Internally Displaced Persons, April 2016, pp. 1 & 10.
 As of September 2015.
 In October 2015 Israel reported that gravel would be removed from the dual use list, but 19 items remain, many of them critical for reconstruction.
 Cited in Lani Frerichs, “Belligerent Occupation and Humanitarianism in Gaza,” A.M. Thesis, Center for Middle Eastern Studies, Harvard University, April 25, 2010, p. 8.
 “Interview: The UN in Gaza,” Middle East Policy (Spring 2016).
 Telephone conversation, November 2015.