Sweltering summer weather is worsening conditions in Gaza where nearly all the 2.3 million inhabitants have been driven from their homes by Israel’s military campaign and where there is almost no electricity and little clean water, Reuters reports.

Families living in tents, in crowded shelters in UN schools or crammed into private homes, face the rising summer temperatures without air condition, showers or a functioning health system amid rising rates of malnutrition and disease.

In a school classroom shared as a shelter among different families in Khan Younis in southern Gaza Strip, Amal Nsair, 38, is worried that the rising heat and humidity and the increase in mosquitoes and other insects will harm their health.

Her son cannot sleep and she has nothing to cool him except a fan made from cardboard. The family’s home was in Beit Hanoun, in northern Gaza Strip, which they fled earlier in the conflict.

“My son’s body is full of heat. In the past I would wash him but I need water. I’m very worried about my husband’s health too. He has lost half his weight from carrying water,” she said.