An UNRWA school in al-Maghazi, Gaza [Aseel Mousa/Al Jazeera]

Al-Maghazi, Gaza Strip, November 3 (RHC)-- Days after a UNRWA school in the central Gaza Strip was hit by Israel, killing at least six people, clothes and blankets still hang from the windows and balconies of its other schools, turning the traditional white and blue colours of the United Nations Palestinian refugee agency into a patchwork of bright colours.

The schools have become places of refuge for hundreds of thousands of displaced Palestinians in the Gaza Strip, many of whom believe that the UN designation of these buildings will keep them safe from the constant Israeli bombardment.

According to the UNRWA, more than 613,000 of 1.4 million internally displaced people in Gaza are sheltering in 150 of its facilities across the blockaded territory.  But severe overcrowding, a lack of privacy and inadequate sanitation have put these schools at risk of a prolonged and severe public health crisis, adding pressure to the already overloaded healthcare system which doctors and the health ministry describe as being in a state of total collapse.

And now, with the bombing of the school in the al-Maghazi refugee camp, in which dozens were injured, it is clear that schools may not be the places of sanctuary humanitarian agencies hoped for.  “This is outrageous, and it again shows a flagrant disregard for the lives of civilians,” Philippe Lazzarini, UNRWA Commissioner-General, said. “No place is safe in Gaza any more, not even UNRWA facilities.

“At least 4,000 people have taken refuge in this UNRWA school-turned-shelter. They had and still have nowhere else to go.”  The displaced people in these schools also lack access to life necessities such as water, electricity, food, milk, nappies and essential supplies for period health including sanitary pads, disinfectants and pain relief.

The UN agency said that some shelters are currently hosting 10 to 12 times more people than their capacity.

One school in Khan Younis is hosting 21,000 people. Noor and her family are staying at another school in the southern city, which has approximately 6,000 individuals, or about 1,100 families housed within it. According to those managing the shelter, just over half of the occupants are men, who sleep outside in the playground. Women and children sleep in the classrooms.

“Each classroom has about 50 people,” Noor, who preferred not to give her last name, said. “We sometimes have two hours of electricity, depending on the generators. There’s also a shortage of water most of the time.”

The 25-year-old and her seven-member family were forced to leave their home in the Abasan neighbourhood, on the eastern fringes of Khan Younis in the southern part of the Gaza Strip.  Their house was severely damaged after an Israeli air raid targeted a neighbour’s home, and the family has been living in the UNRWA school in Khan Younis ever since.

“We sought refuge in UNRWA schools with the hope of finding safety, but we found ourselves in an environment ripe for the outbreak of diseases and impending health crises as well as being plagued by constant Israeli aerial and artillery bombardments, day and night,” Noor said.

Displaced Palestinians began taking refuge in this school during the early days of the Israeli bombardment of the Gaza Strip, after a surprise attack on October 7 by Hamas on Israel killed 1,405 Israelis. Over the past 20 days, at least 7,028 Palestinians have been killed in the onslaught, most of them women and children.

Already, the overcrowding and unsuitable hygiene facilities in the makeshift accommodations have led to an outbreak of scabies and smallpox among the displaced population.  The lack of basic hygiene, especially for women, compounds the dire circumstances, especially when it comes to menstruation.

In addition to the physical discomfort associated with periods such as headaches, joint pain, and abdominal and back pain, there is also added psychological distress, worsened by the constant fear the women and girls are experiencing under Israeli shelling.

“Menstruation in the shelter school feels like a nightmare,” Noor said. “There are no blankets, no comfortable mattresses, no sanitary pads, no pain relievers and no access to hot water to make soothing beverages.

“Some girls within these shelters are resorting to taking medication to prevent their menstruation, aiming to avoid the embarrassment and added pain,” she added.

For those who have their period but have little to no access to sanitary products, a distressing practice has emerged where some girls and women have resorted to washing and reusing sanitary pads, inadvertently risking their health due to potential contamination.

In another UNRWA school in al-Maghazi, Amal, her husband and their three young boys are struggling to find the basics.  While UNRWA continues to provide some assistance in shelters, the total siege of the Gaza Strip and the unrelenting bombing have severely constrained access to essential services, which in turn represent a health risk for the displaced Palestinians.

Amal, who said she was afraid to give her last name for fear of Israel targeting her family, was forced to leave her house in the Shati (Beach) refugee camp west of Gaza City on October 13. Her house had been damaged by Israeli bombing, its windows shattered and the doors blown out.

They fled to al-Maghazi in search of safety, but the journey was terrifying, with bombs falling from the sky above. Some families rode in trucks and were targeted by Israeli missiles and killed, while other men, women and children were running in the street.

The only thing Amal could take was an emergency bag, in which she placed their identification cards and some items for her youngest son, Karim, who is not yet one year old.

“The situation in UNRWA schools is so bleak,” Amal said. “I’m struggling to find the right size of diapers for my son. We aren’t receiving any aid for children, and I don’t even have milk to feed him.”  Amal said she has resorted to using cloths instead of nappies for her son, which has given him severe rashes.

She added that she avoids eating even the smallest amounts of tuna and bread provided by UNRWA so she won’t need to use the toilet. Due to a lack of sufficient blankets, her other two children, aged seven and five, now have colds and colic.   “I can’t bear the situation we are living in,” Amal said. “The war is very cruel, and we hear the sounds of bombing all day long.”