Under a tight blockade by Israel and Egypt, the people of Gaza are well acquainted with suffering. Now the Trump administration will be compounding their suffering by cutting much needed financial aid.
Staff at the United Nations Relief and Works Agency for Palestine Refugees (UNRWA), in Gaza have gone on strike paralysing the impoverished region.
The agency has cut more than 965 jobs according to local workers affected by the cuts.
Jaber Thabit, part of UNRWA psychological healthcare staff, speaking to TRT World called the cuts "arbitrary and has no justification".
The fear amongst many of the local staff that have been affected by the cuts in the impoverished Gaza Strip goes beyond their precarious financial situation.
"I have worked 15 years in the agency. I have 10 children. It is a big family. Our economic situation is so bad," said Sami Nasir speaking to TRT World who had his wage cut in half.
"We are afraid that this cut could be a start of other procedures against Palestinians refugees."
What next for the beleaguered agency?
America has blown a massive hole in the UNRWA budget. The agency as a result has resorted to online crowdsourcing for funds, the only UN agency known to be resorting to this method to fund its activities.
In January of this year the Trump administration froze some $300 million of its $365 million in aid to the Agency.
Finally, this September, the totality of US contributions were cut leaving millions of Palestinian refugees in the lurch.
The UNRWA began the year with a deficit owing to American actions.
Adnan Abu Hasna, a UNRWA coordinator based in Gaza speaking to TRT World said "we are facing a huge financial crisis".
"UNRWA is the main service provider in Gaza, schooling more than 280,000 students, feeding more than 1 million people, who are in dire need and face regular shortages," he added.
Keeping the flame alive
The UNRWA has been much maligned by Zionist organisations, the Israeli government and the Trump administration.
Over the last seven decades, the UNRWA has helped keep the issue of Palestinian refugees alive.
In doing so, the issues of the right of return for Palestinians who were forcibly evicted from what is today Israel has been a key sticking point in the negotiations between Israel and the Palestinian leadership.
Many right-wing groups both in the United States and Israel have long sought a defunding of UNRWA believing that once the organisation is hollowed out, its ability to maintain the refugee issue alive will also diminish.
The people of Gaza, 75 percent of whom are refugees, have been under a land, sea and air blockade by Israel and Egypt since 2007.
According to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) more than 53% of the inhabitants of Gaza live in poverty, even with humanitarian assistance.
The blockade shows no signs of easing with catastrophic effect on the living conditions and mortality rates on Palestinian civilians.