As I travelled back to Gaza for the first time in 18 months, any hopeful expectations I had were somewhat muted.

The overall picture is not one of great optimism. The Israeli blockade, which restricts imports and exports of goods to a minimum and prevents Palestinians from entering and leaving, continues to blight this small strip of land. Now into its 11th year, it shows little sign of coming to an end. Long power cuts are the stuff of daily life and the recent reconciliation deal between the two main Palestinian factions, Hamas and Fatah, has delivered almost nothing.

Almost without exception, the first words I heard from the people I met were about the threat of war. On the one hand there are real fears that local jostling for control will lead to open conflict between Hamas and Fatah, as happened in 2007. On the other, another war between Hamas and Israel is seen by many as inevitable, bringing with it devastation like that seen in the summer of 2014.

But conversations quickly move on to the impact of the blockade; tales of refused travel permits and the challenges to normal life. The director of one local institution stated it plainly: 'The situation is very bleak, we don't know where we're going. We are lost in between – and another war will not create a solution.'

One of the biggest effects of the blockade has been on health care. Last week, 16 government clinics closed their doors as they could no longer operate due to a lack of fuel. The impact of power cuts on clinics, with the electricity on for four hours at a time and then off for 12, is really taking its toll. A senior doctor told me of the troubling lack of medicines – 40 per cent of essential children's drugs have been out of stock in government clinics for some time. I heard stories of adult patients buying one tablet at a time as hospitals could not provide full courses of treatment. Many ordinary people are unable to afford the blister packs of drugs we take so easily for granted on the NHS.

The people of Gaza are buffeted by local and regional politics and, perhaps more troublingly, a general indifference from us, the international community. In the midst of this, the local Christian led organisations who work with Embrace the Middle East are making small but significant contributions to support hard-pressed people.

In spite of the blockade, the clinics and hospitals run by Embrace's partners continue to function, their staff working tirelessly to provide some of the poorest and most isolated members of the community with essential care. The Anglican-run Al Ahli Arab Hospital has a free medical mission programme that links up with 35 community-based organisations on the borders and margins of Gaza.

Together they identify women, children and the elderly who can't access good medical care and they bring them to the hospital for diagnosis and treatment. More than 2,500 people benefited from treatment in 2017 and in the coming year we anticipate 17,000 families will be reached through this programme. This is the backbone of their medical outreach work with communities. Their staff told me: 'The free medical mission is a real asset, we can reach the most deprived families by the border, places like Al Moghraqa where there is only one small clinic for 13,000 people.'

The Near East Council of Churches is also active, providing a wide-ranging service to support women – from pregnancy, through a healthy delivery and on to the first few years of their lives. Working to combat anaemia and malnutrition, they are able to support children from disadvantaged homes. In 2017 over 12,500 babies and toddlers benefitted directly from this programme, helping them get a good start in life and avoiding the irreversible damage that these deficiencies can cause. These projects are two bright spots in what is a pretty bleak outlook.

Hope for the future is certainly in short supply. Yes, the shops seemed to have more items on their shelves – but I heard quite clearly that people don't have the money to buy them. The middle-class medical professionals I met talked about getting poorer and for the many thousands who are unemployed, poverty is already a very real problem. Add to that the reduction in salaries of up to 50 per cent felt by government employees over the past twelve months and it paints a very difficult picture.

The hope I did see was in the commitment and care of the local organisations alongside which Embrace has the privilege of working. We don't know if the much-discussed threat of conflict will come soon. But now, perhaps more than ever, we need to pray for peace and an end to the blockade. Alongside this, we need to continue to do what we can to support these excellent local organisations to make their small but significant contributions to help people in need throughout Gaza.

I am particularly challenged and encouraged by the words of one doctor as we left:'We don't wish to be part of history. The organisations you support – what you help us do – is helping to keep Christianity alive here.'

Jamie Eyre is the director of programmes and partnerships at Embrace the Middle East. He and his team partner with 50 local Christian-led organisations in the Middle East, supporting their work with communities affected by poverty and working creatively to help them overcome it.