WASHINGTON — As Secretary of State Condoleezza Rice and Secretary of Defense Robert Gates head out Monday on a rare joint trip to the Middle East, it's not clear what they can accomplish.

Aides to Rice and Gates say the trip has three primary goals, each crucial: to persuade Iraq’s neighbors to do more to help stabilize the country, to counter Iran’s growing ambitions and to try to get real movement on peace between Israel and the Palestinians.

But America's credibility in the region has plummeted. The U.S. has failed to stabilize Iraq, destroy al Qaida, pacify Lebanon, isolate Syria or bolster moderate Palestinians. Instead, its policies have fueled Sunni Muslim extremism and emboldened Shiite Iran, which America's moderate Arab allies consider the two greatest threats to their rule.

So far, its support for Israel's ill-fated war in Lebanon and its efforts to undermine popular radical groups such as Hamas in the Gaza Strip and Hezbollah in Lebanon have borne little fruit. Along with its support for autocrats such as Egypt's Hosni Mubarak, such actions have undercut American claims that it's championing Muslim democracy.

Meanwhile, the clock is ticking on the Bush administration’s time in office. Leaders of friendly Arab states have lost confidence in President Bush’s ability to deliver on his promises and are wary of sticking their necks out too far to cooperate, according to diplomats and some U.S. officials.

“Our credibility is in tatters. They are not going to commit because they don’t trust us. That doesn’t mean they are not concerned about Iran. It just means they just don’t know what we are going to do,” said one senior State Department official, who spoke on condition of anonymity because he wasn't authorized to speak to reporters.

There are also signs of disarray within the administration.

On the eve of the trip, unnamed U.S. officials told The New York Times that Washington believes Saudi Arabia has been unhelpful in Iraq by not supporting Prime Minister Nouri al Maliki's government. The administration publicly disavowed the report, but said that Saudi Arabia could do more to help. The leaked complaint seems unlikely to make life easier for Rice and Gates when they arrive in Jeddah, Saudi Arabia, early in the trip.

The Bush administration also is divided over Iran, with Vice President Dick Cheney’s office pushing for an aggressive military response to Iran's reported aid and training for Shiite militias attacking U.S. troops in Iraq, senior officials said.

Gates and Rice will attend meetings together in Sharm al Sheikh, Egypt, and Saudi Arabia. Rice will then head for Israel and the Palestinian territories to meet with Israeli leaders and Mahmoud Abbas, the weakened Palestinian Authority president whose administration was run out of Gaza by the Islamist group Hamas. Gates is scheduled to visit other gulf states.

Senior Pentagon and State Department officials said the trip is intended to reassure Arab leaders that the U.S. will uphold its security commitments in the region, even as Congress debates pulling troops out of Iraq.

But Arab diplomats in Washington said their governments need more than reassurance. They said that while the U.S. has promised a more active role, they haven't seen a clear plan for Middle East peace or regional security.

Indeed, after Bush called two weeks ago for an international Middle East peace conference, some Arab leaders concluded that the speech lacked specific goals and simply repeated the broad hopes that he's articulated before — stability in the region and moderate, inclusive governments.

“There is no clarity,” one Arab diplomat said on condition of anonymity because he didn't want to disagree publicly with the administration. “The trip in and of itself is not important. What’s important is that the administration commit to dealing with the substantive issues.”

The gulf states want to know how a possible drawdown of troops in Iraq would affect their security and whether it would lead to fewer troops in other parts of the region.

More than what Rice and Gates say on the trip, “people are monitoring the debate in Washington. Everybody is watching that very closely and then will draw their own conclusions,” an Arab official in Washington said.

Sunni-led gulf states fear Iran, but aren't confident that the United States has a strategy for dealing with Tehran, the diplomats said. U.S. officials say they're in the early stages of building an alliance with the gulf states.

“Iraq may be an immediate destabilizing influence. But Iran is something we collectively need to deal with in the long term,” said Geoff Morrell, a Pentagon spokesman.

On the Israeli-Palestinian conflict, Saudi Arabia, Egypt and other U.S. allies in the region want the United States to reach out to Hamas, which now controls Gaza. But Rice has repeatedly ruled out dealing with the group, which is on the U.S. list of terrorist organizations.

