Gaza City - Thin bed sheets provide little comfort to Naima Abu Asar and her three teenage daughters, living in a makeshift tent in the yard of one of Gaza's busiest hospitals.
The family now calls the Shifa Hospital compound home; they lie on the hard ground outside as hospital and ambulance staff rush between patients, and family members frantically check if their loved ones are alive. "The schools [shelters] are bursting with families sheltering [there] already. The only option, for our safety, is here at the hospital," Naima told Al Jazeera.
"Life here is already harsh, but [Israel tries] to crush us more [and more] every day," she said, adding that the family's tent - made from hospital bed sheets and pieces of plastic - doesn't protect them from the scorching summer heat, or the cold at night.
Naima and her three daughters are living within the walled compound of Shifa hospital with dozens of other families, totalling a few hundred people. They are in the same clothes they were wearing when they escaped the bombings near their home in Shujayea, a neighbourhood of east Gaza City that suffered extensive Israeli shelling in July.
"I couldn't retrieve anything from the house. It's all ruined," said 15-year-old Yasmine. "We just managed to escape the artillery shelling, but it killed several of our neighbours. We are lucky to have gotten away with the clothes on our backs."
The schools are bursting with families sheltering [there] already. The only option, for our safety, is here at the hospital.
"We couldn't find anywhere safer or less overcrowded," Naima added, while an elderly man in the makeshift tent next door chimed in, saying that Israel has bombed Gaza hospitals, too.
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Unlike Palestinians sheltering at United Nations or government-run facilities, the Abu Asar family and others now living at Shifa hospital get little support, relying solely on passersby who sometimes share food and other supplies with them.
The UN estimates that about 365,000 Palestinians are living in UN and government emergency shelters or with host families across the Gaza Strip, as at least 16,800 homes have been destroyed or severely damaged since the Israeli offensive began on July 8.
At least 1,980 Palestinians have been killed, and nearly 10,200 others injured, in Israel's operation, according to the Gaza health ministry. Sixty-four Israeli soldiers have been killed, along with two Israeli civilians and a Thai worker.
Kefah al-Harazeen, 25, is also from Shujayea. "Even [during the] ceasefire, as now, I know my home is partially demolished, with much of the stone structure turned to dust and sand which could crash down on our heads," said al-Harazeen.
Sitting at her feet, her two young children have head lice and skin rashes, since it's been nearly one month since the family has been able to shower, al-Harazeen said. She now uses a small pot, filled with water from the hospital's maternity ward, to wash her children.
"I never had to live in the dirt like this before the bombing. Now, viruses are spreading among our children while we all shelter at the hospital and still try to stay clean," al-Harazeen said. "We couldn't get into the UN schools and now we feel excluded from any aid, food or water," she added.
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Chris Gunness, spokesperson for the UN Relief and Works Agency (UNRWA) for Palestinian refugees, said the group does not turn anyone in Gaza away.
"It is UNRWA's policy to turn no one away, whether refugee or non refugee, while there is an emergency in Gaza such as we are now seeing. We assist people on the basis of need," Gunness told Al Jazeera.
Eighty-seven UNRWA schools are currently being used as emergency shelters in Gaza. "The number of displaced fluctuates as families discover that their homes are uninhabitable or lack even the basic amounts of water, electricity, and food available in emergency shelters," the group stated. "Others are returning because they wish to secure their places in shelters should hostilities resume or because of general insecurity."
Gunness explained that UNRWA is currently trying to prepare its facilities for the upcoming school year, which means clearing out the schools that are currently being used as shelters. "To that end, we are trying to consolidate and regroup, moving people into a fewer number of shelters," he said.
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Amal Alaraer, 46, lives at Shifa hospital with nine family members, including her husband and son, who both sustained injuries when Israeli troops fired on a local market in Shujayea, killing at least 17 people and injuring 200 others.
"We sit on pieces of old cardboard medication boxes from Shifa hospital," said Alaraer, as she prepared her children for another night of trying to sleep through loud ambulance sirens. Alaraer told Al Jazeera that her family tried moving to five separate schools being used as shelters, but upon seeing the conditions - overcrowded and lacking basic resources - she decided to go to the hospital instead.
"We gave up and came here to Shifa, where my family was also sheltering," she said. "Children shiver from the cold night air. It hurts me as a mother that I can't make them warm enough."
Despite a five-day ceasefire, which took effect on August 13, holding in Gaza, Alaraer said she is too scared to return home. "We want a long-term truce," she said, "not just these short-pause ceasefires, and then running from Israeli tank shells and missiles again."
Follow Mohammed Omer on Twitter: @mogaza