WASHINGTON — As Secretary of State Condoleezza Rice and Secretary of Defense Robert Gates head out Monday on a rare joint trip to the Middle East, it's not clear what they can accomplish.

Aides to Rice and Gates say the trip has three primary goals, each crucial: to persuade Iraq’s neighbors to do more to help stabilize the country, to counter Iran’s growing ambitions and to try to get real movement on peace between Israel and the Palestinians.

But America's credibility in the region has plummeted. The U.S. has failed to stabilize Iraq, destroy al Qaida, pacify Lebanon, isolate Syria or bolster moderate Palestinians. Instead, its policies have fueled Sunni Muslim extremism and emboldened Shiite Iran, which America's moderate Arab allies consider the two greatest threats to their rule.

So far, its support for Israel's ill-fated war in Lebanon and its efforts to undermine popular radical groups such as Hamas in the Gaza Strip and Hezbollah in Lebanon have borne little fruit. Along with its support for autocrats such as Egypt's Hosni Mubarak, such actions have undercut American claims that it's championing Muslim democracy.

Meanwhile, the clock is ticking on the Bush administration’s time in office. Leaders of friendly Arab states have lost confidence in President Bush’s ability to deliver on his promises and are wary of sticking their necks out too far to cooperate, according to diplomats and some U.S. officials.

“Our credibility is in tatters. They are not going to commit because they don’t trust us. That doesn’t mean they are not concerned about Iran. It just means they just don’t know what we are going to do,” said one senior State Department official, who spoke on condition of anonymity because he wasn't authorized to speak to reporters.

There are also signs of disarray within the administration.

On the eve of the trip, unnamed U.S. officials told The New York Times that Washington believes Saudi Arabia has been unhelpful in Iraq by not supporting Prime Minister Nouri al Maliki's government. The administration publicly disavowed the report, but said that Saudi Arabia could do more to help. The leaked complaint seems unlikely to make life easier for Rice and Gates when they arrive in Jeddah, Saudi Arabia, early in the trip.

The Bush administration also is divided over Iran, with Vice President Dick Cheney’s office pushing for an aggressive military response to Iran's reported aid and training for Shiite militias attacking U.S. troops in Iraq, senior officials said.

Gates and Rice will attend meetings together in Sharm al Sheikh, Egypt, and Saudi Arabia. Rice will then head for Israel and the Palestinian territories to meet with Israeli leaders and Mahmoud Abbas, the weakened Palestinian Authority president whose administration was run out of Gaza by the Islamist group Hamas. Gates is scheduled to visit other gulf states.

Senior Pentagon and State Department officials said the trip is intended to reassure Arab leaders that the U.S. will uphold its security commitments in the region, even as Congress debates pulling troops out of Iraq.

But Arab diplomats in Washington said their governments need more than reassurance. They said that while the U.S. has promised a more active role, they haven't seen a clear plan for Middle East peace or regional security.

Indeed, after Bush called two weeks ago for an international Middle East peace conference, some Arab leaders concluded that the speech lacked specific goals and simply repeated the broad hopes that he's articulated before — stability in the region and moderate, inclusive governments.

“There is no clarity,” one Arab diplomat said on condition of anonymity because he didn't want to disagree publicly with the administration. “The trip in and of itself is not important. What’s important is that the administration commit to dealing with the substantive issues.”

The gulf states want to know how a possible drawdown of troops in Iraq would affect their security and whether it would lead to fewer troops in other parts of the region.

More than what Rice and Gates say on the trip, “people are monitoring the debate in Washington. Everybody is watching that very closely and then will draw their own conclusions,” an Arab official in Washington said.

Sunni-led gulf states fear Iran, but aren't confident that the United States has a strategy for dealing with Tehran, the diplomats said. U.S. officials say they're in the early stages of building an alliance with the gulf states.

“Iraq may be an immediate destabilizing influence. But Iran is something we collectively need to deal with in the long term,” said Geoff Morrell, a Pentagon spokesman.

On the Israeli-Palestinian conflict, Saudi Arabia, Egypt and other U.S. allies in the region want the United States to reach out to Hamas, which now controls Gaza. But Rice has repeatedly ruled out dealing with the group, which is on the U.S. list of terrorist organizations.

"The strategy is based on the assumption that you could isolate, weaken ... Hamas," while strengthening Abbas and his Fatah faction, said Shibley Telhami, a Middle East expert at the University of Maryland. "It cannot succeed. ... Everybody agrees that you can't simply isolate Hamas."

Gates and Rice will encourage Arab leaders to attend the international meeting on Middle East peace that Bush called for in a July 16 speech. The gathering is tentatively scheduled to take place this fall.

Israel and the United States hope that officials from Saudi Arabia, other Persian Gulf states and Morocco — none of which recognizes Israel — will attend. But that appears far from assured.

Before the Iraq war, Washington had strong ties with the gulf states, especially Saudi Arabia. But the overthrow of Saddam Hussein’s Sunni-dominated government and the rise to power of Iraq’s majority Shiites shifted the balance in the region. With an unstable Iraq and their own Shiite minorities politically awakened, many governments feel U.S. actions have weakened their grip on power.