"The strategy is based on the assumption that you could isolate, weaken ... Hamas," while strengthening Abbas and his Fatah faction, said Shibley Telhami, a Middle East expert at the University of Maryland. "It cannot succeed. ... Everybody agrees that you can't simply isolate Hamas."

Gates and Rice will encourage Arab leaders to attend the international meeting on Middle East peace that Bush called for in a July 16 speech. The gathering is tentatively scheduled to take place this fall.

Israel and the United States hope that officials from Saudi Arabia, other Persian Gulf states and Morocco — none of which recognizes Israel — will attend. But that appears far from assured.

Before the Iraq war, Washington had strong ties with the gulf states, especially Saudi Arabia. But the overthrow of Saddam Hussein’s Sunni-dominated government and the rise to power of Iraq’s majority Shiites shifted the balance in the region. With an unstable Iraq and their own Shiite minorities politically awakened, many governments feel U.S. actions have weakened their grip on power.

Some countries, such as Egypt, have maintained close ties with Washington, but Saudi Arabia and others have begun to distance themselves.

Rice and Gates have their work cut out for them. With 18 months left in office, it will be difficult to reshape the way the region sees the United States, said William Quandt, a professor of international relations at the University of Virginia, who as an aide to President Jimmy Carter helped craft the 1978 Camp David accords between Israel and Egypt.

“I don’t think they have a real strategy that has much chance of working,” Quandt said. Gates, who joined the administration in December, “may be able to calm things down a little. But that won’t change the course.”

First of two parts

On a recent November morning, in between his administrative hospital rounds and amid various workers’ strikes, continuing political uncertainty and growing worry that the Israeli-Palestinian conflict was on the verge of yet another cycle of spiraling violence, Dr. Tawfiq Nasser pulled out his wallet and showed a visitor his identification cards.

“In this country, we have a habit of collecting cards,” the Palestinian doctor said dryly.

He held up three cards in quick succession: a magnetic security card to expedite his way through Israeli checkpoints; an identification card issued by the Palestinian Authority; and a third card certifying that he works for a nongovernmental organization: in this case, for the Lutheran World Federation, for which he serves as head of the Augusta Victoria Hospital in Jerusalem and also oversees the hospital’s program of village health clinics in various parts of the West Bank.

Nasser’s main focus, and worry, however, was about a permit due to expire the next day that allowed him to enter Israeli territory and return to his office in Jerusalem. A strike by Israeli bureaucrats was suddenly complicating his life -- without a new permit, he and his staff would be stranded.

The sudden concern about the permit overtook Nasser’s rapid-fire explanation about the fragmented health care system in the Palestinian territories. He argued that as long as an occupation exists, with its attendant checkpoints, delays and transportation snafus, villagers closer to one city to will be forced to go to another for their basic health care. And as a result, their health will suffer.

With a sudden, unexpected snafu about permits added to the mix, Nasser began to lose patience, becoming increasingly impassioned and angry as he spoke to a visitor. “All of our lives are run by bureaucrats in a settlement. You tell me this is no occupation, that it this is just security,” he said.

“Tomorrow, I don’t know if I can go to work,” he said, his voice rising. “And who is punished? The patients. Hamas, they’re not punished. It’s my patients.”

Declarations of impatience, frustration and outright anger are becoming increasingly common among Palestinians these days -- particularly those whose faces and voices are too rarely seen or heard in depictions of Palestinian reality in the West.

The “moderate” sector of teachers, academics, students, government officials and doctors -- the vanguard of Palestinian “civil society” who are not questioning the permanence of the state of Israel, even though they are clearly fed up with the politics of the Israeli occupation -- have, by dint of professional training and patience, kept day-to-day Palestinian society running. They have done so amid an ongoing political stalemate between rival political factions, militants and the Israeli government, and a humanitarian situation that has been worsening by the week.

Weary of politics but keenly aware that just about everything in their contested land is highly political, they are increasingly pessimistic about any resolution to their plight.

