Harsh winter weather is making life even more difficult for hundreds of thousands of displaced people in Gaza, many of whom fled their homes months ago without warm clothes or blankets. Some could not carry much and others did not think they would need to prepare for months of war, stretching into the coldest months of the year. “I see a lot of people sleeping on the ground, with no mattress and no blankets,” said Mohammad Shaban, a doctor working in a makeshift hospital set up inside a school transformed into a refugee shelter. A few classrooms hold his 60 patients; the others shelter 1,700 refugees. “It is cold and crowded, with 50 people in one room, which makes it easy for diseases to spread,” he said. “In the last week, because of the bad weather, we have a lot of cases from influenza and common cold.” Even those who still have money struggled to find winter clothes and blankets in the markets that are still open, said Hiba Saleh, a mother of four children aged between one and 11, who fled northern Gaza. Shops have sold out, secondhand clothes that might have been passed on have been abandoned or destroyed in bombing, and aid groups focus on bringing in food, medicine and water. “The situation in the markets is very poor, there is nothing to meet people’s needs in terms of winter clothes or blankets, and aid from outside is very limited,” she said in a phone interview. “Previous wars in Gaza were not as extremely harsh as this one.” Homes and schools are already crammed with refugees, so more recent arrivals are mostly living in the open. Saleh said a tent city had sprung up beside rooms her family rented a few weeks earlier, in a place with no water, sanitation, or other services. “We were very lucky to find a place,” she said of the three rooms they now share with two other families. “Everyone lives in tents, it doesn’t matter if you are rich or poor, money doesn’t facilitate life in Gaza.” Only a few have received robust tents from aid groups; most are vulnerable to the elements in makeshift shelters put together from wood, cloth or other scavenged materials. Leo Cans, the Médecins Sans Frontières’ head of mission for Palestine, said: “Heavy winds destroyed tents last night. Temperatures can drop to about 9-10C during the night and for those who live in tents the situation is particularly dire. “People burn pallets in the street to have heat. Most people brought nothing with them when they left their homes. There is a lack of food and water, but also of warm clothes, jackets, blankets, or even mattresses to sleep on.” Rain, which came on Friday and is expected to continue this week, deepens the misery. At the school where Shaban works as a doctor, it floods the grounds and a lack of sanitation for the huge number of people living there means a risk of sewage pollution. Many children were already dealing with severe gastroenteritis, made worse by the lack of water, he said. Families of up to 20 people get only five litres a day. Refugees in tents have often been forced to set up camp in low-lying parts of Gaza prone to flooding. And even those like Saleh who have better shelters say they cannot heat their rooms. Proper firewood, which is allowed to dry out for months or years after it is harvested, has vanished from the market. Farmers are cutting down trees to sell but the wood is only good for cooking outside. “Newly cut trees create a lot of smoke, we can’t use them for heating, just cooking,” she said. Getting any new supplies from Rafah is challenging, the streets are crowded with bored, desperate refugees, there is little transport, and shops are running out of many essentials. “Visiting Rafah is really heartbreaking. It will take you one day at least to get some items that you need,” she said “Today my husband managed to get a pack of diapers, it was the greatest thing for this week. I was down to the last two or three, I’d told him, we can skip a meal, please get diapers.”