Executive Summary

For nearly 17 years, Israel has imposed a stifling blockade on the Gaza Strip, affecting all its vital (social, economic, and humanitarian) sectors. Despite the humanitarian situation of Gaza reaching an unprecedented deterioration and the succession of eight Israeli governments since the beginning of the blockade, Israel has maintained its collective punishment policy against nearly 2.38 million Gazans in a way that clearly exposes Israel’s intention to inflict great material and moral damages on them.

Israel imposed its blockade on Gaza after Hamas won the legislative elections in January 2006. Greater restrictions and sanctions were imposed in mid-2007 after Hamas took full control of the Strip.

Israel also carried out repeated military attacks—including four major attacks, the last of which was in May 2021—against Gaza, causing the almost complete disruption of the economy and production, the destruction of large parts of the infrastructure and economic facilities, and the death and injury of thousands of unarmed civilians.

The blockade caused the multiplication of the humanitarian crisis indicators in Gaza. For instance, the unemployment rate has risen from 23.6% before the imposition of the blockade in 2005 to 47% at the end of 2022—one of the highest rates in the world. Likewise, poverty has risen sharply due to Israeli restrictions from 40% in 2005 to 61.6% in 2022.

Gaza’s economic indicators plummeted due to the blockade. The long closure procedures, the ban on exports and imports, and the destruction of factories and economic facilities during the military attacks left heavy losses in all economic and productive sectors. The most recent military attack in May 2021 alone destroyed hundreds of economic facilities, with a total loss of about $400 million.

Moreover, since Israel prevents or restricts the entry of medicines and medical supplies into Gaza, the health sector is one of the most affected by the blockade, causing healthcare services to decline.

In this annually updated report, Euro-Med Monitor sheds light on the impact of the Israeli blockade on Gaza. It examines the most prominent humanitarian crises suffered by the population in Gaza, particularly in terms of the health, economic, and social aspects.

Isolated enclave

Israel has a long history of isolating the Gaza Strip and imposing numerous closures over the past two decades. However, the blockade imposed following the victory of the Hamas movement in the 2006 Palestinian Legislative Council elections was an unprecedented form of collective punishment. Israel declared the Gaza Strip a closed area and imposed penalties on the Hamas-led government, including restrictions on imports of fuel, and other goods, as well as the movement of people in and out of Gaza.

The blockade was further tightened in 2007, when all kinds of fuel, including gasoline and diesel, were restricted, along with goods such as meat and biscuits. In addition, the fishing zone was limited, and all border crossings were closed.

Over the years, Israel worked to broaden and deepen the isolation of the Gaza Strip. One of the most draconian restrictions in its impact was Israel’s separation of Gaza from the West Bank. This separation policy restricted entry into and exit from Gaza, preventing university students and professionals from continuing their education outside the Gaza Strip. The policy also had a profound impact on patients receiving healthcare, businessmen trading, and families staying united.

Israeli military attacks

During the past 15 years, Israeli forces launched four major attacks on the Gaza Strip: in 2008-2009, 2012, 2014, and 2021. In addition, other air and ground attacks occurred during the entire period of the blockade.

Operation Cast Lead (2008-2009)

The first of the major attacks started on 27 December 2008 and lasted for 21 days—ending on 18 January 2009.

On the first day of the attack, around 80 Israeli warplanes launched a series of raids on Hamas government buildings and security facilities. The airstrikes continued for eight days, after which Israel launched a massive ground operation, using a large number of its tanks, infantry soldiers, and special military units.

Over the course of the three-week operation, Israeli forces dropped an estimated 1 million kilograms of explosives, causing the destruction of nearly 4,100 houses and damaging 17,500 others. 1,436 Palestinians were killed, and approximately 5,400 others were injured, including many women and children.

Operation Pillar of Defence (2012)

This attack started on 14 November 2012 and lasted for eight days, ending on 21 November 2012. Israeli warplanes killed 162 Palestinians, wounded nearly 1,300, and destroyed 200 houses. Another 1,500 homes were damaged.

Operation Protective Edge (2014)

A deadly Israeli attack on Gaza started on 8 July 2014 and lasted 51 days—ending on 26 August 2014.

