- Under ceasefire deal, Israel was supposed to allow 600 aid trucks to enter Gaza daily, but the number ‘does not exceed 100 to 150 at best,’ says Gaza municipality spokesperson

- ‘Tents, blankets, and warm winter clothing are in dire need … Everything is needed because so much has been destroyed,’ says Shaina Low of the Norwegian Refugee Council in Palestine

- Extreme cold, coupled with lack of tents and heating, has led to a rise in hypothermia, pneumonia, and other cold-related illnesses, says Palestinian doctor Kifah Abunada

ISTANBUL

As winter tightens its grip on Gaza, the combination of severe weather, lack of adequate shelter, and Israel’s ongoing blockade of humanitarian aid has created an increasingly desperate situation for hundreds of thousands of displaced Palestinians.

Cold temperatures, relentless rain, and strong winds have turned makeshift shelters into barely livable spaces, offering little to no protection from the elements.

Israel’s restrictions on aid deliveries – both in terms of quantity and type – have only compounded the crisis, leaving many without access to the most basic necessities, including food, medicine, and heating supplies.

The curbs were among the key violations cited by Hamas when it announced on Monday that it would postpone the release of more Israeli prisoners, initially scheduled for Saturday, unless Prime Minister Benjamin Netanyahu’s government complied with the terms of the ceasefire agreement.

The first phase of the ceasefire, intended to last 42 days, was supposed to ensure that 600 aid trucks entered Gaza daily and that the Rafah border crossing would be fully reopened within a week.

However, according to Hosni Mahna, a spokesperson for the Gaza municipality, the number of trucks coming in daily falls far short of what is needed.

“Gaza needs 500-600 trucks per day to meet its minimum basic needs, but what actually enters does not exceed 100 to 150 at best,” Mahna told Anadolu.

“This aid is often insufficient and lacks basic materials such as tents, blankets, and heating supplies. The markets have become flooded with commercial goods … that the population cannot afford,” he added.

According to Mahna, Israel not only restricts the number of trucks allowed to enter but also dictates the type of aid permitted, leading to a severe shortage of essential supplies such as medicines, foodstuffs, and fuel required to operate bakeries and hospitals.

‘Everything is needed because so much has been destroyed’

International aid groups and officials have raised the alarm over how the inconsistent flow of supplies due to Israeli roadblocks is worsening humanitarian conditions in Gaza.

“The health system is ruined. Malnutrition is rising. The risk of famine persists,” said Hanan Balkhy, regional director for the Eastern Mediterranean at the World Health Organization.

“We are ready to scale up our response, but we urgently need systematic and sustained access to the population across Gaza, and we need an end to restrictions on the entry of essential supplies.”

A recent update from the UN aid coordination office said nearly 1 million displaced Palestinians are living in “substandard tents or makeshift shelters, with families resorting to sewing old rice sacks together for basic cover.”

“The cold weather has a catastrophic impact on hundreds of thousands of Palestinians living in tents and temporary shelters, especially with the lack of heating and basic supplies to protect against rain and strong winds,” said Mahna.

Families, including young children and the elderly, sleep on cold dirt or cement floors without insulation, increasing their risk of infection and illness. Strong winds have also ripped apart makeshift tents, while heavy rains have flooded entire shelter camps, leaving many in uninhabitable conditions.

“There is an acute shortage of tents. In the Gaza and North governorates alone, we need at least 120,000 tents to temporarily shelter residents who have lost their homes, but what has been delivered so far covers only 10% of the actual need,” said Mahna.

Shaina Low, a communication adviser for the Norwegian Refugee Council (NRC) in Palestine, described the dire situation: “It’s not just cold weather – it’s been incredibly windy. People living in makeshift shelters, tents, or other structures without any insulation or meaningful protection are facing extreme conditions. They’re completely exposed to the rain.”

Low also pointed out that many families returning to their homes – or what remains of them – have done so without shelter materials, only to find their neighborhoods in ruins.

She noted that for months, aid organizations had been urging increased humanitarian assistance in preparation for winter.

“We knew that people were going to be on the move once the corridor reopened and allowed them to return north. So, it doesn't make sense to distribute a 50-kilogram tent when people have to carry it for 8-10 kilometers on foot just to get home,” she explained.

“In terms of shortages, it’s tents, blankets, and warm winter clothing that are in dire need. You see pictures of kids without shoes on – everything is needed because so much has been destroyed.”

Cold-related illnesses and worsening health crisis

As temperatures drop, cold-related illnesses have become widespread throughout Gaza, putting additional strain on an already crippled healthcare system.

Mahna detailed the alarming health crisis, stating that respiratory infections, influenza, and bronchial diseases have skyrocketed, particularly among children and the elderly, whose immune systems are weakened due to prolonged malnutrition and poor living conditions.

“Living in a humid and uninsulated environment increases the risk of respiratory diseases, joint problems, and skin infections such as sores and rashes. People are unable to change their wet clothes or dry their blankets, which exacerbates these issues,” he said.

He also warned that overcrowded shelter centers have become breeding grounds for infectious diseases due to lack of clean water and proper sanitation.

Kifah Abunada, a Palestinian doctor in Gaza, echoed these concerns: “Respiratory infections and malnutrition-related diseases, such as anemia – especially among pregnant women and children – have significantly increased.”

She further noted that skin conditions like scabies, lice infestations, and fungal infections have become widespread.

“The situation has worsened with the emergence of diseases that were previously rare, such as polio and tuberculosis. Moreover, the lack of adequate and appropriate medications has exacerbated the crisis,” she said.

Harsh winter conditions have also led to an increase in hypothermia, pneumonia, and other cold-related illnesses, particularly among infants and the elderly. Additionally, waterborne diseases such as hepatitis have surged due to the lack of clean water and poor sanitation.

Abunada also highlighted a growing mental health crisis among Gaza’s displaced population: “Cases of severe anxiety, panic attacks, and involuntary urination have increased due to constant instability, lack of security, and the widespread displacement of families.

“The psychological toll – especially on children who have endured continuous bombings and displacement – is profound, manifesting in PTSD, depression, and long-term emotional distress.”