Israel’s military operations in the Gaza Strip and the ongoing blockade of the Hamas-ruled enclave have caused as much as $16.7 billion in economic damage, the United Nations said last week.

In a report submitted to the UN General Assembly, the UN Conference on Trade and Development (UNCTAD) put the estimated cumulative economic cost between 2007 and 2018 at $16.7 billion, a sum that is six times Gaza’s annual gross domestic product for 2018. The agency said the poverty rate reached 56% in 2017, compared to the expected 15% projected for that year were it not for the blockade and military operations.

Hamas seized control of the Gaza Strip, a tiny seaside territory of some 2 million people, from the rival Palestinian Authority in 2007. Israel and Egypt have since maintained a blockade that rights groups say amounts to collective punishment. Travel abroad is difficult for Gazans, with just two crossings — Erez to Israel and Rafah to Egypt — open for limited pedestrian travel.

The movement restrictions, combined with three wars with Israel since 2007, have devastated Gaza’s economy and left a majority of the population without clean drinking water, electricity or a proper sewage system.