Some countries, such as Egypt, have maintained close ties with Washington, but Saudi Arabia and others have begun to distance themselves.

Rice and Gates have their work cut out for them. With 18 months left in office, it will be difficult to reshape the way the region sees the United States, said William Quandt, a professor of international relations at the University of Virginia, who as an aide to President Jimmy Carter helped craft the 1978 Camp David accords between Israel and Egypt.

“I don’t think they have a real strategy that has much chance of working,” Quandt said. Gates, who joined the administration in December, “may be able to calm things down a little. But that won’t change the course.”

First of two parts

On a recent November morning, in between his administrative hospital rounds and amid various workers’ strikes, continuing political uncertainty and growing worry that the Israeli-Palestinian conflict was on the verge of yet another cycle of spiraling violence, Dr. Tawfiq Nasser pulled out his wallet and showed a visitor his identification cards.

“In this country, we have a habit of collecting cards,” the Palestinian doctor said dryly.

He held up three cards in quick succession: a magnetic security card to expedite his way through Israeli checkpoints; an identification card issued by the Palestinian Authority; and a third card certifying that he works for a nongovernmental organization: in this case, for the Lutheran World Federation, for which he serves as head of the Augusta Victoria Hospital in Jerusalem and also oversees the hospital’s program of village health clinics in various parts of the West Bank.

Nasser’s main focus, and worry, however, was about a permit due to expire the next day that allowed him to enter Israeli territory and return to his office in Jerusalem. A strike by Israeli bureaucrats was suddenly complicating his life -- without a new permit, he and his staff would be stranded.

The sudden concern about the permit overtook Nasser’s rapid-fire explanation about the fragmented health care system in the Palestinian territories. He argued that as long as an occupation exists, with its attendant checkpoints, delays and transportation snafus, villagers closer to one city to will be forced to go to another for their basic health care. And as a result, their health will suffer.

With a sudden, unexpected snafu about permits added to the mix, Nasser began to lose patience, becoming increasingly impassioned and angry as he spoke to a visitor. “All of our lives are run by bureaucrats in a settlement. You tell me this is no occupation, that it this is just security,” he said.

“Tomorrow, I don’t know if I can go to work,” he said, his voice rising. “And who is punished? The patients. Hamas, they’re not punished. It’s my patients.”

Declarations of impatience, frustration and outright anger are becoming increasingly common among Palestinians these days -- particularly those whose faces and voices are too rarely seen or heard in depictions of Palestinian reality in the West.

The “moderate” sector of teachers, academics, students, government officials and doctors -- the vanguard of Palestinian “civil society” who are not questioning the permanence of the state of Israel, even though they are clearly fed up with the politics of the Israeli occupation -- have, by dint of professional training and patience, kept day-to-day Palestinian society running. They have done so amid an ongoing political stalemate between rival political factions, militants and the Israeli government, and a humanitarian situation that has been worsening by the week.

Weary of politics but keenly aware that just about everything in their contested land is highly political, they are increasingly pessimistic about any resolution to their plight.

Something of their situation was summed up recently by Latin Patriarch Michel Sabbah of Jerusalem, a longtime champion of Palestinian rights, when he met earlier this month with a group of American journalists who write for Catholic publications.

Speaking of the situation in the Gaza Strip but also about the fate of Palestinians generally, Sabbah said: “They are not terrorists; they are people who are living under oppression and who are reacting. And not all of them are reacting. There are Palestinians who don’t react at all, who go on living their lives in despair and humiliation and poverty. They go on living under occupation without any reaction.”

Others feel similarly -- with a pronounced touch of pessimism. “We’re going nowhere,” Rafik Husseini, the chief of staff to President Mahmoud Abbas, said during an interview at the Palestinian Authority’s headquarters in Ramallah.

Sulieman Harb Shalaldeh, the mayor of the municipality of Sier, near the city of Hebron, expressed the hope that he could soon govern normally.

“Let us keep the politics outside so that our people can continue their lives,” Shalaldeh said recently to the group of journalists. Shalaldeh has to deal with competing political claims, day-to-day-tensions, and now strikes by frustrated Palestinian workers who have not been paid since U.S.-led international sanctions and cuts to the Palestinian Authority by the Israeli government were imposed in March. The cuts by the Israelis alone have resulted in a monthly loss of $50 million in customs receipts.

The mayor’s comments were echoed by a teacher who greeted her American guests with fresh fruit, cakes and tea. “The majority of Palestinians, 90 percent, have no relationship with politics,” she said. “But politics are reflected severely in their daily life.”

So is history. To an outsider what is perhaps most striking in Palestinian refugee settlements and other public spaces are murals depicting uprooted villages lost for 50 years or more, with some still clinging to keys and land titles of areas now occupied by Israeli homes, public spaces and even shopping malls.

Given the overwhelming sense of history and grievance that prevails here, the teacher’s name is all the more revealing. The woman speaking was named Palestine Hussein.