Euro-Med Monitors field team documented 60,664 Israeli land, sea, and air raids, which killed 2,147 Palestinians (in many cases multiple deaths in the same family) and wounded 10,870 others. 17,123 homes were damaged, of which 2,465 were destroyed.

Operation Guardian of the Walls (2021)

The operation started on 10 May 2021 and lasted for 11 days, ending on 21 May 2021.

The attack resulted in the killing of 254 Palestinians, including 66 children, 39 women, and 17 elderly people, in addition to the injury of about 1,948 others, according to the Palestinian Ministry of Health. (According to the field statistics of Euro-Med Monitor, the number of wounded reached 2,212).

Closure of border crossings

After Israel imposed the blockade on the Gaza Strip, it closed all border crossings except the Erez Crossing (for the movement of people) and the Kerem Shalom Crossing (for goods). Both were closed security and political tensions between the Palestinian and Israeli sides.

Another crossing is Egypt’s Rafah Crossing in the south of the Gaza Strip, which Gazans usually rely on to travel to and from Gaza as an alternative to the Erez Crossing, on which Israel imposes severe restrictions for crossing.

Before Israel imposed its blockade on Gaza, individuals and goods moved in and out through six crossings: Erez, Karni, Nahal Oz, Kerem Shalom, Sufa (via Israel), and Rafah (via Egypt).

The average number of trucks allowed to enter Gaza before 2006 was about 70 per day, in addition to 583 trucks loaded with humanitarian supplies. The majority of those goods entered through the Karni Crossing in the northeast. Nahal Oz Crossing, east of Gaza City, was the main entrance for the fuel needed to power Gaza’s sole power station.

The Karni and Sufa crossings were closed in 2007 and 2008, respectively. Now, most goods enter the Gaza Strip through the partially operational Kerem Shalom Crossing.

During the two years following the imposition of the blockade, the average number of trucks entering Gaza per day dropped to 112 total per day—a fifth of what entered before the blockade.

After that, Gaza was denied exporting goods except in small amounts.

As for Erez crossing, which is designed to handle large numbers of daily travellers, it only allows a small number of foreigners working in international relief institutions or journalists to move. In addition, a small number of Palestinians are allowed to leave the country on humanitarian grounds.

First: freedom of movement

Gazans have only two travel ports: the Rafah Crossing bordering Egypt and under Egyptian control, and the Erez Crossing bordering Israel and under Israeli control.

Freedom of movement – Erez Crossing

Palestinians face numerous complex restrictions if they decide to travel to or from Gaza through the Israeli-controlled Erez Crossing. Gazans usually go through long procedures, from bureaucratic follow-ups in order to register their names for travel and security checks to a waiting period that may extend to several weeks or months to obtain an Israeli permit. However, obtaining this permit is conditional upon the fulfilment of certain stringent criteria set by the Israeli authorities, which change from time to time.

Even those fortunate few who obtain a permit may be denied travelling when they arrive at the crossing for no clear reason. The Israeli authorities sometimes send notifications to merchants, including old and well-known businessmen who have travelled through the Erez Crossing for many years, informing them that their permits have been withdrawn without explanation for what is known as a “security ban”.”

The Israeli authorities open the Erez Crossing for some exceptional cases, which are grouped as follows:

1. Holders of commercial permits.
2. Patients and their companions.
3. Exceptional humanitarian cases (marriage, death, or illness).

Although the Israeli authorities allow these groups to cross, it takes a long time to process their requests. In addition, processing a request for visiting a sick relative may take more than 50 working days, and the permit is not granted in most cases. A request for a patient who needs treatment or urgent surgery may take more than 23 working days.

Before the blockade was imposed on Gaza, the monthly average of Palestinian travellers from the Erez crossing was about 30,000 according to Gisha. In 2019, the number dropped to about 14,960, while in 2020, the number was 4,600. In 2021, the number reached 8,954. In 2022, the monthly rate of exits increased significantly, reaching about 34,000 cases per month, as a result of Israeli authorities granting approximately 15,000 Gaza Strip residents work permits in Israel.

A table showing exits from Erez Crossing from January 2010 until December 2022.

Source: Gisha

Freedom of movement – The Rafah Crossing

The Rafah Crossing is the main lifeline for Gazans who need or wish to travel to Egypt and other countries since Israel’s Erez Crossing is so tightly controlled.

