Punishing years under siege, Cast Lead's devastation, and regular IDF air, land and sea attacks took a terrible toll on Gazans physically, economically and emotionally.

In 2010, Doctors Without Borders (Medicine Sans Frontiers) said over half of children under age 12 need mental health help. Moreover, one-third of cases are severe.

Gaza Community Mental Health Program PR Director Husam El Nounou blamed crisis conditions on closure and regular Israeli attacks. Begun in 1993, it stiffened markedly after the second Intifada began.

Following Hamas' January 2006 legislative victory, harsher people traffic and goods restrictions were imposed. In June 2007, siege compounded partial isolation. As a result, hopelessness, virtual imprisonment, and regular Israeli attacks affect all Gazans, especially young children and youths.

According to Husam:

"The effect is most felt by those who are in greatest need of travel such as students studying abroad, the sick requiring medical attention unavailable in Gaza, and people whose work requires them to travel or trade in exports and imports."

The World Health Organization (WHO) calls the link between physical and mental health well documented. Closure caused food shortages. Nutritional deficiencies and poor physical health resulted. In combination with inadequate healthcare and other deprivation, emotional problems developed.

Without imports and spare parts, sanitation facilities can't operate properly. According to a Gaza Mental Health Community Program study, mental health outcomes deteriorated markedly in the past five years. Depression increased 17.7%, and 95% of those surveyed felt imprisoned.

Cast Lead and regular Israeli attacks heighten crisis conditions. Over 82% of Gazan children felt endangered during Cast Lead. Two-thirds fear more war, and over 40% want revenge.

Other research found similar results. Islamic University in Gaza's Jameel Tahrawi analyzed children's drawings. He found over 82% related to Cast Lead. A comparable UN study found two-thirds of respondents experienced worse health outcomes since the war. In most cases, it's emotionally related.

According to Husam, "(w)omen especially tend to bury mental health problems as they may reduce chances of marriage."

In contrast, men become more violent. Women and children bear the brunt. Children are less attentive in school. Their educational outcomes and later life opportunities suffer. Feelings of entrapment result.

Isolation prevents overseas study to develop professional mental health skills. To compensate, the Gaza Mental Health Program began a post graduate mental health intervention course to train practitioners.

Nonetheless, conditions remain critical and won't improve until siege conditions and Israeli attacks end.

A Final Comment

In mid-February, a power crisis gripped Gaza. Out of fuel, the Strip's power plant can't operate properly. Protracted outages occurred. An acute fuel shortage exists. Vital services can't function. Drinking water, health and sanitation facilities are affected.

On February 14, the Gaza Electricity Distribution Company shut down operations. Around two-thirds of Gaza was affected. Citing unprecedented challenges, the company said severe complications restricts daily electricity distribution to six hours daily, followed by 18 hour outages.

Gaza's Health Ministry declared a state of emergency. Hospital generators lack enough fuel to operate properly.

Health Ministry's General Supplies Stores director Bassam Barhoum said long outages combined with acute fuel shortages affect the entire Strip. The deficit's 72%. The toll on hospitals and other healthcare facilities is devastating.

According to Health Ministry spokesman Ashraf al-Qidra, over 80% of patients face deteriorating health conditions. He also warned disaster may affect all patients in vital hospital department whose treatment depends on dependable electricity supplies.

Those most affected include premature incubator babies, patients suffering renal failure, those requiring intensive care, and others needing surgery and emergency treatment. In fact, many departments face total paralysis if crisis conditions don't end soon.

The Coastal Municipalities Water Utility (CMWU) warned it's unable to supply water in proper amounts. It said despite efforts to operate wells and pumping plants, it's impossible to do so properly under current conditions.

Gaza's Palestinian Energy Authority blamed lack of fuel on measures to prevent delivery. Israel used to supply industrial fuel. Frequent border crossing closures, denial of regular supplies, and high prices got the Palestinian Energy Authority to stop Israeli imports in January 2011.

Instead, it relies on Egyptian supplies. Much comes smuggled through tunnels. Egypt agreed to supply more. On February 20, limited amounts arrived. Egyptian authorities pledged much more and would begin pumping 500,000 liters daily followed by another 100,000 for gas stations within days.

They also pledged to increase electricity supplies to 22 megawatts from 17 megawatts supplied free. Moreover, a deal struck with Egypt will increase electricity flows to 62 megawatts within two to four months.

In addition, emergency diesel will be provided. Egypt's electricity and power minister Hassan Younes said "(t)he increase comes in the framework of a quick attempt to relieve the suffering of the Palestinian people."

Regular shipments will arrive by truck through Israeli controlled Kerem Shalom crossing. Hamas fears it will restrict supplies to inflict punishment.

Gaza's Energy Authority director Omar Katana hopes crisis condition will be resolved shortly. Egypt agreed to help. A joint Egyptian-Palestinian committee was formed to examine best ways to deliver fuel through "official channels."

Various power routes are being considered. In addition, expanding power line capacity and rehabilitating Gaza's power plant take on urgency.

Meanwhile, crisis conditions still exist. Operating normally under siege is impossible. Israel's closure prevents imports of vital equipment and spare parts needed for maintenance and upgrades.

At full capacity, Gaza's power plant produces 80 megawatts of electricity. Katana hopes planned cross border transmission capability increases will boost it to 300 megawatts.

Costing $50 million, it requires 18 months or longer to "resolve the Gaza problem once in for all" provided Israel doesn't wage war and destroy it.

Earlier Gaza Blackouts

Following Gilad Shalit's June 2006 capture, Israel bombed Gaza's power plant, destroying its transformers. The damage was never fully repaired. Current capacity combined with purchased electricity supplies only 62% of Gaza's needs.

In October 2007, Israel restricted fuel transfers, including industrial diesel for Gaza's power plant. After months of shortages and outages, supplies came through tunnels at lower prices.

In 2010, after EU diesel fuel payments stopped, Hamas bought supplies from Egypt. However, no formal agreement was reached. So Egypt can cut or stop supplies if it wishes.

Moreover, Fatah and Hamas dispute responsibility for Gaza's energy. Agreed reconciliation didn't resolve it. In addition, tunnel supplied fuel is cheaper than other supplies. Moreover, Israel controls three border crossings, including for fuel. Kerem Shalom isn't designed for its transfer and has limited capacity.

If Fatah and Hamas can resolve differences and Israel doesn't impose punitive restrictions, these obstacles can be overcome. At issue is will all sides cooperate for the welfare of 1.7 million Gazans?

Stephen Lendman lives in Chicago and can be reached at <mailto:lendmanstephen@sbcglobal.net>lendmanstephen@sbcglobal.net.

Also visit his blog site at sjlendman.blogspot.com and listen to cutting-edge discussions with distinguished guests on the Progressive Radio News Hour on the Progressive Radio Network Thursdays at 10AM US Central time and Saturdays and Sundays at noon. All programs are archived for easy listening.

<http://www.progressiveradionetwork.com/the-progressive-news-hour/