Something of their situation was summed up recently by Latin Patriarch Michel Sabbah of Jerusalem, a longtime champion of Palestinian rights, when he met earlier this month with a group of American journalists who write for Catholic publications.

Speaking of the situation in the Gaza Strip but also about the fate of Palestinians generally, Sabbah said: “They are not terrorists; they are people who are living under oppression and who are reacting. And not all of them are reacting. There are Palestinians who don’t react at all, who go on living their lives in despair and humiliation and poverty. They go on living under occupation without any reaction.”

Others feel similarly -- with a pronounced touch of pessimism. “We’re going nowhere,” Rafik Husseini, the chief of staff to President Mahmoud Abbas, said during an interview at the Palestinian Authority’s headquarters in Ramallah.

Sulieman Harb Shalaldeh, the mayor of the municipality of Sier, near the city of Hebron, expressed the hope that he could soon govern normally.

“Let us keep the politics outside so that our people can continue their lives,” Shalaldeh said recently to the group of journalists. Shalaldeh has to deal with competing political claims, day-to-day-tensions, and now strikes by frustrated Palestinian workers who have not been paid since U.S.-led international sanctions and cuts to the Palestinian Authority by the Israeli government were imposed in March. The cuts by the Israelis alone have resulted in a monthly loss of $50 million in customs receipts.

The mayor’s comments were echoed by a teacher who greeted her American guests with fresh fruit, cakes and tea. “The majority of Palestinians, 90 percent, have no relationship with politics,” she said. “But politics are reflected severely in their daily life.”

So is history. To an outsider what is perhaps most striking in Palestinian refugee settlements and other public spaces are murals depicting uprooted villages lost for 50 years or more, with some still clinging to keys and land titles of areas now occupied by Israeli homes, public spaces and even shopping malls.

Given the overwhelming sense of history and grievance that prevails here, the teacher’s name is all the more revealing. The woman speaking was named Palestine Hussein.

Facts on the ground

The phrase “facts on the ground” is often used to describe the reality of what Palestinians see as the things that make a viable Palestinian state and society difficult if not outright impossible: Israeli settlements, outposts, settler roads, checkpoints, the routing of a 420-mile separation barrier. But it just as easily could describe the deleterious humanitarian situation in the Palestinian territories themselves.

The territories’ gross domestic product stands at $1,183 per capita, according to the World Health Organization. Unemployment rates overall stand at 25.3 percent, while rates of poverty overall are 56 percent. The poverty rate in the impoverished Gaza Strip stands at an astonishing 80 percent.

“The population’s socioeconomic conditions and access to health care are severely affected by lack of contiguity between the West Bank and Gaza and restrictions on movements,” the World Health Organization said in a recent summary.

Current conditions -- exacerbated by an unsettled political situation -- are believed to have worsened humanitarian problems: Chronic malnutrition has long been a problem in the territories and has been particularly acute in Gaza, where a 2003 study by CARE International indicated that 13.3 percent of small children in Gaza suffered from chronic malnutrition -- 11 percent higher than a “normally nourished” population would suffer.

What precipitated the current crisis was the January victory of the political faction Hamas in Palestinian Legislative Council elections. Hamas’ victory in turn led to international sanctions that have cut assistance to the Palestinian Authority -- a move that Palestinians have decried as unfair and unjust.

“You wanted democracy and now when you see the fruit of our democracy you say, ‘No, we will boycott you.’ ” Sabbah said about the popular reaction to the move: “This is wrong, unfair and unjust for the Palestinian people.”

The Israeli and U.S. governments said sanctions are justified because Hamas is a terrorist organization. Palestinians -- and this includes those aligned with the rival political faction Fatah -- acknowledge and even embrace Hamas’ militancy. But they have also stressed what they say is Hamas’ political and humanitarian roots and argue that Hamas is no al-Qaeda. In fact, they contend, beginning in the 1970s, Israel itself helped foster the creation of Hamas as an Islamic alternative to the secular Palestine Liberation Organization.