Facts on the ground

The phrase “facts on the ground” is often used to describe the reality of what Palestinians see as the things that make a viable Palestinian state and society difficult if not outright impossible: Israeli settlements, outposts, settler roads, checkpoints, the routing of a 420-mile separation barrier. But it just as easily could describe the deleterious humanitarian situation in the Palestinian territories themselves.

The territories’ gross domestic product stands at $1,183 per capita, according to the World Health Organization. Unemployment rates overall stand at 25.3 percent, while rates of poverty overall are 56 percent. The poverty rate in the impoverished Gaza Strip stands at an astonishing 80 percent.

“The population’s socioeconomic conditions and access to health care are severely affected by lack of contiguity between the West Bank and Gaza and restrictions on movements,” the World Health Organization said in a recent summary.

Current conditions -- exacerbated by an unsettled political situation -- are believed to have worsened humanitarian problems: Chronic malnutrition has long been a problem in the territories and has been particularly acute in Gaza, where a 2003 study by CARE International indicated that 13.3 percent of small children in Gaza suffered from chronic malnutrition -- 11 percent higher than a “normally nourished” population would suffer.

What precipitated the current crisis was the January victory of the political faction Hamas in Palestinian Legislative Council elections. Hamas’ victory in turn led to international sanctions that have cut assistance to the Palestinian Authority -- a move that Palestinians have decried as unfair and unjust.

“You wanted democracy and now when you see the fruit of our democracy you say, ‘No, we will boycott you.’ ” Sabbah said about the popular reaction to the move: “This is wrong, unfair and unjust for the Palestinian people.”

The Israeli and U.S. governments said sanctions are justified because Hamas is a terrorist organization. Palestinians -- and this includes those aligned with the rival political faction Fatah -- acknowledge and even embrace Hamas’ militancy. But they have also stressed what they say is Hamas’ political and humanitarian roots and argue that Hamas is no al-Qaeda. In fact, they contend, beginning in the 1970s, Israel itself helped foster the creation of Hamas as an Islamic alternative to the secular Palestine Liberation Organization.

The Israeli and U.S. governments have interpreted the Hamas victory as a worrisome sign of growing Palestinian and Islamic militancy, while Palestinians have tended to view the Hamas victory as a protest vote and a referendum on what they say was a corrupt and out-of-touch Fatah elite that had, the sentiment went, cravenly compromised with Israel during the 1990s. (While Hamas controls the Palestinian legislature, President Mahmoud Abbas is aligned with Fatah.)

Over dinner at a Ramallah restaurant, Nader Said, a development studies specialist who teaches at Birzeit University, said public sentiment went something like this: “Let’s try Hamas; we know Hamas won’t work, but let’s stick to our identity.” He said that Hamas had hit a deep public nerve.

However one defines Hamas and interprets the elections, the results proved a smashing blow in at least one respect: Western sanctions remain in place against the Palestinian government, with assistance being cut off until Hamas recognizes Israel’s right to exist and renounces violence against Israel.

These demands form the core of contention between various the Palestinian factions and were cause for continued dispute recently between Hamas and Fatah over a new compromise prime minister. The current prime minister, Ismail Haniyeh of Hamas, has said he would resign if it would help restore international assistance to the Palestinian government.

The practical result of all of this is that salaries for some 140,000 government workers are not being paid -- prompting a joke by Husseini, the presidential chief of staff. He said recently on a Sunday evening that he was beginning his second work shift, at no pay. “I knew this would be a 75 percent reduction of pay,” he said. “I didn’t expect it would be 100 percent.”

Jokes aside, the sanctions have not only caused obvious hardships but also prompted a 70-day teachers’ strike, as well as walkouts by other public employees. Worsening day-to-day public services have become the norm.

“The boycott has had a devastating and cumulative effect,” said Tom Garofalo, the Jerusalem-based country representative for Catholic Relief Services. “Things are declining geometrically.”

Maybe not indefinitely, however: The end of the teachers’ strike Nov. 11 proved a major relief, and Arab nations that had joined the boycott have announced they will drop it, in part because of anger over a recent Israeli military attack in Gaza.

Nonetheless, reminders of what has been a stark, confusing and dispiriting time are everywhere: A school built with assistance from Catholic Relief Services in the village of Sier recently stood empty. A group of school administrators and parents huddled around a small administrative office and said both they and students have felt stranded and isolated by the strike and the international boycott, which they said have worsened the day-to-day hardships imposed by the occupation.

“What can we do?” said headmaster Ahed Mohid Jebreen who, like the parents, spoke about their coping mechanisms in an economy that has stalled -- be it borrowing from shop owners (and piling up debts), or selling family jewelry to pay bills.

“All the world is punishing us for our democracy, and that is not fair,” Jebreen said. Such punishment, he and the others stressed, is not punishing Hamas, but punishing the struggling Palestinian middle class and poor people.

A recent survey spearheaded by Said’s Development Studies Program confirmed those anecdotal observations: Of 1,200 persons surveyed in September, nearly three-quarters said their daily lives and living conditions had become worst since the January elections.

