The batteries are the size of a button on a man's shirt, small silvery dots that power hearing aids for several hundred Palestinian students taught by the Atfaluna Society for Deaf Children in Gaza City.

Now the batteries, marketed by Radio Shack, are all but used up. The few that are left are losing power, turning voices into unintelligible echoes in the ears of Hala Abu Saif's 20 first-grade students.

The Israeli government is increasingly restricting the import into the Gaza Strip of batteries, anesthesia drugs, antibiotics, tobacco, coffee, gasoline, diesel fuel and other basic items, including chocolate and compressed air to make soft drinks.

This punishing seal has reduced Gaza, a territory of almost 1.5 million people, to beggar status, unable to maintain an effective public health system, administer public schools or preserve the traditional pleasures of everyday life by the sea.

"Essentially, it's the ordinary people, caught up in the conflict, paying the price for this political failure," said John Ging, director of the U.N. Relief and Works Agency in Gaza, which serves the majority refugee population. "The humanitarian situation is atrocious, and it is easy to understand why -- 1.2 million Gazans now relying on U.N. food aid, 80,000 people who have lost jobs and the dignity of work. And the list goes on."

Israeli military and political leaders say the restrictions are prompted by near-constant rocket and small-arms attacks and concerns over what uses Palestinian gunmen might have for some materials entering Gaza, particularly fuel and batteries.

The Israeli cordon tightened in June, when Hamas, a radical Islamic movement at war with Israel, seized control of Gaza. Israeli officials have insisted to the Bush administration that no humanitarian crisis would result from the sanctions imposed on the territory.

But for Gazans, caught between Israel's concrete gun towers and the Mediterranean, the sense of crisis is pervasive as they struggle to keep their homes intact, buy essential food from a shrinking and increasingly expensive stock, and educate their children.

"I hold every man, woman and child in Israel responsible for this," said Geraldine Shawa, 64, the Chicago-born director of the Atfaluna Society. A tall, imposing woman who has lived in Gaza for 36 years, Shawa has watched the fortunes of her pupils squeezed in recent months by what she calls Israel's practice of collective punishment.

Israeli military officials said last week that 2,000 rockets had been launched from Gaza toward Israel this year, killing two Israelis, wounding many others and instilling fear across the southern region. Since the U.S.-sponsored peace conference in Annapolis, Md., last month, Israeli airstrikes and ground forces have killed 26 Hamas gunmen, the Islamic organization says, as well as at least four Palestinian civilians.

Hamas's military wing is not behind most of the rocket attacks, for which smaller armed groups generally assert responsibility. But Hamas leaders do little to stop the firing of the rockets and rarely, if ever, condemn them.

On Tuesday, Israeli tanks rolled into the central Gaza city of Khan Younis. Six armed Palestinians from the Popular Resistance Committees, a militant splinter group, and the radical Islamic Jihad organization were killed in fighting. Israeli officials labeled the operation "routine."

"I hold each of them responsible, just as they obviously seem to hold all of us responsible," Shawa said of the Israelis. "If the Israeli government really has the power and the desire to change, well, this is pushing me in exactly the opposite way -- over the edge."

An Isolated Collective

Moamen Ayash, a frail, 6-year-old Palestinian boy in navy blue slacks and a pressed dress shirt, walked to the whiteboard at the front of his tidy classroom to work through some simple sign phrases.

Moamen has not had a working hearing aid for three months. Israeli military officials said they had no idea the batteries were not being delivered.

The inability to hear even the faintest sounds, which hearing aids sometimes make possible for the deaf, hinders children such as Moamen from acquiring spoken language.

Because few of the estimated 20,000 Gazans suffering from hearing loss know even rudimentary sign language, the deaf here represent an isolated collective, dependent for funding largely on the kindness of strangers and the proceeds of their own crafts shop.

Their condition resembles in some ways the larger estrangement of Gaza, a fenced-in, chaotic jumble of squalid refugee camps set amid rubble-strewn dunes that might someday be perches for resort hotels overlooking the turquoise sea.

Work is rare. Food is scarce. Gasoline is so hard to come by that Mahmoud al-Khozendar, 49, has hung an effigy of a man in a suit above the empty gas pumps at his station. The sign pinned to the hanging man's chest reads: "The Man in Charge."

Israel delivers electricity to Gaza that provides roughly 60 percent of the territory's energy. An Israeli Supreme Court decision is expected any day on whether the supply can be reduced as punishment for the rocket fire from Gaza, which Israel evacuated in the fall of 2005 after nearly four decades of military occupation.