In 2005, before the blockade was imposed, the Rafah Crossing operated normally. Records show that an average of 40,000 people per month entered or left Gaza via the crossing. However, this has changed since July 2013 due to the political situation in Egypt, which greatly affected the work of the crossing and caused it to be closed for long periods, exacerbating the humanitarian situation.

Since May 2018, the Rafah Crossing began to operate on an almost regular basis. Despite this, travel conditions through the crossing caused great suffering for travellers. For example, a person wishing to travel from the Gaza Strip via the Rafah Crossing is put on a waiting list with tens of thousands of other people. These periods sometimes extend to six months or more, which may cause losses to the travellers or affect their medical, educational, or professional opportunities. Added to this are the complications of travel and the lengthy procedures that travellers face on the Egyptian side.

In 2020, when the crossing’s work was mainly affected by the outbreak of the Coronavirus pandemic, the monthly average of Palestinians entering and exiting through the Rafah Crossing amounted to about 4,245. The crossing was closed for extended days, and hundreds of thousands remained—including patients, students, and business owners—waiting to exit and enter through the crossing. As for 2021, the crossing work improved significantly, and it was opened most days of the year to tens of thousands of residents. The monthly rate of entry and exit of individuals through it during 2021 was about 15,000.

The noticeable improvement in crossing work persisted in 2022, with the monthly rate of entry and exit of individuals reaching approximately 23,000 per month. The crossing was open for 245 days of the year and closed for the rest.

A table showing the statistics of entry and exit through the Rafah crossing from January 2010 until December 2022

Source: Gisha

Second: Transportation of goods

The Israeli-controlled Kerem Shalom Crossing operates five days a week (from Sunday to Thursday) for the entry and exit of goods to and from the Gaza Strip. Its work is significantly affected or completely closed during political and security tensions, Israeli military attacks on the Strip, or Israeli holidays.

Since the Israeli authorities started the blockade, they have only allowed an unannounced list of goods to enter the Strip. All goods not on the list are banned.

Gazans usually rely heavily on the Kerem Shalom Crossing to bring necessary materials that cannot be produced or manufactured in Gaza, including raw materials needed for construction and industries, fuel, medical equipment, canned foods, fruits, and others.

In 2022, The Israeli authorities closed the Kerem Shalom crossing several times under security pretexts, the most notable of which was in August during the Israeli military attack on the Islamic Jihad movement in Gaza. The closure lasted about five days and caused the only power plant in the Strip to shut down due to a lack of fuel supplies, exacerbating the humanitarian crisis.

Furthermore, Israeli authorities continued to impose severe restrictions on the entry of construction materials through the Kerem Shalom crossing, particularly those classified as “dual-use” goods, which Israel claims could be used for military purposes.

This year, they allowed the entry of “fibre optics” used in fishing boat maintenance, but only in limited quantities and under strict international supervision. The list of prohibited items includes medical equipment, items required for the agricultural sector and fishing industry, communications equipment, and other commodities. Although Israel considers these goods to be dual-use, many of them are essential to daily life and Gaza’s economic growth.

Movement of goods through the Kerem Shalom Crossing

In 2005, about 10,400 trucks entered Gaza through the Karni Crossing. After the blockade was imposed, Israel closed the Karni Crossing in June 2007, the Sufa Crossing (designated for building materials) in 2008, and Nahal Oz (designated for fuel) in 2010.

Since then, specifically from 2007-2010, the number dropped to about 2,400 trucks per month (23% of the rate before the blockade). The Kerem Shalom Crossing became the only crossing designated for transporting goods to and from the Gaza Strip.

In 2022, Kerem Shalom Crossing operated for 234 days. The monthly average of trucks entering the Gaza Strip was approximately 6,494 trucks, accounting for approximately 62% of the average of entry before the imposition of the blockade, considering the population increase since 2005 and the number of trucks in that year.

According to the Agreement on Movement and Access of 2005, Israel agreed to allow Gaza to export 400 trucks daily to Israel, the West Bank, and other countries, based on estimates of Gaza’s exporting capabilities.

In 2005, nearly 10,000 trucks exited Gaza—about 833 trucks per month. However, from June 2007 to October 2014, the number of trucks exiting Gaza per month declined to 1.5%, about 14.7 trucks.