The Israeli and U.S. governments have interpreted the Hamas victory as a worrisome sign of growing Palestinian and Islamic militancy, while Palestinians have tended to view the Hamas victory as a protest vote and a referendum on what they say was a corrupt and out-of-touch Fatah elite that had, the sentiment went, cravenly compromised with Israel during the 1990s. (While Hamas controls the Palestinian legislature, President Mahmoud Abbas is aligned with Fatah.)

Over dinner at a Ramallah restaurant, Nader Said, a development studies specialist who teaches at Birzeit University, said public sentiment went something like this: “Let’s try Hamas; we know Hamas won’t work, but let’s stick to our identity.” He said that Hamas had hit a deep public nerve.

However one defines Hamas and interprets the elections, the results proved a smashing blow in at least one respect: Western sanctions remain in place against the Palestinian government, with assistance being cut off until Hamas recognizes Israel’s right to exist and renounces violence against Israel.

These demands form the core of contention between various the Palestinian factions and were cause for continued dispute recently between Hamas and Fatah over a new compromise prime minister. The current prime minister, Ismail Haniyeh of Hamas, has said he would resign if it would help restore international assistance to the Palestinian government.

The practical result of all of this is that salaries for some 140,000 government workers are not being paid -- prompting a joke by Husseini, the presidential chief of staff. He said recently on a Sunday evening that he was beginning his second work shift, at no pay. “I knew this would be a 75 percent reduction of pay,” he said. “I didn’t expect it would be 100 percent.”

Jokes aside, the sanctions have not only caused obvious hardships but also prompted a 70-day teachers’ strike, as well as walkouts by other public employees. Worsening day-to-day public services have become the norm.

“The boycott has had a devastating and cumulative effect,” said Tom Garofalo, the Jerusalem-based country representative for Catholic Relief Services. “Things are declining geometrically.”

Maybe not indefinitely, however: The end of the teachers’ strike Nov. 11 proved a major relief, and Arab nations that had joined the boycott have announced they will drop it, in part because of anger over a recent Israeli military attack in Gaza.

Nonetheless, reminders of what has been a stark, confusing and dispiriting time are everywhere: A school built with assistance from Catholic Relief Services in the village of Sier recently stood empty. A group of school administrators and parents huddled around a small administrative office and said both they and students have felt stranded and isolated by the strike and the international boycott, which they said have worsened the day-to-day hardships imposed by the occupation.

“What can we do?” said headmaster Ahed Mohid Jebreen who, like the parents, spoke about their coping mechanisms in an economy that has stalled -- be it borrowing from shop owners (and piling up debts), or selling family jewelry to pay bills.

“All the world is punishing us for our democracy, and that is not fair,” Jebreen said. Such punishment, he and the others stressed, is not punishing Hamas, but punishing the struggling Palestinian middle class and poor people.

A recent survey spearheaded by Said’s Development Studies Program confirmed those anecdotal observations: Of 1,200 persons surveyed in September, nearly three-quarters said their daily lives and living conditions had become worst since the January elections.

The survey also revealed that while Hamas’ popularity has declined precipitously -- from 50 percent in April to a mere 31 percent five months later -- a majority of those polled still thought Hamas should form a coalition government. And a majority, 62.3 percent, also said Hamas should not be expected to recognize Israel immediately. The poll also found that distrust of the United States was as widespread and deep as could possibly be: a full 94.4 percent said the United States had not played a constructive role in resolving the Israeli-Palestinian standoff.

This tense environment has also affected the response of American humanitarian agencies, such as Catholic Relief Services, that receive U.S. government funding for projects in the Palestinian territories. Catholic Relief Services has to abide by a no-contact rule with all Hamas officials, though it can still keep contact with such national bodies as the Palestinian president’s office.

As a practical result, that means the Catholic agency “has had to roll with some big changes,” Garofalo said. It has also made it occasionally difficult for local staff who, like any “on-the-ground” humanitarian workers, must deal with local authorities and governments no matter what their political affiliation. “We can function, but it has been difficult for our staff who work in Hebron, Bethlehem and Gaza,” Garofalo said.

These and other difficulties have changed a society that despite its many challenges was, in Said’s words, vibrant and hopeful. Now, day-to-day life seems more fragmentary and pinched, with horizons eclipsing. “The whole dream of a Palestinian state is in danger,” he said.

