The refrigerator in the Shiham household is bare save for a container of cheese, a bucket of tomatoes, and some wrinkled cucumbers. The meat in the freezer is rationed as the family of eight lives on handouts and intermittent welfare stipends.
"Every two weeks, we eat meat. When the children miss it, we have it," says Douaa Shiham, a widowed mother of seven who often sends her children to school with no lunch. "I have no say in what we eat. I wait for the charity to come."
A sign of economic deterioration in the West Bank and Gaza, the growing pressure on the Shiham family reflects a crisis that affects one-third of all Palestinians and threatens another 12 percent, according to a study by a division of the United Nations World Food Programme (WFP).
Families like the Shihams in this Palestinian refugee camp have coped with poverty even before Hamas took power in January 2006. But human rights workers and the families themselves say that conditions have grown much worse in the aftermath of the international economic boycott of the government led by the Islamist militants.
Humanitarian groups call it "food insecurity," a predicament in which a family lacks the money to purchase the food necessary to meet basic needs.
While the WFP says that food insecurity has remained steady at 34 percent, the organization has had to increase the number of beneficiaries of its food aid program by 25 percent to 600,000 Palestinians to stave off a broader crisis.
The problem is most acute in Gaza, where Israeli security clampdowns at commercial and civilian crossings have pushed unemployment to 39 percent and exposed 54 percent of 1.4 million Gazans to food insecurity, according to the WFP.
Once a month, WFP food aid recipients get a shipment of flour, sugar, oil, chickpeas, beans, salt, and canned meat, though it is often insufficient because families of 10 often get rations based on a family of seven.
Since her husband died nearly a year and a half ago, Mrs. Shiham and her children have become dependent on payouts of 500 shekels ($120) every three months. When the donors to the Palestinian Authority (PA) initiated an aid boycott last spring because of Hamas's refusal to recognize Israel, the stipends from the social welfare ministry became more infrequent, coming just every six months.
Shiham also made the round of local Islamic charities, but some were shut down by the Israeli army on suspicion they had served as a financial conduit for Hamas.
Breakfast for the family consists of tea, bread, and olive oil. Lunch is often rice and lentils. Though Shiham can afford vegetables if she buys leftover produce at discount prices, she rarely has money for fruit.
"My kids love apples and they love bananas," she says. "Today, my son asked for apples, and I said, 'I don't have the money.' I started thinking, 'How am I going to get money for apples?' "
Though the international sanctions were aimed at the Hamas-led government, because the Palestinian economy is so dependent on public spending, per capita growth declined as much as 10 percent in 2006, according to a preliminary estimate by the World Bank. The reversal of three consecutive years of growth was also affected by a rise in security closures around Gaza and West Bank cities.
Israel argues that despite the security measures to protect its citizens against terrorist attacks, it is doing everything it can to ease the suffering of the Palestinian population.
"We are committed to working with the international community to ensure there are no food shortages in the territories," says Mark Regev, a spokesman for the Israeli Foreign Ministry. "No one wants to see innocent Palestinians pay the price of an extremist and shortsighted Palestinian government."
But Daphna Golan, a researcher at Hebrew University's Minerva Center for Human Rights, argued that Israel needs to loosen restrictions of Palestinian movement to allow the Palestinian economy to grow. "If we want a normal future here," she says, "we don't want neighbors who are hungry."
In Ramallah, signs of the desperation can be seen at traffic intersections and in automobile queues at Israeli checkpoints, where there has been an increase in the number of children hawking merchandise like gum and plastic toys to earn pocket change.
"People want their kids to start bringing in income," says Jamil Rabah, an independent pollster who studies food insecurity for the WFP. "It's close to begging."
The food distress is reflected by cutbacks in the quantity and quality of food purchased. It has also prompted Palestinians to cut corners on items normally considered essential, like education and medical services.
"They keep their bellies full at the expense of not going to the doctor," Mr. Rabah says. "Food remains the last resort because food is living."
The WFP defines the Palestinian poverty line at a total expenditure of $2 per person per day. Those who suffer from food insecurity only have $1.60 per day to spend.
In the Kalandia Refugee Camp, Rubin Hussein flipped through ledgers that list the debts of his customers. They owe him nearly $20,000. Consumption has plummeted, and those who still buy are forced to purchase frozen meat.
"People don't eat high-quality meat," he says. "They go for the cheaper meat."
With a 500-shekel debt of her own at the butcher, Shiham says she hasn't been to the shop in two months. All of the meat in the refrigerator was donated by relatives during a recent holiday.
When her children ask her why classmates eat chicken schnitzel and bologna for lunch while they make do with bread and hyssop, there is not much to say: "I tell them, 'I can't give you.' "