In 2022, the monthly average of trucks exported from the Gaza Strip via the Kerem Shalom crossing was approximately 428 trucks, accounting for only 35% of the monthly rate of trucks exported in 2005, one year before the blockade.

Movement of goods through the Salah El-Din Gate with Egypt

The movement of goods entering from Egypt through the Salah al-Din Gate adjacent to the Rafah crossing remains vital for Gazans. They include fuel and building materials, which are not allowed to enter through the Israeli Kerem Shalom Crossing. However, the gate operates on a limited scale and does not meet the needs of the population of Gaza, with over 2 million people. Private companies under the control and supervision of the Egyptian army and the Hamas authorities in Gaza operate the gate.

In 2022, the number of working days at Salah al-Din Gate reached 150 in 2022, with approximately 38,003 trucks loaded with food, construction materials, and fuel imported and 1,696 trucks exported.

On average, about 3,166 trucks enter the Salah al-Din Gate monthly. Despite the importance of the gate for importing materials and goods that are not allowed through the Kerem Shalom Crossing with Israel, it is insufficient to satisfy the increasing demands of the Strip’s population.

Economy

The Gaza Strip’s economy has wallowed in a general recession ever since the Israeli blockade was imposed, resulting in the near-total closure of commercial crossings and paralysis of the economic movement, especially during the Israeli military attacks.

As a result of the direct targeting of the economic sectors—especially the agricultural sector, on which much of the population of Gaza depends—the marketing capacity of many agricultural plant and animal products has weakened due to restricted movement and difficulty in accessing agricultural land and animal and fish facilities. Additionally, markets were disrupted, and many agricultural products and fish lost their exportation opportunity. This led to a sharp drop in the prices of many commodities and huge losses to producers.

In general, the repeated military attacks on the Strip, along with the enforced blockade and long-term occupation, inflicted heavy economic losses on the population. According to a UNCTAD report issued in November 2020, the economic cost of the Israeli occupation of Gaza during the past decade was estimated at $16.7 billion, which means that the per capita economic loss due to the blockade amounted to about $9,000.

The unemployment rate in the Gaza Strip remained among the highest in the world. After reaching about 23.6% in 2005, it reached about 61.6% in 2022.

These economic crises were accompanied by a decrease in per capita GDP and an increase in poverty rates from 40% in 2005 to 61.6% in 2022.

The effects of the Israeli blockade, combined with the Covid-19 pandemic, have caused food security in the Gaza Strip to deteriorate, with around 53% of the population now facing food insecurity.

Agricultural sector

With an estimated production value of $430 million, the agricultural sector is one of the most important economic sectors in Gaza, contributing up to 6% of the gross national income (GNI). This field employs approximately 55,000 people, 32,000 of whom are farmers and the remainder work in agricultural support services.

The agricultural sector faces significant challenges as a result of Israel’s restrictions on exporting and importing agricultural products, equipment and materials, or direct targeting of crops and agricultural lands during border incursions or military attacks on the Gaza Strip, which began with the imposition of the blockade in 2006.

The agricultural sector suffered significant losses in August 2022 as a result of the Israeli army’s military attack on the Islamic Jihad movement in the Gaza Strip, as Israeli air strikes destroyed several agricultural lands, irrigation networks, and agricultural equipment. The direct losses of this were estimated to be $600,000.

The Israeli army effectively imposes a 300-meter-wide buffer zone along the eastern border of the Gaza Strip, allegedly due to security concerns. Although the Israeli authorities claim they allow farmers to reach 100 meters from the fence on the condition of prior coordination, its practices on the ground prove the opposite. Farmers are exposed to grave dangers when approaching that area and are therefore unable to conduct their business normally.

Following the Israeli military attack on the Strip in December 2008, Israel increased the buffer zone within the Strip’s borders to between 1,000 and 1,500 meters. This area constituted about 17% of Gaza and 35% of its agricultural land.

Moreover, during the years of the siege and military attacks, the Israeli forces destroyed large areas of agricultural land, which led to heavy losses incurred by farmers and landowners.

After the 2012 military attack, Israel allowed the residents 100 meters near the fence, but in 2013, the number rose to 300 meters.

