GAZA CITY  The women were bleary-eyed, their voices weak, their hands red and calloused. How could they be expected to cook and clean without water or electricity? What could they do in homes that were dark and hot all day? How could they cope with husbands who had not worked for years and children who were angry and aimless?

Sitting with eight other women at a stress clinic, Jamalat Wadi, 28, tried to listen to the mental health worker. But she could not contain herself. She has eight children, and her unemployed husband spends his days on sedatives.

“Our husbands don’t work, my kids are not in school, I get nervous, I yell at them, I cry, I fight with my husband,” she blurted. “My husband starts fighting with us and then he cries: ‘What am I going to do? What can I do?’ ”

The others knew exactly what she meant.

The Palestinians of Gaza, most of them descended from refugees of the 1948 war that created Israel, have lived through decades of conflict and confrontation. Their scars have accumulated like layers of sedimentary rock, each marking a different crisis  homelessness, occupation, war, dependency.