Over the past 100 days, he added, the people of Gaza have gone from “the sheer shock of losing everything, in some cases every member of their family, to a debilitating struggle to stay alive and protect their loved ones. 

“Every time I visit Gaza, I witness how people have sunk further into despair, with the struggle for survival consuming every hour.” 

Lazzarini said that in southern parts of Gaza near Rafah, close to the border with Egypt, makeshift shelters made from plastic sheeting have sprouted up everywhere, even on streets, as displaced people attempt to shield themselves from the cold and rain. More than 20 people can be crammed into these fragile dwellings, he added. 

The population of Rafah has almost quadrupled in the past two months and now exceeds 1.2 million, said Lazzarini. The congestion is so intense that vehicles are barely able to navigate through the throng, he added. 

“Everyone I met had a personal story of fear, death, loss, trauma to share,” he said. “In Deir Al-Balah, in the middle areas, I visited one of our schools-turned-shelter. The overcrowding was claustrophobic and the filthiness was striking. 

“I heard stories of women foregoing food and water to avoid having to use the unsanitary toilets. Skin diseases and head lice are rife, with those affected stigmatized. People were struggling for food and medicine during the day, feeling cold and damp during the night. 

“They wish to return to their lives before the war but realize, with deep anxiety, that this is unlikely to happen anytime soon.” 

Given the restrictions on the flow of commercial goods into the Gaza Strip as a result of the conflict, the cost of essential items has risen as much as tenfold, from fruit and vegetables, which are barely available, to baby milk and even a second-hand blanket, Lazzarini said. Sanitation and healthcare services are also seriously compromised. 

“Mountains of uncollected rubbish now fill the streets,” he said. “The chronically ill do not have sufficient medicine and must learn to live with alternatives or do without, from basic insulin for diabetes to daily tablets for high blood pressure. People are not able to wash and stay clean. 

“Long and repeated blackouts in telecommunications, including internet and mobile phones, add to the distress as people feel cut off from the rest of the world. The siege is the silent killer of many.” 

Lazzarini lamented the fact that reliable information about conditions in northern Gaza remains scarce because access is still highly restricted. He was denied permission to visit the area and said UNRWA aid trucks frequently face significant delays at checkpoints. 

“Many desperate people now approach our trucks to get food directly off them, without waiting for distribution,” he said. By the time the Israeli authorities give our convoys the green light to cross, trucks are almost empty. 

“Our staff are equally impacted. Despite this, they work tirelessly to support the people around them. I am not able to reassure them that they, let alone their families or UN facilities, will be safe.