Israel determines these permissible distances that Palestinian farmers are obligated to abide by, fearing that the authorities will target them if these rules are breached. Yet, the Israeli forces often target farmers in the permitted areas, even if the rules are not violated, without any justification. In addition, Israeli forces carry out periodic incursions of agricultural lands where farmers work in safe areas.

In addition, the Israeli forces spray pesticides along the security fence that extends 40 kilometres in the eastern Gaza Strip, apparently to prevent trees from growing to expose the area for security considerations. The spraying operations usually cost farmers hundreds of thousands of dollars over the course of the year.

In 2022, farmers incurred great losses as a result of Israel opening rainwater floodgates to the east of the Strip, which caused 300 dunums of agricultural land to be flooded and completely destroyed.

In addition, livestock breeders suffered heavy losses, represented by the death of large numbers of birds and animals as a result of the interruption of supplies of animal feed due to the closure of border crossings. On the other hand, agricultural facilities, feed factories, wells, main and secondary pipelines, agricultural ponds, fish farming stations, feed stores, agricultural equipment stores, pesticides, and bee farms were severely damaged.

In terms of exporting agricultural products from the Gaza Strip, Israel imposed a complete ban on the export of goods from the Strip after tightening its blockade in 2007. This decision reduced the amount of agricultural production marketed outside the Strip from approximately 3,544 tons per month until the first half of June 2007 to nearly zero in the subsequent period, exacerbating the Strip’s economic collapse.

The ban on exporting agricultural products from Gaza to the West Bank lasted seven years, until 2014. It was then permitted in limited circumstances as part of cease-fire negotiations during Israel’s military attack on the Gaza Strip in 2014.

In 2022, Israel permitted the marketing of additional goods, as average agricultural exports reached 5,377 tons per month between January and August 2022 (an estimated value of $6.3 million), representing a 67% increase over the same period in 2021 (an estimated value of about $434,000). This is because 2022 was a “Sabbatical Year” according to Jewish law. During this year, Jews stop working in agriculture and rely on agricultural production from non-Jews.

From 2006 to February 2022, the value of agricultural losses as a result of the Israeli blockade and multiple military attacks was estimated to be more than $1.3 billion, with those who were affected receiving only 30% compensation.

Fishing Industry

The Oslo Accords, signed by the Palestine Liberation Organization (PLO) and Israel in 1994, stipulate that Palestinians are allowed to sail up to 20 nautical miles (37 kilometres) off the shores of the Gaza Strip. However, Palestinians have always been prevented from reaching that distance and are only allowed less than 12 nautical miles.

Due to restrictions, periodic attacks, and bans on the entry of supplies necessary for fishermen to continue their work, the number of people working in the fishing field decreased from about 10,000 in 2000 to about 4,000 fishermen. These people support an estimated 40,000 people, which means threatening the livelihood of these fishermen would threaten the lives of tens of thousands of citizens in Gaza.

Fishermen in Gaza suffer their inability to practice their work freely in the area they are allowed to sail and work as a result of repeated Israeli attacks, limiting the fishing area, which ranges from 6 to 15 nautical miles at best, in addition to banning the supply of equipment and supplies for fishermen.

Israel routinely reduces the fishing zone in Gaza. In 2006, Israel reduced the fishing zone to ten nautical miles, then to six nautical miles, and then to three nautical miles in 2009 following Operation Cast Lead. At the beginning of 2019, Israel announced the expansion of the fishing area to 12 nautical miles and then allowed fishing at 15 nautical miles. However, in 2019, the fishing zone was reduced nine times as collective punishment measures, including four times when they closed the sea completely.

In 2021, Israel maintained this policy and reduced the fishing area several times during the year, especially during the Israeli attack in May, when the complete closure of the sea caused the disruption of fishing and indirect damages estimated at $2 million. In September, the fishing area was extended back to 15 nautical miles.

Israeli restrictions and attacks on the work of Gaza Strip fishermen in the sea persisted in 2022, as Israeli naval forces carried out hundreds of attacks during the year, at a rate of about 30 attacks per month. This included the confiscation of 25 boats and the detention of 63 Palestinian fishermen, the majority of whom were later released.

Furthermore, Israeli naval forces carried out almost daily attacks at sea on fishermen’s boats, including direct shooting at fishermen and their boats and spraying water inside the boats in an attempt to drown and damage them. These practices resulted in the injury of around 20 fishermen during the year.

