Aida Yassi used to be a woman of the world. Born in the Old City of Jerusalem, she proved to be a gifted dressmaker at a very young age. Her talent took her to several royal courts in the Middle East. As a young woman she was the personal seamstress to the Hashemite queen of Jordan. Later, she worked for the women of the Saudi royal family, embroidering gowns with gold and silver thread.

“Look,” she says, showing a picture of her work. Her remarkably long fingers delicately hold a small plastic-covered photo album.

“This is me, and I wasn’t even 14 years old when this picture was taken. I made the dress myself.”

All of the album’s pictures record the career of the now 72-year-old woman faded and worn images of the creator clothed in her dresses and gowns made at various stages of her professional life. She wants to show off her creations, but she gives up when she fails to locate her work in her crammed studio apartment.

Ms. Yassi lives in the Christian Quarter of the Old City of Jerusalem. To reach her home, one passes through a green-painted iron gate — decorated with a cross — just off a tiny, narrow lane. She shares a courtyard with a number of neighbors, but they do not share in each other’s lives.

The room is dark: Slim beams of daylight slip through a small window carved into the wall in her “kitchen,” which is actually a shelf holding a cooking plate and a few utensils. Only when the door is left ajar does sunlight flood the tightly packed room, revealing pockmarked walls and peeling paint.

Aicda Yassi has no family network. She visits the doctor on her own, walks unaided to the post office and manages other routine errands alone. Yet she needs help cooking her meals. She also depends on the regular care of a nurse, and she longs for comfort to help shut out the fear and loneliness that overcome her every so often. Fortunately, the Elderly Supportive Community Services Center, known locally as the Good Samaritan Center, provides such assistance.

Raja Salameh, who administers the program, knows well the needs of the 450 or so people who have come to depend on it. But the lives of elderly people, almost all of whom are Christian, are far more complicated than they appear. The Old City’s walls hide secrets as well as inhabitants.

“Aida has never been married and has no children,” he says walking into Ms. Yassi’s room.

“I was married to a British soldier while in Saudi Arabia,” she protests.

“I had a daughter and a son. But their father took both children with him back to England and I have never seen them again.

“Once, someone gave me a picture of a young man and told me this was my son,” Ms. Yassi says, pointing to a small black and white photograph on the wall.

The silence that follows is deafening.

The Good Samaritan Center was founded in 2000 and received recognition as a nonprofit three years later. Since 2005, the center has been based in a former hostel owned by the Greek Orthodox Patriarchate in the heart of the Christian Quarter, but Raja Salameh emphasizes that the center does not belong to any one church. Rather, it provides services for all those who live in the city’s ancient Christian Quarter.

“We serve the Lord in a good way,” he says, adding that seven Muslim families who live in the quarter also use the services of the center.

The center receives funding from the Finnish government, CNEWA-Pontifical Mission, international groups and charities.

Until the late 19th century, the Old City was Jerusalem. Stout stone walls and gates — constructed on ancient foundations by the Ottoman Turks in the 16th century — encircled five quarters, each of which contained shrines sacred to the communities that lived there, notably the Western Wall for the Jews, the Church of the Holy Sepulchre for the Christians and the Dome of the Rock and Al Aqsa Mosque for Muslims.

While the Old City occupies only an estimated 220 acres (about .35 square mile), it remains the most contested piece of real estate in the world. After World War II, the United Nations developed a plan to partition Palestine into autonomous Arab and Jewish states, bound together in an economic union. Rather than divide Jerusalem, the United Nations proposed it become a separate body, shared by all and administered by the international community.

The Arab-Israeli War in 1948, however, prevented the implementation of the U.N. plan. Once hostilities subsided a year later, the Old City and its eastern suburbs became a part of the Hashemite Kingdom of Jordan. Renewal of hostilities in June 1967 altered the reality. The Israelis took all of Jerusalem, annexing the Old City and its eastern suburbs immediately after the Six Day War.

