I’ve been coming to Gaza for a long time.  My first time was in 1985 and this is now my seventh trip to the region.  In the 80’s, there were no substantial physical barriers between Gaza and Israel. Many Gazans worked as day laborers in Israel and many spoke Hebrew.  Group taxis traveled freely between East Jerusalem and the West Bank, and directly into Gaza City.  The society here in Gaza was much more Westernized and secularized than it is today.  Women wore blue jeans and ponytails, and the hijab and the naqab were not nearly as ubiquitous as they are today.  It was hardly a perfect relationship between Israelis and Palestinians; more of a privileged class and servant class based on the birthright of whether or not one was born Jewish.  But there was abundant interaction between the two societies back then.

Then came the first intifada and then the Oslo “Peace Process” which was really a “Piece Process.”  This culminated in the division of the two societies and the isolation of Gaza from the rest of the world.  There was false hope then and a second intifada.  Gaza was locked down as a consequence and became the world’s largest prison.

When I re-entered Gaza some 18 years later in 2003, it was a much different world.  Dr. Haidar Abdul Shafi, a respected physician and civic leader here in Gaza, explained to me why he had walked out of the Madrid Peace negotiations in 1991.  “I concluded that the Israelis were negotiating in bad faith,” he said.  It took me a while to fully understand what he was talking about, but slowly it became clearer.  Gaza was now surrounded by a hideous “Berlin Wall”.  Rachel Corrie had just been mowed down by a giant bulldozer.  Houses and apartment blocks were being systematically destroyed under the orders of Ariel Sharon “to look for tunnels”.  Over 2000 people in Rafah were made homeless as a direct result of Israel’s pursuit of the tunnels.

In 2006 I entered Gaza during a time of assault.  The streets of Beit Hanoun were ripped apart.  Over 85 Palestinians were killed in Beit Hanoun and then 19 members of the Al Athamna family were massacred as they slept in their beds.  I interviewed some of the grief stricken survivors a few days after their onslaught.  Apache attack helicopters reigned death and destruction from the skies directly above us; we rushed to the Kamal Adwan Hospital to assist local doctors as 5 young men in their 20s died right in front of us.   It was a time of palpable fear for me, as I shared for the first time the fear that local Gazans feel routinely.

In 2008, I entered Gaza by boat.  I was part of the maiden voyage of the Free Gaza Movement; we were the first boats to arrive from international waters in 41 years.  Gaza had been under a tightening siege.  There were 40,000 people on the shores of the Gaza Marina waiting to greet us.  It was a time of euphoria, as we demonstrated to the people of Gaza that there are many of us around the world have not forgotten them; many around the world who do care about them after all.  There were several more boat trips, four of them successful, and then flotillas.  Then there was the massacre on the Mavi Marmara.  My Italian friend Vittorio Arrigoni was martyred two years ago, and he is still remembered by the people of Gaza today.

Then came the horror of Cast Lead.  I last entered Gaza again in October 2009 in its aftermath.  The streets were filled with entire blocks of rubble; entire neighborhoods had been leveled; the siege had been tightened still and there were no resources like concrete to rebuild.  Dr. Marwan Assalya, the general surgeon at Al Awda Hospital where we were assigned, shared horrific photographs of people he had cared for during the previous winter.  There were pictures of victims of white phosphorus attacks with second, third and fourth degree burns all over their bodies.  There were recipients of DIME weaponry who had had their arms completely sheared off by vaporized micro-shrapnel.  Patients who survived lingered, only to succumb later to sepsis; or if they survived that, to cancer, as a direct result of the tungsten heavy metal vapor supplied by the US arms industry.  And there were pictures of drone victims who had had both legs blown off; These were the survivors; there were no pictures of the ones blown completely to smithereens.

So now it is April 2013 and I enter Gaza again.  We enter through Erez and we are forced this time to sit through a one hour PowerPoint presentation by the Israeli military outlining how benevolent Israel tries to help, and how these ungrateful Palestinians respond with rockets and are their own worst enemy.  I try not to grimace; I try not to hurt myself biting my lip. I try not to vomit or show any indication of what I am thinking.  We just want to get through this, so we can enter Gaza and be with our friends.

So now we are here in Gaza.  Our medical team disperses to various assignments.  Dr. Bob Haynes and I are teaching elements of Advanced Cardiac Life Support at Shifa and Public Aid hospitals.  We are giving lectures to very bright young medical and nursing students at Al Azhar and Islamic Universities.

We are being greeted by smiling and attentive students who still show hope and amazing resiliency for their future.  In Gaza, hope springs eternal; Phoenix keeps rising miraculously from the ashes, especially among the youth.

The tunnel economy has flourished in spite of the siege.  There are now donkey carts hauling around Egyptian cement everywhere, and there are shiny new cars I haven’t seen before which have been brought in through the tunnels in the south.  The nicer parts of Gaza City are showing new shops and new businesses.  But while some are prospering, many others among the many poor are lost in time.  The refugee camps we visit seem even more soiled and overcrowded than before, and there is trash everywhere.  The UN is running out of money to maintain its food assistance program and people are revolting against them. The Hamas government is getting more forceful in their enforcement of traditional Islamic law. In spite of this, the people in these camps remain courteous, curious to see us and friendly.   Gaza is a pressure cooker.  The UN predicts that Gaza may become inhabitable after 2020.

But we will keep coming back as long as we can.  Our conscience demands this of us.