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Families dig trenches to use as latrines. Fathers look for food and water.
Children rummage through rubbish and ruined buildings for wood or cardboard for their mothers to burn for cooking.
Over the past three weeks, Israel’s offensive in Rafah has sent nearly a million Palestinians fleeing the southern city of Gaza.
Most have already been displaced repeatedly during Israel’s nearly eight-month war in Gaza, which aims to destroy the militant group Hamas but has devastated the territory and caused, according to the United Nations, near starvation.
The situation has been worsened by a drop in the amount of food, fuel and other supplies reaching the UN and other humanitarian groups for distribution to the population.
The Palestinians, who relied in part on humanitarian aid even before the war, were largely on their own to find the basics of survival.
“The situation is tragic. You have 20 people in the tent, no clean water, no electricity. We have nothing,” said Mohammad Abu Radwan, a teacher with his wife, six children and another extended family.
“I can’t explain what it feels like to live in permanent displacement, to lose your loved ones,” he said.
”All this is destroying us mentally.”
Abu Radwan fled Rafah soon after the Israeli assault on the city began on May 6, when the bombardment approached the house where he was hiding.
He and three other families paid $1,000 ($1,500) for donkey carts to take them to the outskirts of Khan Younis, about six kilometers away.
It took them a day of living outside before they could gather the materials for a makeshift tent.
Next to the tent they dug a trench for a toilet, hung blankets and old clothes around it for privacy.
Families typically have to buy wood and tarps for their tents, which can run up to $US500 ($750), not including ropes, nails and the cost of transporting the material, aid group Mercy Corps said.
Israeli authorities, which control all entry points into Gaza, are allowing more private commercial trucks into the territory, the UN and aid workers say.
More fruits and vegetables are in the markets and the prices of some have fallen, Palestinians say.
However, most homeless Palestinians cannot afford them.
Many in Gaza have not been paid for months and savings are running low.
Even those who have money in the bank are often unable to withdraw it because there is so little physical cash in the territory.
Many turn to black market exchanges, which charge up to 20 percent to give cash for account transfers.
Meanwhile, humanitarian convoys with free supplies have fallen to near their lowest levels in the war, the UN says.
Previously, the UN received several hundred trucks a day.
That has fallen to an average of 53 trucks a day since May 6, according to the latest figures from the UN humanitarian agency on Friday.
About 600 trucks a day are needed to prevent starvation, according to USAID.
Over the past three weeks, most of the aid arrivals have entered through two points from Israel in northern Gaza and through a US-built floating pier that accepts supplies by sea.
The two main crossing points in the south, Rafah from Egypt and Kerem Shalom from Israel, are either out of business or largely inaccessible to the UN because of the fighting nearby.
Israel claims to have let hundreds of trucks through Kerem Shalom.
But the UN has been able to collect only about 200 of them from the Gaza side in the past three weeks due to Israeli military restrictions, the expanding offensive, Israeli airstrikes and Hamas rocket fire, UNRWA spokeswoman Juliet Touma said on Tuesday.
Fuel input has dropped to about one-sixth of what is needed, Tuma said.
This makes it difficult for hospitals, bakeries, water pumps and aid trucks to operate.
The American aid group Anera “is having difficulty distributing what we can get to the people who need it because there is so little fuel for trucks,” said spokesman Steve Fake.
Most of those fleeing Rafah poured into an Israeli-declared humanitarian zone centered on Muwasi, a largely barren strip of coastal land.
The zone was extended north and east to reach the edges of Khan Yunis and the central city of Deir al-Balah, both of which are also full of people.
“As we can see, there is nothing ‘humanitarian’ in these areas,” said Suze van Meegen, head of the Norwegian Refugee Council’s Gaza operations, which is in the Rafah area.
Much of the humanitarian area has no charity kitchens or food market and no functioning hospitals, only a few field hospitals and even smaller medical tents that cannot handle emergencies.
They give out pain relievers and antibiotics if they have them, according to Mercy Corps.
The Muwasi area has no water resources or sewage systems.
As human waste is dumped near the tents and garbage piles up, many people suffer from gastrointestinal diseases such as hepatitis and diarrhea, as well as skin allergies and lice, Mercy Corps said.
One aid worker who fled Rafah said he was lucky and could afford to rent a house in Deir al-Balah.
“You can’t walk” into the city from all the tents, he said, speaking on condition of anonymity because his agency did not authorize him to speak.
Many people he sees on the street are yellow with jaundice.
Israel says its Rafah offensive is vital to its military goal of wiping out Hamas in Gaza after the group’s October 7 assault in which militants killed around 1,200 people and kidnapped around 250 others from southern Israel. Israel’s campaign in Gaza sparked by the attack has killed an estimated 36,000 people, according to the Gaza Ministry of Health.
Aid groups have warned for months that an attack on Rafah would worsen the humanitarian disaster in Gaza.
So far, Israel’s operations have failed to achieve the planned all-out invasion, although fighting has expanded from the eastern parts of Rafah to its central areas.
Civilians flee in Rafah as Israel continues its offensive
Of the exodus caused by the attack, satellite images taken by Planet Labs PBC on May 24 show dense new tent camps running the length of the coast from north of Rafah to outside Deir al-Balah.
Tents and shelters are densely packed into mazes of corrugated metal and plastic sheets, with blankets and sheets draped over poles for privacy.
Tamer Saeed Abu’l Kheir said he goes out at 6 a.m. every day to find water, usually returning around noon to the tent outside Khan Younis, where he and nearly two dozen relatives live.
His three children, aged four to 10, are always sick, but he said he has to send them out to collect wood for the fire.
He worries that they will come across unexploded bombs in the destroyed houses.
His aging father has difficulty moving and uses a bucket toilet, and Abu’l Keir must regularly pay to transport him to the nearest hospital for kidney dialysis.
“Wood costs money, water costs money, everything costs money,” said his wife, Leena Abu’l Keir. She broke down in sobs.
“I’m afraid that one day I’ll wake up and lose my children, my mother, my husband, my family.”
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