By Alan Johnston
BBC News, Gaza
An elderly man called Raabeh Al Masri sat in a Gaza City hospital ward linked by a tube in his arm to a machine that keeps him alive.
Dialysis patients at Shifa Hospital have had their treatment reduced
The dialysis unit was doing its job. It was pumping and whirring, and flushing his blood of contaminants.
But Mr Al Masri was worrying about the future.
He has watched a disturbing and potentially dangerous decline in the standard of care that the hospital can give him.
Staff say that Western efforts to starve the new Hamas-controlled Palestinian government of cash are partly to blame.
On account of the hospital's shortages of equipment and drugs, Mr Al Masri's visits for dialysis have been reduced from three to two times a week. And he says he definitely feels the difference.
"I am very, very sick," he said, in halting English. "I can't sleep in the night. My eyes can't see. No oxygen. No oxygen."
He says that fluid builds up in his body, and that his skin tone changes.
"I want the European Union and the Americans to help us," he said. "Because we have nothing here."
Out of cash
And Shifa Hospital's spokesman, Juma As-Saqqa said: "We are facing disastrous problems."
He said Israel's frequent shutting of its border with Gaza on security grounds have caused considerable disruption to supplies.
There have been many days of closure, with the most recent coming after Palestinian militants attempted to launch an attack on Israeli workers at the Karni cargo terminal.
Surgery has been reserved for emergency patients
Shifa Hospital's other major problem is that the health ministry is simply out of cash.
Like all other government departments, it has received no money since Hamas took over.
Israel stopped paying the tens of millions of dollars a month that it owes the Palestinians from customs and other revenue collection.
The US and the European Union, which regard Hamas as a terrorist organisation, have cut off all economic assistance.
And donations offered from the Islamic world never reached the new government. Banks refused to transfer it, fearing that the Americans would freeze them out of the international financial system if they were deemed to have assisted Hamas in any way.
The Western pressure is aimed at forcing Hamas to renounce violence and recognise Israel.
But in Hamas's view, it is not just the West Bank, East Jerusalem and Gaza that constitute occupied Palestinian territory - it is all of Israel too.
As the international political storm rages, Dr As-Saqqa and his colleagues struggle to keep Shifa going.
"Now we've stopped elective surgery in order to divert what remains of our drugs to emergencies," says Dr As-Saqqa
But he worries most about the dialysis ward.
Health ministry cash shortages are putting services at risk
He says that having to reduce patients like Mr Al-Masri from three to two dialysis sessions a week is dangerous. Toxins can accumulate in the blood of people who are already very ill.
Four of these patients died last month.
Dr As-Saqqa said: "They had been doing dialysis for more than five years, and they died last month. Why?"
He says that he cannot prove that the reduction in the amount of dialysis they received caused their deaths - but that as a doctor he is convinced that it was the reason.
Reflecting on the wider financial disaster now engulfing his hospital, Dr As-Saqqa said: "I blame Hamas first. I blame the European Union second. I blame Israel. I blame the US.
"All of them are to blame because humanitarian aid should not be linked to the political situation."
Dr As-Saqqa believes that his whole battered society is at the moment on course for disaster.
He says that he fears a complete breakdown of authority.
Dr As-Saqqa dreads the thought - but he fears that there will be bloodshed.