The survey also revealed that while Hamas’ popularity has declined precipitously -- from 50 percent in April to a mere 31 percent five months later -- a majority of those polled still thought Hamas should form a coalition government. And a majority, 62.3 percent, also said Hamas should not be expected to recognize Israel immediately. The poll also found that distrust of the United States was as widespread and deep as could possibly be: a full 94.4 percent said the United States had not played a constructive role in resolving the Israeli-Palestinian standoff.

This tense environment has also affected the response of American humanitarian agencies, such as Catholic Relief Services, that receive U.S. government funding for projects in the Palestinian territories. Catholic Relief Services has to abide by a no-contact rule with all Hamas officials, though it can still keep contact with such national bodies as the Palestinian president’s office.

As a practical result, that means the Catholic agency “has had to roll with some big changes,” Garofalo said. It has also made it occasionally difficult for local staff who, like any “on-the-ground” humanitarian workers, must deal with local authorities and governments no matter what their political affiliation. “We can function, but it has been difficult for our staff who work in Hebron, Bethlehem and Gaza,” Garofalo said.

These and other difficulties have changed a society that despite its many challenges was, in Said’s words, vibrant and hopeful. Now, day-to-day life seems more fragmentary and pinched, with horizons eclipsing. “The whole dream of a Palestinian state is in danger,” he said.

“We’ll do the small things we do each day,” he said. “But the big picture is desperate.”

He paused for a moment. “We’re asked, “Why do you have fundamentalists?” he said. His response: “It’s because you are closing all of the windows of fresh air.”

That is perhaps nowhere more evident than in Gaza, a place other Palestinians call everything from a prison to a mental asylum.

Potential powder keg

It doesn’t take long to learn that Gaza can break your heart.

A sunny Mediterranean outpost that contains some of the most crowded and densely populated urban areas on the planet, Gaza is an impoverished and dispiriting place until you listen to college-age students and young people speak passionately about furthering their skills in computer sciences and English -- although they do so amid the more-than-occasional and not terribly distant cracks of gunfire rounds.

Kidnappings are common here -- though it is said that they often stem more from boredom than from any political or even monetary motivation -- and have added to the sense of a powder keg in the making.

Now in the hands of the Palestinian Authority after a series of well-publicized withdrawals by Israel, Gaza is distinctly different from the West Bank, where Israeli and Palestinian communities collide and jut into each other. In Gaza, a sense of isolation and even imprisonment has taken root, resulting in ennui at best, contempt and extremism at worst.

“Throw whatever you want at us” is how presidential chief of staff Husseini describes popular sentiment in Gaza. “They are desperate. They have no hope. And they have nothing to lose but their chains.”

It is from Gaza that small, homemade rockets are often fired into Israel, prompting what Palestinians have called Israeli overreaction, but what Israel has declared as justified security measures of self-defense.

“I know the Gaza people are suffering,” said Bahij Mansour, a one-time member of the Israeli diplomatic corps who now heads Israel’s department of religious affairs and who spoke on Israeli policies recently to a group of Americans. But he said that Israel feels justified in protecting its borders along the Gaza Strip.

It is Gaza, in the town of Beit Hanoun, that drew worldwide focus recently when Israeli artillery killed 18 Palestinians -- including 13 members of a single family -- in a military operation that was criticized internationally and resulted in a United Nations Security Council resolution of condemnation that was vetoed by the United States. Israel, apparently embarrassed by an incident that killed primarily women and children, called the shelling “a mistake.” The move prompted new threats of suicide bombings, as well as fury throughout the Arab-speaking world and even talk of a third intifada within the occupied territories.

If the long-term ramifications of the Israeli action and the Palestinian response remain to be seen, it is not hard to imagine that the voices of Palestinian moderates in Gaza may become harder to hear.

Mohammed Ismail, 22, is one such voice. Active in a Gaza youth leadership program, Ismail is a one-time English student, an avid reader of Ernest Hemingway, and has hopes of studying English at the graduate level. He acknowledged that Gaza residents have reached a level of anger where they are “not afraid of losing everything.”

At the same time, though, he knows there are liberals in Israel who do not support their government’s policies toward the Palestinians and wishes there was a way for them to make common cause with Palestinians like himself.

One reason he believes that should remain a priority is because of a simple truism, recognized by many but maybe by not all on both the Palestinian and Israeli divide.

“We are here, they are there. We’re not leaving, and they’re not leaving.”

Chris Herlinger, a New York freelance journalist, recently traveled to Israel and the Palestinian territories as part of a prize for Catholic Relief Services’ Eileen Egan Award for Journalistic Excellence, which he won for reporting on Darfur for NCR in 2005. Photographer Paul Jeffrey, also an Egan Award winner, assisted with the reporting for this article.

We are either living in a reverie or in denial. When someone you know gets injured in this conflict, you expect to have feelings of outrage, deep sadness, or at least the manifestation of these feelings should be the normal outpourings of grief, sorrow and concern. And yet, news of casualties of a latest Israeli atrocity or an inter-factional battle does not faze people as it once did.

