Umm al-Nasr, Gaza Strip: Everybody in Gaza fears another war. After the 2014 conflict, which killed 2250 Palestinians and 70 Israelis, little has changed on the ground for the territory's 2 million residents.

A local psychiatrist, Khaled Dahlan, recently told me in Gaza that Palestinians had multi-generational trauma, having been dispossessed and attacked for decades. "We have had so many conflicts" in the last 70 years, he said.

The World Health Organisation estimates that at least 20 per cent of the population has severe mental illness.

Daniel Shapiro, the US ambassador to Israel under former US president Barack Obama, recently warned that "the next war in Gaza is coming".

Israel's military Chief of Staff, Lieutenant-General Gadi Eisenkot, explained in late March that his country reacts "disproportionately" to rocket fire from the strip. "The reality in Gaza is volatile," he said.

Eisenkot warned that the Hamas authority in Gaza was "continuing to dig [tunnels] underground and to build their abilities and defensive capabilities". Israel claims Hamas has new heavy rockets with which to attack Israeli border towns.

Israel's State Comptroller released a report on the 2014 war that found the Israeli government was uninterested in avoiding a military conflict. "There was no realistic diplomatic alternative concerning the Gaza Strip," it stated.

Hamas recently elected a new leader in Gaza, Yahya Sinwar, who reportedly opposes reconciliation with Israel. He served 22 years in an Israeli jail before being released in a prisoner swap in 2011. Tensions rose again after the alleged Israeli assassination in late March of a senior Hamas militant in Gaza.

Yet Israeli Defence Minister Avigdor Lieberman said in late 2016 that his country would help rebuild Gaza – if Hamas disarmed.

"We will be the first to invest in a port, an airport and industrial areas", he told a Palestinian newspaper in October. Israel's Transport Minister Israel Katz proposes building an island near Gaza to service its people – but Israel would control its air, sea and land borders.

Hani Muqbel, head of the Hamas Youth Department, told me in Gaza that his group's philosophy was different to Islamic State's or al-Qaeda's. "They're destroying the image of Islam," he said. In contrast, Hamas had built a "national liberation movement".

He acknowledged the current difficulties in Gaza but blamed the "Israeli occupation, siege and the [rival Fatah-run] Palestinian Authority [in the West Bank]".

Many said they wanted to leave and build a life elsewhere.

Muqbel said that Hamas did not want another war but that its issue with Israel "wasn't between Jews and Muslims. It's not a religious war, it's about land."

He demanded that Western powers stop claiming Hamas "wanted to kill Jews because they're Jews. We do not."

The Israeli media largely ignores Gaza and Israelis are not legally allowed to visit. Yet former Mossad chief Tamir Pardo recently said that the occupation was the country's only "existential threat".

An editorial in the liberal newspaper Haaretz urged the government of Israeli Prime Minister Benjamin Netanyahu to "immediately consider other ways of halting the deterioration in Gaza – first and foremost by alleviating the wretchedness of life there".

The Israeli human rights group Gisha recently found that Israel had massively reduced the ability of Gazans to leave in the last months, dropping 40 per cent compared to last year's average. In February, only 7301 people went through the Erez checkpoint, which connects Gaza to Israel and the occupied West Bank. It was the lowest number since the end of the 2014 war.

Countless Gazans haven't left for years. Many told me that it was impossible to plan anything major in life, such as marriage or travel, with certainty because applications to leave Gaza were routinely rejected by Israel with no reason given. Often they were ignored entirely.

The effect of the wars and isolation has been dramatic on the domestic lives of men and women. The last years have seen an explosion of Western aid organisations in Gaza working with local NGOs on furthering women's rights in a male-dominated society. Many women said that these courses gave them awareness of their legal and social rights along with the ability to resist and leave a violent marriage.

The United Nations Commission on the Status of Women recently released a draft resolution that highlighted the status of Palestinian women. It expressed "deep concern" about the "ongoing illegal Israeli occupation and all of its manifestations", including "incidents of domestic violence and declining health, education and living standards, including the rising incidence of trauma and the decline in psychological well-being", especially for girls and women in Gaza.

A lawyer with the Gaza-based NGO Aisha Association for Woman and Child Protection, Asma Abulehia, said that she met six to seven women every day who faced domestic abuse or economic uncertainty. However, many women couldn't leave their houses to seek help, trapped by an abusive husband or family.