Today, an estimated 31,000 people live in the Old City: some 22,000 Arab Muslims in the Muslim Quarter; about 5,500 Christians in the Christian area; 3,000 Jews in the Jewish Quarter and about 500 Armenians in the Armenian Quarter. The Israelis demolished the Moroccan Quarter in 1967, enlarging the Jewish Quarter and easing access to the Western Wall.

The Israeli government has permitted those who live in the Old City to apply for Israeli citizenship. But most, especially the city’s Palestinian population, do not want to assume an Israeli identity in hopes that East Jerusalem will become the capital of an independent Palestinian state. Instead, Palestinian residents who are not Israeli citizens carry identity cards that permit them to live and work in the city and to apply for benefits. Israel considers them “permanent residents” of Jerusalem, which makes them eligible for social and municipal services as well as its prerequisite obligations, such as taxes.

The elderly of the Old City receive a monthly pension from the National Insurance Institute of Israel (N.I.I.). Men receive their state pensions at the age of 67, women at 64. In addition to monetary pensions, the N.I.I. allows each pensioner — according to the individual’s needs — a maximum of 15.5 hours of in-house care. Health services and hospitalization are free of charge, but not the cost of medicines.

The Good Samaritan Center fills in the gaps, providing the elderly with services such as manicures and pedicures, physiotherapy and nominally priced wheelchairs and other aids for lease. The small kitchen, staffed by volunteers from the community, provides 40-50 pensioners with hot meals every day, meals that are delivered by additional volunteers. Friends of the center, many of them students from Bethlehem University, Jerusalem Open University and the Y.M.C.A., also assist the elderly with bureaucratic red tape, helping them fill out requisite documents or accompanying them on visits to various government offices.

Sister Elena of the Little Sisters of Jesus has cared for the elderly of Jerusalem for exactly half of her 68 years — she has been with the Good Samaritan Center since its opening day. Every morning, the French-born nun makes her rounds through the Old City. She takes blood pressure readings, gives insulin injections and checks on the general health and well-being of her senior friends.

“This is my calling,” she says with a smile.

Today she winds her way through the Old City’s narrow lanes to visit Michel Mahal, also known as Abu Issa, and his wife, Bahiah. Entering the small apartment, Sister Elena finds Mrs. Mahal sitting quietly on a simple wooden chair. A female caretaker is cutting her hair. Thin locks of hair gently fall to the stone pavement.

Mrs. Mahal is 74. She used to be a dynamic teacher, but now she suffers from Alzheimer’s disease and requires constant care. On several occasions, she has wandered beyond her courtyard, losing her way in the maze of the Old City.

Her husband sits in a recliner next to his bed. He is connected to an oxygen pump. Severe asthma and diabetes have confined the 78-year-old retired construction worker, and lately his condition has declined. Sister Elena is worried he may not understand the detailed instructions she gave him regarding his daily insulin injections.

The Mahals have three married daughters, all of whom live in the United States. Their only son, who is 41 years old and single, lives with them in a small room facing the kitchen. He has a good job, but according to Good Samaritan’s Raja Salameh, he longs to marry and have a family but suffers from a lack of privacy — he spends much of his free time caring for his elderly parents.

The couple’s caretaker is a local Muslim woman who is paid by the National Insurance Institute to provide in-house care several hours a week. It is not enough and Mr. Salameh has called the N.I.I. to send a social worker to reassess the situation. Sitting on the bed next to Abu Issa, a social worker interviews him. Abu Issa takes deep breathes of oxygen after answering each question.

Sister Elena cuts short her visit so as not to take the time of the social worker whose report might help the elderly couple obtain more hours of weekly in-house care. But the nun is weary. Even though she has just returned from vacation, she feels she has to begin a lot of her work anew.

“While I was gone many of the elderly have not taken care of themselves. They have not stuck to my instructions on what to eat or rather what not to eat. I see a lot of high blood pressure and blood sugar this morning,” she adds.