I want to be in hysterics. I know it is not something ordinary to say, but the truth is, this conflict has made people accept as normal, things that elsewhere would elicit deep reactions of wailing, or at least tears, or the momentary satisfaction of venting anger by breaking dishes across a room. Are the restrained reactions that many Palestinians have are merely a self-defense mechanism? Or are we really in denial about what is going on in down town Ramallah or on the beaches of the Gaza Strip? Has the daily dose of grim stories become such an ordinary thing in our life that we wake up each morning, wanting, needing a fix of the usual blood-drenched front page that we pour over while doing something as normal as having our morning coffee and scrambled eggs?

So, shouldn’t I be in hysterics? When I heard that a photojournalist that I know, Osama Silwadi, had been shot while doing something quite unexciting as to look out his office window during a procession on Ramallah’s main street, I cannot describe the feelings that went through my head. Funny, but I thought emotions are not supposed to be cerebral, and yet, I block feelings, like so many Palestinians (and even some foreigners living among us) have become used to doing, in order not to allow myself the luxury of sinking into a depression every time I hear a story of a child killed or a family annihilated, because there are far too many to count. Many of us have learned over the years that if you allow yourself the slightest chance to let the situation overcome you, you are done for and you will be unable to function.

Osama used to be a photojournalist for AFP and Reuters before he decided to become a freelancer and create a Palestinian image bank (www.apollo.ps). He is a father of three children, who now lies in a coma in a hospital bed in Tel Aviv, so far away from his family and friends in Ramallah that no one can visit him or offer his wife the support she needs at this time.

As Osama watched the procession below on Ramallah’s main street from his office window this past Sunday, boys were shooting into the air to commemorate a fallen comrade. I say boys because my (female) mind cannot accept the fact that mature men would be so irresponsible as to shoot in the air in a densely populated area, where the chance of a stray bullet hitting someone is not a remote possibility, but a certainty. And so, the bullet traveled from the barrel of one of those boys’ guns into Osama’s now non-existent spleen, up near his heart to lodge finally in his spinal cord.

The prognosis is not good and we all hope and pray for his recovery, knowing that when he finally wakes up from his coma, he will find that his reality has changed so dramatically around him and he will have to grapple with whether or not he will be able to resume his life as he had once lived it. All those times in the field when he knew that he was a taking chance on life by snapping shots of stone-throwing youths confronting soldiers, or non-violent protestors against the Wall, did he never stop to think that life is so fragile in any case that even a simple walk under rickety scaffolding or taking the wrong turn in a road can result in a fatal accident?

Not to sound like a cliché, but such is life, whether you have lived in a conflict zone all your life or not, you cannot cower in your house forever in the off-chance that you might be struck by lightening. Perhaps, however, people who have gone through trauma feel invincible and the sense of danger is blunted and lightly brushed aside, and so it could quite have possibly been those thoughts that went through Osama’s mind seconds before the impact of the bullet ripped through his body.

It is odd how yesterday morning, when I heard the news, all I could think about is how ordinary this news sounded, despite the fact that Osama had been on my mind quite often these past few days, because I was looking at some recent photos I had taken with his voice about light, lines and frame running through my head. I realized with some unease that I lost the ability to be shocked, indeed a friend told me once that he also lost the ability to be astonished by such things as the first flowering of spring or the birth of a child and that is how I feel sometimes, like I am a car in neutral mode most of the time. And while I am deeply saddened by what has happened to Osama, I am unable to reach down into that deep place where I will allow myself to feel more than the very superficial of feelings and I know that tears will not come.

It completely worries me, this sense that we are becoming a nation of zombies, who have turned off the tap of basic human responses to bad and good news alike that something like the recent inter-factional fighting is not so shocking or unexpected. Once you stop being shocked, then you stop being afraid, and once you stop being afraid, you can do anything out of the bounds of acceptable human behavior. The signs of intimidating armed men running unrestrained among the population should be dealt with immediately and decisively.

More importantly, the indications that we are heading toward a civil war that so many are trying to suppress and deny, will become a full-blown reality if this is allowed to continue and then there will be no turning back to a time when Palestinians put the national interests before the factional, if ever there were such a time. If that should happen, there will be more innocent bystanders like Osama, who will pay the heavy price of the craziness that we have sunken to in recent months, and ultimately Palestine will hemorrhage outwards and be drained of its wealth of people, who today still have the ability to save it from becoming yet another tragic tale for the history books.

I have a feeling which becomes stronger as the days pass that now is the time for starting a new path for peace. Although such feelings sometimes are strange and bizarre, the facts on the ground drag the thinking to a whole new direction.

The election of Hamas for the government of Palestine is nothing but a new motive in that direction. Since its election and up until the massacre of Beit Hanoun - and what is in between of the strangulating and strict siege - the whole world roared for the renewed pains of the Palestinian people. Even in Israel itself, women and men are denouncing such massacres and famines. Moreover, Europe expressed its resentment through marches and demonstrations, the last of which was the European Union denouncement of Israel; the Arab League voice was raised a little higher.

From another perspective, there is evidence that the long-term dialogue, which started as if it is a dialogue between two deaf parties Fatah and Hamas, returned the sense of conscious awareness for the talking parties. They are on the edge of a new declaration, which I think became almost ready, waiting for a deal regarding the Israeli soldier, exchange of prisoners, stoppage of rockets, and guarantees to transfer money.