“We’ll do the small things we do each day,” he said. “But the big picture is desperate.”

He paused for a moment. “We’re asked, “Why do you have fundamentalists?” he said. His response: “It’s because you are closing all of the windows of fresh air.”

That is perhaps nowhere more evident than in Gaza, a place other Palestinians call everything from a prison to a mental asylum.

Potential powder keg

It doesn’t take long to learn that Gaza can break your heart.

A sunny Mediterranean outpost that contains some of the most crowded and densely populated urban areas on the planet, Gaza is an impoverished and dispiriting place until you listen to college-age students and young people speak passionately about furthering their skills in computer sciences and English -- although they do so amid the more-than-occasional and not terribly distant cracks of gunfire rounds.

Kidnappings are common here -- though it is said that they often stem more from boredom than from any political or even monetary motivation -- and have added to the sense of a powder keg in the making.

Now in the hands of the Palestinian Authority after a series of well-publicized withdrawals by Israel, Gaza is distinctly different from the West Bank, where Israeli and Palestinian communities collide and jut into each other. In Gaza, a sense of isolation and even imprisonment has taken root, resulting in ennui at best, contempt and extremism at worst.

“Throw whatever you want at us” is how presidential chief of staff Husseini describes popular sentiment in Gaza. “They are desperate. They have no hope. And they have nothing to lose but their chains.”

It is from Gaza that small, homemade rockets are often fired into Israel, prompting what Palestinians have called Israeli overreaction, but what Israel has declared as justified security measures of self-defense.

“I know the Gaza people are suffering,” said Bahij Mansour, a one-time member of the Israeli diplomatic corps who now heads Israel’s department of religious affairs and who spoke on Israeli policies recently to a group of Americans. But he said that Israel feels justified in protecting its borders along the Gaza Strip.

It is Gaza, in the town of Beit Hanoun, that drew worldwide focus recently when Israeli artillery killed 18 Palestinians -- including 13 members of a single family -- in a military operation that was criticized internationally and resulted in a United Nations Security Council resolution of condemnation that was vetoed by the United States. Israel, apparently embarrassed by an incident that killed primarily women and children, called the shelling “a mistake.” The move prompted new threats of suicide bombings, as well as fury throughout the Arab-speaking world and even talk of a third intifada within the occupied territories.

If the long-term ramifications of the Israeli action and the Palestinian response remain to be seen, it is not hard to imagine that the voices of Palestinian moderates in Gaza may become harder to hear.

Mohammed Ismail, 22, is one such voice. Active in a Gaza youth leadership program, Ismail is a one-time English student, an avid reader of Ernest Hemingway, and has hopes of studying English at the graduate level. He acknowledged that Gaza residents have reached a level of anger where they are “not afraid of losing everything.”

At the same time, though, he knows there are liberals in Israel who do not support their government’s policies toward the Palestinians and wishes there was a way for them to make common cause with Palestinians like himself.

One reason he believes that should remain a priority is because of a simple truism, recognized by many but maybe by not all on both the Palestinian and Israeli divide.

“We are here, they are there. We’re not leaving, and they’re not leaving.”

Chris Herlinger, a New York freelance journalist, recently traveled to Israel and the Palestinian territories as part of a prize for Catholic Relief Services’ Eileen Egan Award for Journalistic Excellence, which he won for reporting on Darfur for NCR in 2005. Photographer Paul Jeffrey, also an Egan Award winner, assisted with the reporting for this article.

We are either living in a reverie or in denial. When someone you know gets injured in this conflict, you expect to have feelings of outrage, deep sadness, or at least the manifestation of these feelings should be the normal outpourings of grief, sorrow and concern. And yet, news of casualties of a latest Israeli atrocity or an inter-factional battle does not faze people as it once did.

I want to be in hysterics. I know it is not something ordinary to say, but the truth is, this conflict has made people accept as normal, things that elsewhere would elicit deep reactions of wailing, or at least tears, or the momentary satisfaction of venting anger by breaking dishes across a room. Are the restrained reactions that many Palestinians have are merely a self-defense mechanism? Or are we really in denial about what is going on in down town Ramallah or on the beaches of the Gaza Strip? Has the daily dose of grim stories become such an ordinary thing in our life that we wake up each morning, wanting, needing a fix of the usual blood-drenched front page that we pour over while doing something as normal as having our morning coffee and scrambled eggs?