In addition to limiting fishing areas, shootings, and arrests of fishermen, Israeli authorities restrict the entry of materials required for boat maintenance and restoration. However, in 2022, for the first time since the imposition of the blockade, Israeli authorities agreed to allow the entry of very limited quantities of fibre optics used in the maintenance of fishing boats, subject to close and permanent international supervision.

In August 2022, Israeli authorities extended punitive restrictions to include a ban on exporting fish from Gaza to the West Bank due to the security situation worsening after the military attack on the Islamic Jihad movement in the Strip. This resulted in the fishing industry workers incurring heavy losses estimated at $800,000.

Following that, Israeli authorities allowed the resumption of exports, but with a reduction in the amount of fish allowed to be exported to approximately 20 tons per month, from up to 100 tons per month before the ban, negatively impacting fishermen’s income.

Healthcare

Due to the long Israeli blockade, Gazans suffer difficult conditions at various levels, especially in terms of health care. The blockade has caused permanent shortages of medicines, supplies, and basic medical equipment. The health sector is one of the most affected sectors by Israeli prevention policies. It is almost completely collapsed, especially with the outbreak of the Coronavirus pandemic in late August 2020.

Since the imposition of the blockade in January 2006, the health sector has witnessed many setbacks and challenges that have had a severe impact on the health services provided to the citizens of the Gaza Strip. During the Israeli military attacks, the Israeli forces, directly and indirectly, targeted hospitals, health centres, and medical personnel. In addition, the restrictions imposed on the entry of medicines, medical supplies, and maintenance parts for medical devices have a tremendous impact on the health sector.

The health sector in the Gaza Strip is dependent on three supporters. First, external transfers for treating diseases that Gaza hospitals cannot handle. Patients are transferred to hospitals in the West Bank, Israel, or other countries abroad. The second is related to foreign medical delegations, which often specialize in specific health fields such as bones or nerves. These delegations contribute to some extent in treating many medical conditions, especially for those who cannot travel due to the Israeli ban, who constitute 50 % of the total number of patients who obtained permits for treatment abroad. The third is the medical aid provided by the World Health Organization, UNRWA, and the Palestinian Authority.

The Gaza Strip’s population, estimated at two million and 380 thousand people, is served by 35 hospitals with a total capacity of 3,587 beds, of which the Ministry of Health manages 2,824 beds, accounting for approximately 78.7% of the total number of beds.

According to the Ministry of Health, figures show that there is a severe shortage of basic medicines and medical supplies, in addition to health services for sectors such as cancer patients and maternal and child care. The deficit in drug balances reached about 45%, while it reached about 33% in medical consumables and about 60% in laboratory and blood bank supplies.

After years of the Israeli blockade, health care services in the Gaza Strip declined by 66%, emergency and operations services by 23%, kidney and dialysis services by 42%, cardiac catheterization and open-heart services by 66%, and orthopaedic services by 13%.

While the Gaza Strip records about 1,800 cancer cases annually, the specialized health services provided to cancer patients, who number about 12,600 patients in the Strip, remain in their worst condition, while more than 50% of cancer patients need to travel abroad to receive radiotherapy, chemotherapy, and the atomic survey, which is not available in Gaza.

In general, the Ministry of Health in Gaza remains unable to provide the necessary medical services for patients with blood and tumours in the Strip. The hospitals in Gaza remain threatened with stopping surgical operations completely due to the lack of necessary medical materials, which are prevented from entry by the Israeli authorities, such as nitrous gas used for anaesthesia and for patients who are dying in operating rooms.

During the year 2022, the increase in the number of patients and injured in emergencies had the greatest impact on the inability of hospitals and medical centres to receive them on a regular basis, despite the opening of new health departments or centres from time to time. However, what these departments need in terms of medicines, materials, medical supplies, and medical staff remains largely missing. Therefore, hospitals in Gaza usually resort to referring serious cases for treatment outside the Strip, either in hospitals in the West Bank, Israel, or Jordan through the Erez crossing or in Egypt through the Rafah crossing.

