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One 23-year-old woman living in north Gaza said "dizziness has become a constant feeling" as well as "general weakness and fatigue from the lack of food and medicine".

Adham al-Batrawi, 31, who used to live in the affluent city of al-Zahra but is now displaced in central Gaza, said hunger was "one of the most difficult parts of daily life".

He said people had to get "creative just to survive", describing through WhatsApp messages how he would over-cook pasta and knead it into a dough before cooking it over a fire to create an imitation of bread – a staple in the Palestinian diet.

"We've invented ways to cook and eat that we never imagined we'd need," he said.

He added that the one meal a day he had been eating recently was "just enough to get us through the day, but it's far from enough to meet our energy needs".

Half of Adham al-Batrawi's family home in al-Zahra was destroyed, he told the BBC

Elsewhere in central Gaza, in the city of Deir al-Balah, nurse Rewaa Mohsen said it was a struggle to provide for her two young daughters, aged three and 19 months.

She said she had stockpiled nappies during the ceasefire earlier this year but that these would run out in a month.

Speaking over WhatsApp on Thursday, she said her daughters had grown used to the sounds of bombing that would ring through the apartment. "Sometimes I feel more afraid than them," she wrote, adding that she would distract her children with colouring books and toys.

The next day, over voice note she said evacuation orders had been issued for her area before an Israeli strike hit a nearby building.

When she returned to her home to "clean the mess", she found that the doors and windows had been blown off.

"Thank God that I am still alive with my girls," she said.

When asked if she would stay in the apartment, she responded: "Where else will I go?"

Across Gaza, medics described the impact of the blockade on medical supplies and said they no longer felt safe at work following Israeli strikes targeting hospitals.

Nurse Randa Saied said she was working at the European Hospital in Khan Younis when it was hit in an Israeli strike this week, describing it as a moment of "pure terror and helplessness".

Israel has long accused Hamas of using hospitals as covert bases and for weapons storage, which the group denies.

The European Hospital is no longer operating, but Randa said staff and patients had moved to the nearby Nasser Hospital.

"Our patients are mothers, sons, daughters and siblings – just like us. We know deep in our hearts that our duty must not end, especially now when they need us the most," she said.

Reuters
Images from the European Hospital in Khan Younis show piles of rubble on the floor

Staff at Nasser and other hospitals in Gaza told the BBC the blockade meant they were running short on basic supplies like painkillers and gauze, and had to shut down some services.

The US has confirmed that a new system for providing humanitarian aid to Palestinians in Gaza through private companies is being prepared, with Israeli forces set to secure the centres' perimeters. The United Nations has criticised the plan, saying it appears to "weaponise" aid.

Back in Gaza City, Ismail's father said he struggled with no longer being able to provide for his six children.

"My children go to sleep hungry," he said. "Sometimes I sit and cry like a little kid if I don't manage to provide food for them."

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