In the rank, crowded wards of Gaza City's Shifa Hospital, the dispensary is out of 85 essential medicines and close to using up almost 150 others.

Dialysis treatment has been cut back from three to two times a week for even the most critically ill kidney patients, roughly 900 in all. A stack of nearly two dozen blood-cleaning machines gathers dust in a corner, awaiting spare parts that Palestinian doctors say have not been allowed through the border crossings between Gaza and Israel.

The minister of health, Bassem Naim, said in an interview last week that he is husbanding a two-week stock of anesthetic at a time when Israel is threatening to mount a broad military offensive into Gaza to end the rocket fire.

"They have turned Gaza into an animal farm -- we only are allowed to get what keeps us alive," he said.

Since June, Naim said, more than three dozen Palestinians seeking treatment for cancer and other critical illnesses at Israel's more advanced hospitals were rejected for passage by Israeli security agencies. The Israeli nonprofit group Physicians for Human Rights estimates the number of rejections "in the tens."

According to Naim, at least 29 patients have died since June, including 12-year-old Tamer al-Yazji, who Palestinian health officials said was denied entry into Israel after developing acute complications from encephalitis. Of the patients who approached Physicians for Human Rights for help, seven died before being granted passage to Israel, according to the organization.

"What do you call sending dozens of Gaza patients to a slow death because they are refused treatment?" Naim said. "That's not a humanitarian crisis. That's a war crime."

Maj. Peter Lerner, Israel's military liaison for international organizations working in Gaza, said 8,000 Gazans have been permitted to enter Israel for medical care since June.

It is not a risk-free venture for Israel. In 2004, a Palestinian woman detonated an explosives vest near the main Erez Crossing, killing four Israelis and herself. A year and a half later, a 21-year-old Palestinian woman passing through Erez for medical care at Soroka hospital in southern Israel was discovered smuggling a 20-pound bomb, which she unsuccessfully attempted to detonate.

"Hamas should be held accountable to the Palestinian people in Gaza," Lerner said. "They can't fire rockets in the morning and expect the crossings to be open for the sick in the afternoon."

Blackouts and Shortages

When Israel withdrew 8,500 Jewish settlers from Gaza along with the soldiers protecting them, Israeli leaders said the strip could become a prosperous proving ground for a future Palestinian state.

But since the rocket attacks from Gaza began -- killing a total of 13 Israeli citizens since the start of the most recent Palestinian uprising in September 2000 -- the frequent closure of crossings to Israel has choked the export-reliant Palestinian economy.

Hamas, which won parliamentary elections in January 2006, trounced the U.S.-backed Fatah movement in Gaza in June. The violent takeover, which Hamas swiftly consolidated politically and culturally, cemented the strip's isolation.

The political divide is widening between the West Bank, where the U.S.-backed administration of Palestinian Authority President Mahmoud Abbas of Fatah is in control, and Hamas-run Gaza. The two regions were once envisioned as the twin territories of a Palestinian state.

Now rolling blackouts have begun across the strip, partly because the Palestinian Authority refused for days last week to pay the Israeli company that supplies fuel to Gaza. The strip was receiving only about 24,000 gallons of diesel fuel a day, the lifeblood of the private-sector economy. Before June, the strip received nearly 80,000 gallons of diesel a day.

The Authority has paid its bills, but Israel has limited daily diesel deliveries to Gaza to about 50,000 gallons, some of which is used by the Hamas government and security forces. In addition, Israel sends 80,000 gallons a month directly to the U.N. agency for refugees to ensure that its operation continues.

Lerner, the Israeli military liaison, said this week that he would contact the International Committee of the Red Cross to make sure hearing-aid batteries would be allowed through the crossings.

A spokeswoman for the Atfaluna Society said none had been received so far.

The restrictions have also hampered the society's vocational programs, which use well-equipped wood shops, weaving looms and pottery studios. Thread for traditional Palestinian embroidery, wood for painted boxes and pottery glazes mostly remain on the far side of the backlogged Israeli border crossings.

"We may have enough for another month," said Mohamed al-Sharif, 36, who supervises the classes. "Then we will run out again."

Trucks carrying tobacco and coffee usually have low priority in the lines backed up at the crossings. Israeli military officials say they try to push 60 to 70 trucks through a day, despite frequent rocket and small-arms attacks.

In the meantime, Gazans improvise. "We've bought 20 tons of coffee from every store here we could find," said Riyadh Haigar, owner of the popular Delice Coffee Shop. "Maybe it'll last a month. Then we close the doors."