Writing for Al Jazeera last October, ahead of the Cairo Donor Conference for Gaza, I warned that it was not enough to pledge large sums - as donors duly did. We needed to learn from past failures and ensure that the aid was actually delivered. Alas, six months on from the attacks, my worst fears have been realised. Pledges have not been fulfilled, reconstruction has stalled and hope is draining away.
This month we learnt that just over 5 percent of the money pledged to rebuild Gaza after last summer's devastating 51-day conflict with Israel has been delivered. What does this say about the international community's commitment to the beleaguered territory and its 1.8 million residents?
I was in Gaza last week and have never known the place more depressed. The rubble has not been cleared. Power cuts continue. The economy has not begun to recover and poverty is widespread. You see destroyed buildings everywhere.
Some 100,000 people are still homeless after their homes were destroyed in the bombing. Some of them have moved in with other members of their family and are living in impossibly crowded conditions. Others, less fortunate, live in caravans, UN shelters or in damaged homes exposed to the elements. It was cold and wet while I was there. The situation teeters on the brink of another major crisis.
Another major crisis
I visited Gaza with a team of UK surgeons, specialists in limb reconstruction, who are working with their Palestinian colleagues to help repair the bones of some of those most seriously injured last July. This is a programme run by Medical Aid for Palestinians with funding from the UK Department for International Development.
We carried about $265,000 worth of medical equipment with us from the UK, dragging it in suitcases on the long walk from the Erez crossing. I saw it immediately be put to use in the operating theatres of Shifa hospital. Wonderful in many ways - but what kind of system is it when this is the way you equip your hospitals? When the local doctors are reliant on visiting consultants to teach them new skills because they cannot leave Gaza to train outside?
The health services are struggling to cope. They are overburdened and under-resourced. There are, once again, severe shortages of drugs and consumables as the supplies delivered in the war run out. Many of the staff have not been paid for months, others are receiving only 60 percent of their salaries as a result of the Palestinian Authority's financial crisis which has been compounded by Israel's withholding of tax revenues. What health service in the world could function in a situation like this?
I also saw the impact of the continued legacy of the conflict. Over 8,000 "explosive remnants of war" - unexploded shells, grenades, bombs - remain scattered across Gaza, posing fatal risks to children in particular. During my visit, our surgeons helped treat three seriously injured children who'd picked up one of these deadly devices. It was a reminder that while we mark the six-month anniversary of the ceasefire, the conflict continues to take a terrible toll.
While the logistics of getting medical aid into Gaza are difficult, they are nothing when compared to the obstacles in the way of meaningful reconstruction.
While the logistics of getting medical aid into Gaza are difficult, they are nothing when compared to the obstacles in the way of meaningful reconstruction. To meet Gaza's housing needs, including rebuilding destroyed or severely damaged homes and addressing natural growth, 735 truckloads of materials need to enter Gaza every day for the next three years.
This daily truck requirement was not reached for the entire month of November when an average of only 287 trucks with building materials entered Gaza per day. While December saw a slight improvement, the whole process stalled in January due to a lack of funds.
Why? Everyone is blaming someone else. The Palestinians blame Israel for the ongoing siege and point to the failure of the Gaza Reconstruction Mechanism (GRM) which was established as a temporary system after the war to facilitate the transfer of materials for reconstruction.
Israel blames the Palestinians for their inability to heal their divisions and abide by the terms of agreement of the reconstruction mechanism. The UN points the finger at donors who have not delivered on their pledges.
Ordinary Palestinians in Gaza look on with growing dismay. They feel abandoned and forgotten. They are the ones suffering while those with power over them remain locked in entrenched positions. They are unable to leave and powerless to change things. Although the people of Gaza are astonishingly resilient, this impasse and continuing isolation are testing them to the limit.
The deadlock must be broken. Donors must deliver on their pledges. The PA and Hamas must settle their differences for the greater good of their people and for the possibility of peace. Israel must live up to its responsibilities as the occupying power and lift the siege. Egypt, too, must play its part by reopening the Rafah crossing on a regular and reliable basis.
Considering the horrors of what we saw last July and the very real possibility of it being repeated, we must start fresh new efforts to return hope to Gaza.
Tony Laurance is the chief executive of Medical Aid for Palestinians and former head of the WHO in Palestine.
The views expressed in this article are the author's own and do not necessarily reflect Al Jazeera's editorial policy.
Source: Al Jazeera