All such positive initiatives were crowned by a significant European initiative, which Toni Blair, personally, drafted a week before it was declared, calling for participation of Iran and Syria in regional political negotiations regarding Palestine, Iraq, and Lebanon. The Spanish Prime Minister announced the new European initiative which is holding a special conference for peace in the Middle East. At all levels, steps are accelerating, and at all doors hands are knocking, and Palestinians have to realize that they have to move fast and work harder before it is too late in order to take advantage of the accelerating events.

Hamas, in particular, went through a bitter experience, since its winning of the elections. No one was spared from conspiring against Hamas, even if the victims were the Palestinian people as a whole. Hamas did not do well in its leadership and management of the past events. It was not ready, despite its genuineness and intentions. Today, Hamas has a golden and historical opportunity and I hope that it does not waste it and waste another 24 years of the Palestinian people's lives.

Briefly, Hamas has a heavy responsibility, which is not just winning elections, forming governments, appointing ministers, distributing allowances for ministers and others, marching parades, distributing goods and scholarships, hiring individuals, and releasing enthusiastic slogans. This is not the responsibility of the government; This is not what we expect from the government.

The responsibility of Hamas is finding solutions for the cause of Palestinian people and its chronic battle with Israel. It is a political battle that can not be solved by power or rockets; it is an ideological battle that Hamas should go through amongst itself and its Cadres regarding the horizon of the solution that guarantees that Muslims, Christians, Jews, and all religions live in an equal environment in the holy land, based on adoption of rightness, law, and peace. It is not Hamas role to keep challenging by slogans of resistance, confrontation, refusal, and hard-mindedness. Such solutions are the easy ones. The main and difficult mission is the ability to reach solutions and ideal formulation for co-existence, without having dominance or control for a certain religion over another.

The noble-minded and final solution for any liberation movement or revolution is the liberation of human beings, and ensuring rightness and implanting justice without discrimination or favoritism. That is peace which Islam calls for. That is why Islam is calling us to preserve blood and life and enjoyment of peace as the big meaning for Islam is peace itself. As a result, Hamas has a basic duty of showing the bright face of Islam after it was exposed to many aching defeats, particularly after the world- with some conspiring Islamic assistance, was successful in linking the name of Islam with Terrorism.

This is the significant role of Hamas, that is; to give Islam the image that is able to convert the international public opinion to support Islam, the Islam of rightness, the Islam of human rights, the Islam of peace. Over the past decades, we got used to play broken CDs to listen to it in every occasion, when houses and blood was scattered in every occasion we revert to sadness and grief, where many of us became professional in slapping our own faces and releasing the tuning slogans, and reverting to old-fashioned means of solace.

What is needed today in this new era is something that is related to thinking and ideology to break through the world. What is needed today is new minds and intellectuals, to save us and our cause from the immature and slogans. Such slogans and means brought us nothing but more defeats. We have tried the slogans and failed over and over again.

This is the real challenge for Hamas movement. If it succeeded, we succeed with it. If it failed, it will be a new setback for us that might extend for long decades, terminating Hamas, as others did, and terminating a new generation of our Palestinian cause.

The political scene in Palestine and Israel offers no solace. In Palestine, the usual old populist rhetoric was wheeled out with people calling for earthquake-like revenge, while mediocre politicians got busy trying to score public relations points over other mediocrities. They reminded me of student speakers at London's Hyde Park Corner. The exception was President Mahmoud Abbas who seemed in genuine pain and was genuinely angry. He was always committed to peace and denouncing killings and violence.

The Israeli scene is even worse. The signs are ominous when people like Avigdor Lieberman are welcomed into the Cabinet while the once promising Defense Minister, Amir Peretz, appears to have been thoroughly chewed and absorbed by the military establishment.

This should not be the time for mediocrity, politicking or revenge from individuals and other parties. They have wasted too much time and too many lives. They were occupied with wars and killings in the name of dignity, freedom, and security. They were not concerned about peace, which is solely means dignity, freedom, and security. It is now more urgent than ever for all those who still truly believe in peace - Palestinians, Israelis and friends and allies all over the world - to unite their efforts in order to give reconciliation and peace a last chance. This is vital as there are international moves and signs signaling that it is about time. This is evidenced nowadays that warmongers like Donald Rumsfeld are out, the rest should be pursued wherever they are and particularly in Palestine and Israel. Even Blair himself who was calling for war became in his way to be vanished politically, despite the fact that he is trying to be peace calling. I don't need to contemplate their paranoid question: Do they want to make peace? The answer, on behalf of all people, is an unequivocal "yes." But, we have to expose the foes of peace and freedom. We know how powerful the Pentagon and the Israeli war machine are. This war machine, with its hegemony over Israeli politics, is bigger than Israel itself and must be stopped. It is a tool of death and destruction. The Israeli political community, public and leadership alike, must know that it is a captive of this powerful establishment. Israelis should know that their security will only be found through strategic peace with Palestinians, and not through the power to kill, subservience to the powerful military machine or dependence on the American administration.

