Etaf Abdel-Rahman's 10-year-old son stands in line at a neighbourhood bakery for four hours to get eight loaves of bread to feed the 15 people crowded in her small apartment in Gaza.
Some Palestinians rush to bakeries and shops during a daily three-hour Israeli pause in firing to stock up for the day. But international aid workers say that many fear venturing outside and are without badly needed supplies.
Many shops are empty and grocery stores in the crowded al-Nasser neighbourhood in the centre of Gaza city were selling only lemons and onions, Abdel-Rahman, 50, said by telephone.
Meat, chicken, vegetables, and fruit are a scarce commodity and prices have soared due to the conflict, Abdel-Rahman said.
"We have been without electricity for 14 days in a row," Abdel-Rahman said. "During the short ceasefire period, people rush to the Shifa hospital or to mosques that have generators to charge their mobile phones." Barbara Conte, a spokeswoman for the World Food Programme, one of two U.N. agencies that help feed much of the population, said it is very difficult to hand out food because people are afraid to leave their homes and go to distribution centres.
"That is why we call for an immediate ceasefire," she said.
International sanctions were imposed on Palestinians when Hamas won a parliamentary election in 2006 and were tightened on the Gaza Strip, along with an Israeli-led blockade, when the group seized control of the enclave in 2007.
Smuggling of food and supplies from Egypt through tunnels filled some of the gap, along with official humanitarian aid, but Israel's offensive, which began on Dec. 27, has largely cut off that supply route.
3 of 24 hours
Palestinian officials said the three-hour daily ceasefire, introduced by Israel last week, was insufficient to allow aid distribution disrupted by the fighting.
Israel, as it has done for most of the years since it pulled out its troops and settlers in 2005 following 38 years of occupation, is allowing aid agencies to move limited food, medicine and other supplies by truck into 1.5 million-population enclave.
"Trickle of assistance"
But John Ging, director of operations in Gaza for the U.N. Relief and Works Agency (UNRWA) said about 100 aid trucks per day entering Gaza were carrying "just a trickle of assistance".
Up to 500 were needed daily, he said, to meet the needs of 1.5 million people, including wheat for bread.
Human Rights Watch said in a report this week that Israel's daily break in attacks to facilitate the supply of humanitarian aid to Gazans was "woefully insufficient".
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According to aid workers, more than 80 percent of the Gaza Strip's population, need aid from international humanitarian organisations.
UNRWA, set up to help Palestinian refugees who fled or were driven from their homes when Israel was created in 1948, now supports some 750,000 Gazans classed as refugees. The WFP is supporting another 365,000, an increase of 100,000 people since Israel began its assault aimed at ending Hamas rocket fire. Palestinian President Mahmoud Abbas and his West Bank-based leadership declared the Gaza Strip, where nearly 1,000 Palestinians have been killed, a "national disaster region", and demanded international protection for its people.
Gazans say that in addition to shortages of fuel, food and medical supplies, they also must contend with a deteriorating sanitation situation due to water and electrical cuts.
Shaima Abu Hatab, 22, from Khan Younis in the south of the 45-km strip of coastline, said a cooking gas cylinder was sold before the war for $150, but can no longer be found now.
That, for example, was why the WFP has started supplying ready-to-eat meals of bread and canned meat, Conte said.
Um Youssef, from Nusseirat in the centre of the strip, said many people were short of money and could not afford to buy what little and expensive goods were offered in the markets because banks had been shut since the fighting began.
"People are suffering a lot," said Hassan Abu Youssef, 42, who also lives in central Gaza. "But the problem is that people have no hope that this suffering will ever end."