In this case, the vast majority of patients who receive a medical referral covered by the Palestinian Ministry of Health in Ramallah remain in the hands of Israel to allow them to travel abroad for treatment. At least eight patients, including three children, from the Gaza Strip, have died in 2022 as a result of Israeli authorities’ delays or refusals to grant them permits to exit through the Erez crossing for medical treatment.

Furthermore, the health sector is greatly affected by other factors such as continuous electricity cuts and running out of fuel, which sometimes affects the work of these hospitals for several hours or days and causes a real threat to the lives of hundreds of patients who need electricity on a regular basis, such as those in intensive care departments, pediatric nurseries, and kidney patients.

On the other hand, the decrease in financial support directed to the health sector affected the sector’s ability to absorb new employees, which greatly reduced the medical staff and prompted several doctors to migrate abroad due to successive financial crises and limited employment opportunities that, if available, would be with low salaries.

Power crisis

The power crisis in the Gaza Strip goes back to 28 June 2006, when the Israeli army bombed the sole power station in the Gaza Strip during one of its military operations. This resulted in the destruction of six main transformers in the station. Since then, Gaza has suffered a large energy deficit. The crisis reached various peaks, during which electricity was cut off for periods of up to 20 hours per day.

The station remained in a near-complete suspension due to Israeli bombardment until it was repaired and returned to work partially in 2009. After the station was repaired, the European Union financed the costs of the fuel needed to operate the plant. This situation continued until the European Union decided to transfer what it used to pay to the Palestinian Ministry of Finance in Ramallah, provided that the ministry would assume the task of paying for the fuel itself. However, the quantity decreased from that moment to 4,500 cubic meters per month, sufficient to produce only 30 megawatts, which can only power one generator at the plant. This caused further cuts in power supply hours in 2010.

In 2011, the power plant in Gaza began using Egyptian fuel and became powered by three generators, producing about 80 megawatts of power. However, at the beginning of 2012, the Egyptian fuel shortage crisis began to emerge after reducing the quantities supplied to Gaza. The plant started to draw on its reserves until they were completely depleted, and the station stopped working on 14 February 2012.

In 2017, the electricity crisis reached its climax after the Palestinian Authority’s decision on April 27 to stop paying for the electricity that Israel supplies to Gaza through ten electricity lines carrying 125 megawatts (about 30% of Gaza’s electricity). As a result of this decision, Gazans had no power for more than six hours a day, which significantly affected the daily life of the residents.

In 2018, there was a noticeable improvement in the quantities of electricity delivered to the homes of residents in the Gaza Strip as a result of donations and funds provided by the Qatari government to solve the crisis. At the time, the power plant operated with three generators, and residents had electricity for about half of the day. However, this rate is not enough to meet the residents’ daily needs for electricity.

The power crisis surfaced again in June 2019 and continued during 2020 as the Israeli authorities prevented fuel from entering Gaza. Citizens only received between four and six hours of electricity per day. Such a low rate affected several major important sectors such as the health sector. The repeated power cuts threatened the lives of hundreds of patients on ventilators, as well as infant incubators and operating rooms.

The impact of power cuts has been reflected in the work of municipalities. Due to power cuts, sewage stations stop working for long hours, forcing municipalities to drain wastewater into the sea, which threatens the lives of citizens and pollutes the seawater. The crisis also had the greatest impact on the commercial and industrial sectors. More than 80% of the sector’s factories stopped working due to a lack of energy, which exacerbated the living crisis and increased the unemployment rate.

In 2021, the Gaza Electricity Company suffered severe losses due to the Israeli military assault on the Gaza Strip in May, estimated at around $10 million, as reported by the company. This was a result of Israeli forces targeting infrastructure in dozens of major areas in Gaza, which led to a shutdown of 6 Main electricity lines around the Strip during the attack, causing the electricity crisis to worsen further.

In 2022, Gaza residents continued to receive 6-8 hours of electricity per day, followed by a 12-hour power outage.

It is worth noting that the Gaza Strip needs nearly 640 megawatts a month, but the amount that has reached the sector since the beginning of the crisis (during the years of the blockade) has not met even half its needs for electricity. The Israeli lines provide 120-125 megawatts, the power plant provides (by Qatari fuel) from 60 to 70 megawatts only, and the Egyptian lines, which used to provide power with a capacity of 23 megawatts, have been suspended since March 2018.

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