Responsible Palestinian leaders, from Hamas particularly, must make every effort to restore the Israeli public's confidence in Palestinians, lost after six years of horror and lies. They should make the effort to convince their own constituencies of the merits of peace and help shape a new culture. This should be done systematically and on all fronts. Imagine if Hamas comes out today, after all this pain, and declares a complete ban on all forms of violence and extend its hand for peace, rather than launching rockets and announcing publicly its responsibility for them.

Israel must be told, by Hamas and others, that it is a country in the Middle East, and so is Palestine. These two countries must live together or die together. Between them, they have all the ingredients for prosperity and together they can help the region and the world.

The world must be offered the chance to see the good Palestinian, the good Arab and the good Muslim. We must be offered the chance to see the good Jew and the well-intentioned Christians and West. It is all in our grasp, but, we need to take that important leap by acting now with courage and wisdom.

A unified vision and strategy on the Palestinian side must lead us toward peace. Hamas is an essential part of the political map and should declare its readiness to rise to the responsibility of not only making internal reforms but, more importantly, participation in making peace with Israel.

Hamas' rise to power was well-deserved and democratic. It is tragic that it was not ready for this dramatic chance, and it is tragic Hamas was never given a fair chance to govern. After months of pressure, Hamas is yielding to the calls of the international community. Hamas should be encouraged and be engaged on all levels and all conspiracies must stop. A truly democratic culture based on the rule of law is one of the keys to peace.

Fatah and Hamas need to stand behind Abbas' leadership who can help the nation and the region because of his unique stature, position and the worldwide respect for his leadership that is based on his strategic vision of peacemaking. His only weak point is not having the proper tools at his disposal. Hamas and Fatah should provide him with such supportive tools, similar to what is being done by intellectuals and academics. And now is the time.

Eyad El Sarraj director general of Gaza Community Mental Health Programme and a human rights activist.

The recent parliamentary elections in Palestine were the equivalent of a political earthquake. It is an earthquake that brings with it the possibility of dramatic change in the Middle East and beyond. The elections represented the first time in history that an Islamic movement came to power in the Arab world through peaceful and clean democratic elections. It is important, however, to note that religion itself played only a small role in the vote, no more, in my opinion, than 15 percent. The bulk of the vote was a protest against Fateh for its dismal record on all fronts and a defiant message against the Israeli occupation and American policies.

Hamas now is challenged by its history to face the future. I believe it has some smart people who will help it climb down the tree, because if Hamas succeeds in running the country and negotiating peace, the next ten years will see the Arab world ruled by Islamic governments. Hamas is currently agonizing over the issue of recognizing Israel and renouncing violence, but I think it will do so with time. This is a historical moment for the Islamic movement and an opportunity it won't want to miss. Hamas leaders have already declared that they will respect all previous agreements between Israel and the PA, and Mahmoud Zahhar, in recent days, further said that America is "not our enemy and she holds the key to peace in the Middle East."

The question now is how others react. Fateh is finding it all very difficult to swallow, from the president on down. However, it is important that there is a serious internal dialogue with Hamas and that the vote of the people is respected. Even if the vote gave people the opportunity to punish Fateh, Fateh should not punish people by letting Hamas run aground.

The Israeli government will be more than happy if Hamas does not change. Israel already started on a unilateral course under Ariel Sharon. Should Hamas show no inclination to change, it will be all the justification Israel needs to stave off any (muted) international pressure to negotiate and instead continue what Sharon started, grabbing whatever land it wants and giving nothing to the Palestinians, who in any case are not considered by Israel as partners for peace.

The declared Hamas positions of not recognizing Israel and refusing to surrender arms play well in the hearts and minds of the masses, who believe that Israel should first recognize Palestinian rights and end the occupation of Palestinian and Arab land. But Hamas would be well advised to declare its commitment to the Arab Peace Initiative of March 2002, which calls for mutual recognition of Israel and full relations conditioned on Israeli withdrawal from all occupied Arab land. Hamas could also form a cabinet of technocrats and give President Mahmoud Abbas the mandate to conduct foreign policy while Hamas restructures and rehabilitates the Palestinian Authority.

Israel, for its part, stands at a crossroads. Israel has never taken Palestinian rights seriously, let alone been willing to accede to them. The ascendancy of Hamas represents a chance for Israel, but, and this goes for whoever sits at the helm of the Palestinian polity, Israel will never achieve peace without recognizing that Palestinians have rights that must be fulfilled. Hamas' victory represents the ultimate proof. If it were not for the Israeli occupation there would be no Hamas and no armed resistance.

Dr. Eyad El Sarraj

The collective Palestinian psyche is a mixture of painful memories, old and recent traumas, an unyielding quest for freedom and a profound longing for a dignified life.

In December 1987, the Palestinian popular uprising, the Intifada, against the Israeli military occupation opened a dramatic new chapter in the Israeli-Palestinian conflict with far-reaching psychological, political, and socio-economic consequences.

The Israeli army's response to the Intifada was to increase brutal and oppressive measures. These measures included killings, detentions without trial, demolition of homes, torture, deportation, and curfews.