"The Israeli occupation is the main reason for these problems," she told me. "The bad economic situation has worsened social problems, along with ignorance of Islam and unfair laws against women in Gaza."

Due to the suffocating 10-year blockade imposed by Israel and Egypt, support for Hamas has decreased. Many people long for a return of the Fatah-led Palestinian Authority that governs Palestinians in the West Bank, though they aren't convinced it would make much difference to their daily lives. Many said they wanted to leave and build a life elsewhere.

This month, Human Rights Watch released a new report, Unwilling or Unable, detailing Israeli restrictions on human rights workers entering Gaza to document breaches of human rights and international humanitarian law. It accused Israel of severely curtailing the ability of Israelis, Palestinians and internationals to enter or leave Gaza and dismissed its reasons for doing so.

Human Rights Watch asked the International Criminal Court, currently investigating possible war crimes committed in Palestine including Gaza, to determine the "credibility" of Israeli domestic investigations and its restrictions of human rights workers in and out of Gaza.

In a 2015 report the United Nations voiced fears that Gaza would be uninhabitable by 2020. It stated that the 2014 war had "effectively eliminated what was left of the middle class, sending almost all of the population into destitution and dependence on international humanitarian aid".

"Hamas doesn't care for the people," Abulehia said. "They deny violence against women and drug abuse [of the opioid Tramadol] even exists."

Abulehia said violence against women was worsening, though there were no reliable government figures. The Safe House, funded by the Hamas government and run by women in a secure location, is the Gaza Strip's only women's shelter, where up to 50 people can sleep overnight. The average stay is three months.

Many women I met at the Aisha office faced troubling options. Nineteen-year-old Noura al-Reefy married her husband three years ago and wanted a divorce. Her father-in-law sexually harassed her and her husband did nothing.

"He wanted to see my husband and me have sex in front of him and me naked without my hijab," she told me. During multiple visits to Gaza, I'd never heard such graphic accounts of abuse from a woman.

Reefy had attempted suicide twice. She hadn't finished high school but planned to complete her education after divorce. She was forced to marry her cousin "but it was a bad idea from the start. I wish it was easier for women to get divorced here.."

Buthaina Sobh, head of the Wefaq Society for Women and Child Care, told me in conservative Rafah, in the south of the territory, that sexual harassment at work, at home and on the streets was commonplace.

"In our society," she said, "women can't demand sexual pleasure, they're considered a slut. Only men can. However, intellectual women now recognise that women have sexual desires and can ask for it privately."

Sobh said the constant Israeli attacks made Palestinians "used to suffering". She was pessimistic that women's lives could change substantively until the siege was lifted.

Training facilities for women are still rare but slowly growing. In the conservative, Bedouin area of Umm al-Nasr in the strip's north, I visited a multi-storey centre where women learnt tailoring and toymaking for local consumption. A showroom displayed the work for sale. Carpentry classes for women were initially resisted by traditionalist men in the village, but now the teaching of skills in a territory with one of the highest unemployment rates in the world – at least 43 per cent – is being welcomed. The Hamas authority backs the centre and wants similar facilities established throughout the strip.

The centre also runs English courses and exercise classes. Working for the Italian NGO Vento Di Terra, project manager Sara Alafifi said that before the 2014 war many people thought that exercise for women was a waste of time but now healthy bodies were seen as a sensible way to manage stress.

There are alternatives. A group of Israeli and Palestinian economists recently released two studies with the World Bank that outlined a blueprint for economic development in the West Bank, Jordan Valley and Gaza. At the launch in Jerusalem, former Israeli ambassador to South Africa Ilan Baruch was blunt.

"There has been a deliberate Israeli policy to create deficiency," he said. "The international community has to get involved – not as a donor, but to exert pressure."

The constant threat of war against Gaza makes normality impossible. Hypertension, deep anxiety, increasing domestic violence and insomnia are ubiquitous amongst the population.

With hawkish Israeli commentators demanding another war with Hamas, and advocating the assassination of its leaders within days of any conflict commencing, prospects will only improve if the international community can put concerted effort into finding a new direction.

Antony Loewenstein is a Jerusalem-based independent journalist and author.