So, shouldn’t I be in hysterics? When I heard that a photojournalist that I know, Osama Silwadi, had been shot while doing something quite unexciting as to look out his office window during a procession on Ramallah’s main street, I cannot describe the feelings that went through my head. Funny, but I thought emotions are not supposed to be cerebral, and yet, I block feelings, like so many Palestinians (and even some foreigners living among us) have become used to doing, in order not to allow myself the luxury of sinking into a depression every time I hear a story of a child killed or a family annihilated, because there are far too many to count. Many of us have learned over the years that if you allow yourself the slightest chance to let the situation overcome you, you are done for and you will be unable to function.

Osama used to be a photojournalist for AFP and Reuters before he decided to become a freelancer and create a Palestinian image bank (www.apollo.ps). He is a father of three children, who now lies in a coma in a hospital bed in Tel Aviv, so far away from his family and friends in Ramallah that no one can visit him or offer his wife the support she needs at this time.

As Osama watched the procession below on Ramallah’s main street from his office window this past Sunday, boys were shooting into the air to commemorate a fallen comrade. I say boys because my (female) mind cannot accept the fact that mature men would be so irresponsible as to shoot in the air in a densely populated area, where the chance of a stray bullet hitting someone is not a remote possibility, but a certainty. And so, the bullet traveled from the barrel of one of those boys’ guns into Osama’s now non-existent spleen, up near his heart to lodge finally in his spinal cord.

The prognosis is not good and we all hope and pray for his recovery, knowing that when he finally wakes up from his coma, he will find that his reality has changed so dramatically around him and he will have to grapple with whether or not he will be able to resume his life as he had once lived it. All those times in the field when he knew that he was a taking chance on life by snapping shots of stone-throwing youths confronting soldiers, or non-violent protestors against the Wall, did he never stop to think that life is so fragile in any case that even a simple walk under rickety scaffolding or taking the wrong turn in a road can result in a fatal accident?

Not to sound like a cliché, but such is life, whether you have lived in a conflict zone all your life or not, you cannot cower in your house forever in the off-chance that you might be struck by lightening. Perhaps, however, people who have gone through trauma feel invincible and the sense of danger is blunted and lightly brushed aside, and so it could quite have possibly been those thoughts that went through Osama’s mind seconds before the impact of the bullet ripped through his body.

It is odd how yesterday morning, when I heard the news, all I could think about is how ordinary this news sounded, despite the fact that Osama had been on my mind quite often these past few days, because I was looking at some recent photos I had taken with his voice about light, lines and frame running through my head. I realized with some unease that I lost the ability to be shocked, indeed a friend told me once that he also lost the ability to be astonished by such things as the first flowering of spring or the birth of a child and that is how I feel sometimes, like I am a car in neutral mode most of the time. And while I am deeply saddened by what has happened to Osama, I am unable to reach down into that deep place where I will allow myself to feel more than the very superficial of feelings and I know that tears will not come.

It completely worries me, this sense that we are becoming a nation of zombies, who have turned off the tap of basic human responses to bad and good news alike that something like the recent inter-factional fighting is not so shocking or unexpected. Once you stop being shocked, then you stop being afraid, and once you stop being afraid, you can do anything out of the bounds of acceptable human behavior. The signs of intimidating armed men running unrestrained among the population should be dealt with immediately and decisively.

More importantly, the indications that we are heading toward a civil war that so many are trying to suppress and deny, will become a full-blown reality if this is allowed to continue and then there will be no turning back to a time when Palestinians put the national interests before the factional, if ever there were such a time. If that should happen, there will be more innocent bystanders like Osama, who will pay the heavy price of the craziness that we have sunken to in recent months, and ultimately Palestine will hemorrhage outwards and be drained of its wealth of people, who today still have the ability to save it from becoming yet another tragic tale for the history books.