Reporting from Gaza City — Don't ask Hatem Hajaj whether there's a humanitarian crisis in the Gaza Strip.
Four months ago, the unemployed salesclerk's son was born with a heart blockage. Doctors told Hajaj that the baby's only hope was transfer to a Jerusalem hospital because Gaza lacked a pediatric surgery unit.
While his son, Mohamed, fought to breathe on a ventilator, Hajaj spent a week gathering the transfer documents needed under Israel's strict border rules. Then there was another agonizing week, watching as his son's tiny body began to bloat as he waited for an answer.
FOR THE RECORD:
An earlier version of this article misspelled the name Hatem Hajaj as Hate Hajj.
Approval finally came — two days after Mohamed died.
"Why should it take so long for a days-old innocent baby with such a serious problem?" asked Hajaj, 37, in his Gaza City home, clutching the medical records and authorization form that came too late. "No crisis? I lost my son. We're not treated like human beings. Let me ask you: Would Israelis accept to live under these conditions?"
In the aftermath of the deadly May 31 commando raid on an aid supply flotilla, Israel's 3-year-old blockade of Gaza is coming under unprecedented scrutiny. In addition to the naval cordon, Israel and Egypt maintain tight restrictions on the movement of goods and people over their borders, stopping everything from vinegar to the terminally ill.
Israeli officials defend their policy as necessary to prevent rockets and other weapons from reaching Hamas, the Palestinian armed movement that controls Gaza and refuses to recognize Israel's right to exist. They say the reports of dire conditions in Gaza are exaggerated.
"There is no humanitarian crisis in Gaza," Israeli Prime Minister Benjamin Netanyahu said recently in a televised address.
Experts say it's not so simple. Although it's true that there is no hunger and there are no epidemics, the situation in Gaza defies usual categorization, aid officials say.
"Look, it's not like sub-Saharan Africa," said Chris Gunness, spokesman for the United Nations Relief and Works Agency, which assists Palestinian refugees. "We are not talking about a natural disaster or famine caused by failed rains. But Gaza is a political crisis with grave human consequences."
So although some can argue that Gaza's mortality rates are steadily improving, others could note that more Gazans died during Israel's 22-day military assault 18 months ago than civilians were killed in Darfur during all of 2009.
Acute malnutrition in Gaza is well below the "emergency" threshold. But at the same time, a higher percentage of Gazans are dependent on food aid than is true of Somalis.
Health officials report no serious problems with cholera, measles or diarrhea, yet 90% of Gaza's water is so polluted that it's undrinkable, and on average two patients die every month waiting for Israeli permits to leave Gaza for treatment, according to the World Health Organization.
"It's not the kind of disaster that you might see in other places," said Mahmud Daher, head of WHO's Gaza office. "But it's always on the edge of a crisis. And without the help of the international community, it would be a crisis."
Passing through the half-mile Erez checkpoint and emerging into Gaza, the contrast could hardly be more stark. In Israel, there are shopping malls and traffic lights. In Gaza, donkey carts and herds of goats cross the road. Young boys pick through the debris of bombed-out buildings to salvage construction materials.
In Gaza City, sidewalks are filled with idle, unemployed men and lonely shopkeepers, drinking tea and smoking, waiting for customers who rarely come.
At the same time, a certain normality has returned. The stores are stocked with food, electronics, furniture and clothin, much of it smuggled from Egypt through illegal tunnels. Cafes offer espresso and croissants. A shipment of 2010 Hyundai sedans recently arrived. Now that school is out for the summer, families are flocking to the beach to eat ice cream and barbecue.
At Shifa Hospital, Director-General Hussein Ashour says the situation is anything but normal at his overcrowded public facility, which is struggling to stay open amid Israeli and Egyptian restrictions on the importation of equipment and drugs.
His MRI hasn't worked in a year because he can't get a spare part. A replacement CT-scan machine is stuck in the West Bank. There are chronic shortages of medical dyes used for diagnosing cancer, clotting drugs for hemophiliacs and batteries for dialysis machines.
"A one-month supply of anything here is a real luxury," Ashour said.
Waiting lists for nonemergency operations to treat hernias or remove tonsils are 18 months long. And the list of procedures that can't be done in Gaza is growing, including heart surgery, radiation treatment and bone-marrow transplants.