As Israel continues its operation to fully occupy Gaza City, displaced Palestinians in the Israeli-designated “humanitarian zone” in southern Gaza say conditions are worsening as the areas fills up with ever more people.

Reports say that two children were killed, and others were injured reportedly in two Israeli strikes on tents in the zone, raising further questions about safety.

“We are living in such harsh conditions that even an animal couldn’t survive them,” says Sylvia al-Shurafi, who was forced to flee to southern Gaza this week.

“We thought these humanitarian areas they spoke about would have water and tents. We forced ourselves to listen to save our lives, but we’ve ended up living on the street.

“It’s so unjust,” the mother-of-two adds bitterly.

Journalists at Nasser Hospital in nearby Khan Younis said the bodies of two children were brought in after an Israeli strike on their tent in al-Qarara, at dawn. The BBC has approached the Israel Defense Forces (IDF) for comment.

Israel’s military has been ordering hundreds of thousands of Gaza City residents to head south to al-Mawasi near Khan Younis promising better services there.

But those who make the difficult journey – walking for hours or paying hundreds of dollars for transportation along two congested routes – say they are struggling to find food and shelter.

“The situation is really getting worse by the day,” says Olga Cherevko, spokesperson for the UN’s humanitarian office (Ocha) after visiting al-Mawasi.

“It is full and people coming from the north are sitting on the sides of the streets not knowing where to go. People who had shelters, they’ve been worn out or they couldn’t bring them because transportation costs a lot of money and tents are extremely heavy to carry for that distance.”

Ms Cherevko describes meeting a family-of-five from Jabalia, north of Gaza City, who had been looking for a shelter in the south for four days.

They had just two bags of belongings and shared a straw mat as they slept outside in the open. The father had no shoes, and no money left from his savings after months of displacement.

Satellite images show how al-Mawasi, a vast coastal encampment, has expanded since mid-August when Israel declared its new operation to occupy Gaza City, saying it remains a last stronghold of Hamas.

The UN says that more than two million Palestinians are now being told to cram into just 13% of the total Gaza Strip.

“Everyone is looking for a ‘safe spot’,” a father, Mohammed Ismail, complained to the BBC.

“You should see how the tents are stuck right next to each other. There’s no space between one and the next.

“You can hear every word of your neighbour talking to his wife and children. When someone goes to the toilet you can hear them using it. Where are the sewage systems, the sanitation? We call for water and it’s all in vain.

“I swear to God this is real suffering.”

Israel first declared al-Mawasi a “humanitarian zone” when it gave its initial evacuation orders for Gaza City and eastern Khan Younis in October 2023. The UN and other aid agencies have never adopted such a designation.

Since August, the so-called zone has expanded to include areas north and west of Khan Younis city.

While community kitchens, water distribution points and field clinics operate in the area, aid agencies say it is a struggle to accommodate the rapidly growing demand for services.

UN workers say they continue to face tight Israeli restrictions on what they can bring in through crossings. Some food items, such as peanut butter, have now been classified as “luxuries” which are no longer permitted, so that large amounts of aid already procured remain stuck outside Gaza.

In the strip, Israeli coordination is needed to move aid convoys. As Israel expands its offensive in northern Gaza, Ocha says many movements are denied or partially completed.

“Families are fleeing one hellscape only to end up in another,” Tessa Ingram of Unicef tells the BBC, stressing the trauma and daily stress for children.

“The families I speak to tell me that diseases are spreading among their children, they are constantly sick and hungry,” she goes on from al-Mawasi.

“Most people tell me that they eat one meal a day that is generally from a community kitchen. It’s rice or lentils. Parents say they often skip eating any part of that meal so that their children can eat. I hear that people walk for hours to get access to safe drinking water.”

“How do you scale up a humanitarian response in such a small, crowded space?” Tessa Ingram asks: “That’s the big challenge we’re facing at the moment.”

Earlier this month, the Israeli military put out aerial photos which it said showed that southern Gaza still had vacant plots for setting up tents, but experts disagreed with the suggestion.

The IDF’s Arabic language spokesman, Avichay Adraee, also wrote on X that there was “vital humanitarian infrastructure” in al-Mawasi “alongside the continuous provision of food supplies, tents, medicines and medical supplies”.

The Israeli military body, Cogat, says it has recently increased piped water and power supplies for desalination plants to southern Gaza and that it has allowed in 20,000 tents and tarpaulins with tens of thousands more due to come from international agencies in the next fortnight.

While three aid distribution sites are currently operated by the Israeli and US-backed Gaza Humanitarian Foundation, work is under way on two more. Cogat says that about 300 aid lorries are allowed into southern Gaza each day, 80% carrying food.

Humanitarian groups are trying to reopen the European Hospital after it was badly damaged by Israeli strikes in May, killing Hamas leaders. Cogat says two additional field hospitals will also open in southern Gaza soon.

Meanwhile, Sylvia al-Shurafi is washing her son’s one set of clothes. Her family left most of their possessions behind when they left Gaza City after an Israeli bombing damaged their home.

“My children have become very, very weak and they are troubled from what they see and hear – all the explosions. My youngest developed a stutter,” she says.

“He is always tense and afraid.

“Food used to be the last thing that we thought about, now it is the most important thing. It’s just survival,” Sylvia continues.

“Life is very hard, it’s beyond description. We are living only by the spirit of God.”