Ramzi al Burai knows better than most what it means to be imprisoned. This week's botched commando raid on the flotilla of pro-Palestinian aid activists trying to reach Gaza has swung the global spotlight on the Israeli-imposed blockade as never before, but the Al Burai family have been living that reality for the past three years.
Their severely disabled son, Taysir, requires round-the-clock care. Neither Ramzi nor his wife can leave the five-year-old for longer than an hour. Part-asphyxiated during delivery, the boy suffers from an acute neurological disorder. He is unable to talk properly, suffers spasms and anti-convulsant medication has left him partially paralysed.
If his parents could only get him to Germany, or even just across the border to Israel, he would be able to get the specialist medical care that doctors say could lead to a full recovery. Ramzi has repeatedly appealed to the Israeli authorities to allow his son out of the tiny coastal enclave, but has been refused each time.
"My son is the one paying the price of this blockade, nobody else," his 37-year-old father said, sitting in a tiny flat in Gaza's Jabaliya refugee camp. "We can't do anything for him right now: we don't have the medicine."
Three years after Israel and Egypt virtually sealed their borders with Gaza in a bid to weaken the Islamist movement Hamas, the Palestinian residents of the Gaza Strip are deep in despair. Militarily, Israel can boast of success. Hamas, isolated by the siege and cowed by a devastating 22-day military offensive at the end of 2008 that killed 1,400 Palestinians, does not fire many rockets these days at Israel.
But there can be little doubt the civilian population, not Hamas, is suffering from the siege, which has brought a once-thriving economy to its knees.
Gazans are dying from vastly inferior healthcare while Israel denies entry to all but essential goods, forcing traders to smuggle provisions in through a network of tunnels along the Egyptian border, which has given rise to a parallel economy. A land and sea blockade means none but a fortunate few can leave.
At Gaza's al-Shifa hospital, doctors gaze morosely at a grey building that is only half-built. It was supposed to be the hospital's new wing, designed to boost capacity by 30 per cent, but construction was abandoned after the siege prevented any building materials from getting through.
That is perhaps the least of their problems. Doctors say they lack even the most basic equipment, such as sterilisers. Both of their CT scanners can be out of order for weeks at a time because it can take more than a month to obtain the spare parts. Many of the doctors have outdated skills, but cannot travel abroad for training.
"Health cannot be run only by pills and injections," says Mahmoud Daher, head of the World Health Organisation's office in Gaza. "You need a system surrounding this medication."
In a nearby ward, a 20-year-old Palestinian woman is fighting for her life. She suffered massive haemorrhaging after giving birth, and doctors say only an operation in Israel can save her. They have been waiting for Israeli clearance to transfer her for more than 24 hours. When asked what will happen if she is not moved soon, a doctor replies bluntly: "She will die."
Walking along the shorefront a short distance away from the hospital, one could imagine that Gaza City is like hundreds of other seaside towns. Children cartwheel in the surf and build sandcastles while their parents sit watching. Except, of course, Gaza is no ordinary place.
A Turkish flag flutters above a coastguard hut, taking prominence over the ubiquitous Palestinian standard. Gazans feel a deep sense of gratitude to the Turks, who along with hundreds of other peace activists made the failed attempt to breach the blockade with ships laden with humanitarian aid. Of the nine activists killed by Israeli commandoes four were Turkish.
Another ship, the Rachel Corrie, is steaming towards Gaza, but few expect it to get through. But the bloodshed has done what no tale of suffering could do: it has unleashed the wrath of the international community against Israel, and given Gazans a glimmer of hope that the siege is on its last legs.
This week, there have been signs of the blockade springing leaks. Egypt moved quickly to open its Rafah crossing, allowing students, patients and those with foreign passports to cross. In a single day this week, 793 Gazans were able to leave the Strip, and 548 came in, Interior Ministry figures show. Nearly 300 were refused permission to leave.
Although Israel has resolutely defended its policy, Prime Minister Benjamin Netanyahu indicated this week he would seek "creative" solutions to ease the situation in Gaza. How far Israel will go is unclear, because it has long insisted there is no humanitarian crisis in Gaza.
The economic collapse in Gaza is striking. A decade ago, annual per capita income in Gaza was $2,500, and some $400m of goods was exported to Israel annually. When Israel imposed the siege after Hamas seized power in 2007, per capita income fell to around $900. Last year, it was just $600, plunging most Gazans below the poverty line to survive on less than $2 a day.
By the most conservative estimates, unemployment runs at 45 per cent, and the UN Relief and Works and Agency says it gets some 40,000 applications for even the most menial jobs. About 80 per cent of the population is now dependent on UN food parcels, quarterly packages comprising rice, milk, flour, cooking oil, sugar and cans of meat. "We are not Darfur," says Palestinian economist Omar Shaban. "If you removed the siege, people could live as they do in the South of France. We have everything in our homes. But we deserve better lives."
Hundreds of Gazans have not been able to rebuild homes destroyed in the invasion as they cannot obtain the building materials, and children are forced to attend school in shifts. Farmers are unable to plough their lands and fishermen are restricted to a tiny area now empty of fish. And much of Gaza's sewage is pumped into the sea because sanitation facilities are poor.
The smuggling tunnels have brought some relief, but few can afford to buy the foodstuffs that line the shelves of Gazan grocery stores or the shipments of inferior Egyptian cement. But that lifeline could soon be gone: Egypt is building an underground steel wall that would sever the tunnels.
Although most Gazans know that Israel would instantly ease the blockade if Hamas released Gilad Shalit, the Israeli soldier captured in a cross-border raid four years ago, Hamas is basking in the reflected glory of the misjudged assault on the peace flotilla. "I blame Israel," says Hassan Hasuna, a Gaza shopkeeper whose profits have dried to a trickle. "I don't blame Hamas that much because they can't do anything."
On Gaza's shore, Samer, an English teacher, looks out to sea. He has long lost hope of anything different. "The only thing they don't blockade is the air we breathe," he says. "The sea is the last way for Palestinians to have fun."