The Palestinian Human Rights Information Center estimates that during the period of the first Intifada (December 1987 to December 1993), 1,282 Palestinians died (of which 332 were children) as a result of the conflict and 130,472 Palestinians were injured. Among the injured there are those that remain with permanent disabilities. Furthermore, approximately 57,000 Palestinians were arrested (many of whom were subjected to systematic physical and psychological torture)(1), over 481 were deported and 2,532 had their homes demolished. The psychosocial and financial costs for the affected families in terms of medical and psychosocial care, loss of productive time, chronic disability, loss of function, and loss of life and property are enormous. (2)

Two kinds of trauma have been considered the most difficult to cope with – torture and home demolitions

• The use of torture in Israeli interrogation centers was sanctioned by law until the Israeli High Court of Justice ruled in 1999 that all forms of torture during in interrogations are unlawful (except for moderate use of physical pressure!). Research from the Gaza Community Mental Health Programme (GCMHP) showed that 30% of torture survivors developed Post-Traumatic Stress Disorder (PTSD) and that the more a prisoner had been exposed to physical, chemical or electric torture, psychological ill-treatment, sensory deprivation or bombardment, the more he subsequently suffered from intrusive re-experiencing, withdrawal, numbness, and hyper-arousal. Electric and chemical torture constituted the most serious risk for PTSD symptoms. Both physical and psychological methods of torture placed victims at serious risk for intrusive experiences trauma. (3) It is worth mentioning that some political prisoners did not develop signs or symptoms of PTSD.
• Home demolition has been one of the harshest methods of collective punishment carried out on the Palestinian population. During the Al-Aqsa Intifada, the number of demolitions of private homes exceeded thousands The Donor Support Group Statistics in April 2003, estimates total damage of private housing to be US$ 63,008,410. Many families currently live in tents or in relatives' houses, which causes frustration and conflicts between family members. Children who were exposed to loss of home were severely disturbed. (4)

In 1990, the GCMHP established programs to care for children who were most traumatized. Many children have detailed and sequential forms of trauma. Most come from overcrowded homes and many have had their parents arrested, humiliated, beaten and imprisoned. In many instances there was a direct link between events in which the child witnessed humiliation of the father and his desire to throw stones at Israeli soldiers. Children who come from families of imprisoned fathers were more ready to join the struggle against the occupation.

Mental disorder in the Palestinian culture is seen as either a form of weakness, spoiled behavior or spiritual possession, but always stigmatic. Throughout the years, the most immediate resource for Palestinians has been the family, which is still cohesive and eager to assume responsibility for the weak, elderly or ill.

Although the years of occupation and conflict have impacted negatively the physical, psychological and mental well being of Palestinians, the Israeli unilateral disengagement from Gaza could be an opportunity for peace. Ending the cycle of violence and victimization can only be achieved through a political settlement and through national reconciliation.

**Eyad El Sarraj is a psychiatrist, human rights and peace activist. He founded the Gaza Community Mental Health Programme (GCMHP) in 1990 to provide comprehensive community mental health services - therapy, training and research - to the population of the Gaza Strip. He is currently the Chairman.

Mr. President,

I am in full support of your vision and initiative for a greater Middle East. It would be really great if we would get rid of all the dictators, kings or presidents in the Arab countries. It is a beautiful dream to think that one day we will see democracy and respect of human rights within the rule of law. Arab countries, almost all, are lagging seriously behind the rest of the world. Lack of democracy is one of the reasons for violence and terror.

Indeed Mr. President, it would be a miracle if we wake up one day to find no political prisoners, no torture, no military courts and full respect of international laws and treaties.

It would certainly be a huge leap into civilisation and progress.

Some Arab politicians are scared of reform because it means that they would be out of office, and may be out of pocket if not in jail. They use any excuse to reject it, such as "reform should not be imposed from outside."

No one is suggesting that reform will be imposed from outside. They should listen to advice from friends like you. I am sure you also would welcome their advice too, that is if they have any to offer.

Well Mr. President, I have some advice.

To begin with it is vital that you treat the Arabs as partners and not just an area of oil reserves.

Why not give us an example by reforming the US policies?

Would it not be good if America showed more respect to human rights in Guantanamo and elsewhere?

Would it not be beautiful if America began to show respect for international legality, including respect for United Nations Security Council resolutions and ratifying the treaties on the protection of the environment?

Would it not be encouraging if America stopped being one of a minority of two on the international stage -- itself and Israel against the rest of the world?

Would it not open up new possibilities if America started to show fairness by asking Israel to end its four decades of occupation of Palestine and open its doors for the inspection of its stockpiles of weapons of mass destruction -- otherwise America would consider sanctions and possibly war?

Mr. President, by taking action in this way I am confident that you will offer an irresistible example for the Arabs and the rest of the world. After all we are friends and no one is imposing anything on any body.

Finally, Mr. President I want to tell you an Arab popular proverb. It says: ‘He who lives in a glass house should not throw stones at others’. I’m sure you understand.

Sincerely,

Eyad El Sarraj, MD
Chairman of the Board,
Gaza Community Mental Health Programme
Gaza-Palestine

NB. This is my second letter to you and I hope this time I’ll get an answer although I understand how much busy you are.