Since 1856, the St. Vincent de Paul Society has provided relief to the Holy City’s poor. In the 19th century, the society ran a small, 18-bed hospital in the Old City. Since World War I, its members have been instrumental in providing first aid and food to the city’s inhabitants, regardless of creed. Today, the society focuses largely on the situation of the elderly in the Old City, working closely with the Good Samaritan Center to raise funds and coordinate activities.

“This year, we have donated $25,000 for wheelchairs and walking aids for the center,” says Tony Khasham, a successful local Christian businessman who volunteers for the society.

Mr. Khasham’s family has lived in Jerusalem for 800 years, but this chapter in the long life of the family is closing. His own sons have left to study abroad, and he is quite sure they will never come back.

“The youth who have ambitions and want a career must move out of Jerusalem — often out of the country — leaving the elderly without care by first of kin.”

Christian emigration from Jerusalem is not a recent occurrence. Since the 19th century, the city’s Christians have left their homeland in search of opportunities in the Americas and Oceania. But the depopulation of Christians from the entire region has escalated in the past 50 years or so.

While Christians once represented some 20 percent of the population in Palestine during the period of the British mandate (1917-1948), Christians today make up less than 1 percent in the areas under the Palestinian Authority and about 2 percent in Israel. This phenomenon places great burdens on those who remain, including Good Samaritans such as Raja Salameh and Tony Khasham, who are running out of financial and human resources.

Complicating matters further is the ongoing conflict between Israelis and Palestinians. The city’s elderly are perhaps the most powerless of its victims.

“Jerusalem has been forgotten,” says Mr. Khasham.

Since the signing of the Oslo Accords in 1993, which launched the peace process between the State of Israel and the Palestine Liberation Organization, tremendous amounts of energy and money have poured into the development of the nascent Palestinian Authority. Governmental, nongovernmental and church aid have been focused on the West Bank and Gaza. Jerusalem, however, has received little if anything.

Politically the Palestinian population of Jerusalem falls through the cracks.

“Israel does not allow the Palestinian Authority to fund projects in Jerusalem. And relative to the rest of Israeli society, the Palestinians of the Old City are marginalized and neglected,” adds Mr. Khasham.

“We are fed up with all the money going to the West Bank refugee camps,” says Raja Salameh. “When I ask even Christian aid organizations for money for food for the elderly here at the center I get the answer: ‘Sorry. Funds are for the West Bank.’

“This is the Holy City. Who will help her?”

Yousef Samara, known as Abu Ghazi, and his 71-year-old friend George Samara (not related) sit in deep concentration while playing a game similar to rummy.

Now 75, Abu Ghazi used to work as a butcher. His wife has died, but he has three sons and two daughters. His sons have all moved to the United States, but his daughters remain. Every day he meets George at the Good Samaritan Center.

“If we didn’t have the club, where would we meet to play cards,” they ask rhetorically.

The Good Samaritan Center has three floors. The ground floor functions as a club, an entertainment center of sorts with a television, a number of card tables and board games. The second floor houses a clinic-like facility and the center’s administrative offices. A flat roof is the center’s third floor and it is Mr. Salameh’s pride and dream. The roof is at the same level as the lead-covered domes of the Church of the Holy Sepulchre, which is just two buildings away. In the distance, one can see the Mount of Olives.

Here prayers are conducted each Monday.

“When we started the center, all the churches were a bit skeptical. Now they all want to come here to conduct prayers and celebrate liturgies,” he adds. “A few weeks ago, the former Latin patriarch, Archbishop Michel Sabah, led a prayer service. The Greek Orthodox patriarch has been here and next week we will have a priest from Lebanon.”

The roof is not covered and can only be accessed via a steep staircase. Mr. Salameh’s dream is to cover the roof so this huge space can hold a few hundred people and be used for the entire community, the city’s remaining youth, young families and the elderly.

“We hope to get a donation for an elevator,” he says as he reviews plans for the elevator on his desk. But until then, the center has to make do with just keeping its doors open and its pantry stocked.

Danish-born Hanne Foighel has reported from the Middle East for more than 25 years.