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.
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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 Many of the doctors have outdated skills, but cannot travel abroad for training.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."
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