“We did not expect that another winter would pass while we are still under war,” Salah Abu al-Jabeen told AFP on Wednesday. Originally from the north of the Gaza Strip, the 32-year-old is living in an overcrowded makeshift camp in the central Gaza city of Nuseirat.

Nearby, Ahmad al-Razz is equally ill-equipped for the cold. “My tent is made of cloth and flour sacks that I sewed together,” he said.

Like Jabeen, Razz looked elsewhere for somewhere to sleep, but could not find any space in the overcrowded camps and shelters.

After more than a year of relentless war, almost all of Gaza’s population has been displaced at least once, according to the United Nations. Shortages of everything from food and medical equipment to blankets and warm clothing have only made things worse.

AFP journalists saw dozens of people queueing outside a bakery in the southern Gaza city of Khan Yunis on Wednesday, sometimes arguing and shoving in the hope of getting to the front of the line. With little aid getting into Gaza, basic necessities are either absent from market shelves, or sold at exorbitant prices inflated by scarcity.

“The poor water, sanitation, and hygiene situation along with overcrowding in shelters and displacement sites are the major drivers of communicable diseases,” Richard Peeperkorn, the WHO’s representative for the occupied Palestinian territory, said on Wednesday. “As these conditions will likely deteriorate further during the winter, these disease incidences are likely to continue rising,” he told AFP.