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Hundreds of thousands in Gaza face shortages of clean water and medicine.

Sewage systems have been destroyed, sending fetid wastewater into the streets of Gaza City. A critical desalination plant that helped provide fresh water to 250,000 people is offline, leaving at least 800,000 people without access. Landfills are closed, with trash piling up. And dozens of schools have been either damaged or ordered to close, forcing some 600,000 students to miss classes on Monday.

The nine-day battle between Hamas militants and the Israeli military has created a humanitarian catastrophe that is touching nearly every civilian living in Gaza, a coastal territory of about two million people.

The level of destruction and loss of human life have underlined the challenge in the Gaza Strip, already overpacked with people and suffering under the weight of an indefinite blockade by Israel and Egypt even before the latest conflict.

President Biden added his voice to the growing chorus of international leaders calling for a cease-fire on Monday night, but there was little indication that an end to the hostilities was near on Tuesday morning.

Militants in Gaza aimed a barrage of around 100 rockets at southern Israel overnight, adding to the more than 3,300 fired in just over a week. And the Israeli bombardment showed no signs of letting up, with the sound of explosions once again rocking Gaza before dawn.

General Hidai Zilberman, speaking to the Israeli network Army Radio, said there was no plan to suspend operations.

“We have a bank of targets that is full, and we want to continue and to create pressure on Hamas,” he said. “This morning, the chief of staff gave us the plans for the next 24 hours, the targets. We will hit anyone who belongs to Hamas, from the first to the last.”

Hamas said it would not stop its assault, accusing “the criminal Zionist enemy” of “bombing of homes and residential apartments.”

“We warn the enemy that if it did not stop that immediately, we would resume rocketing Tel Aviv,” the militant group’s spokesman Abu Ubaida said, according to Reuters.

While Hamas fighters move through an extensive series of tunnels under Gaza, and as Israeli warplanes drop bombs aimed at destroying that network, it is the people caught between who suffer the most calamitous losses.

Schools in southern Israel within range of the rocket fire have been closed and many families have left the border areas. The constant wailing of sirens warning of incoming rocket fire punctuate daily life, particularly in the south, sending Israelis repeatedly running to shelters.

At least 10 people in Israel have been killed in rocket attacks, the Israeli authorities said.

The death toll in Gaza itself has surpassed 200, including at least 61 children, according to the health authorities in the territory.

And the sprawling humanitarian crisis in Gaza — documented by both United Nations agencies and the local authorities — is growing by the day, adding to pressure on political leaders to pause the hostilities so that relief can reach those in desperate need.

Palestinian activists are planning a general strike on Tuesday to protest Israel’s air campaign in Gaza and other measures targeting Palestinians.

Even before the current conflict, Gaza was facing an economic crisis and political crisis.

Hamas won elections in the territory in 2006 and took full control in 2007, after which Israel put a blockade on the region, citing the need to curb weapons smuggling. Egypt, which shares a border with Gaza, also put in restrictions that tightly control the movement of people and goods in and out of the territory.

Since 2007, Hamas has engaged in three major conflicts with Israel and several smaller skirmishes. After each eruption of violence, Gaza’s infrastructure was left in shambles.

The result, according to a report last year by the United Nations, is that Gaza has “the world’s highest unemployment rate, and more than half of its population lives below the poverty line.”

The latest round of fighting has crippled that fragile infrastructure.

Six hospitals and eight clinics have suffered bomb damage, according to the United Nations’ humanitarian affairs office, basically making medical treatment impossible for most people living in the region.

By Monday, Israeli bombs had destroyed 132 residential buildings and damaged 316 housing units so badly that they were uninhabitable, according to Gaza’s housing ministry.

More than 40,000 people have been forced into shelters and thousands more have sought refuge with friends or relatives, according to the U.N. humanitarian affairs office.

“Until a cease-fire is reached, all parties must agree to a ‘humanitarian pause,’” the office said in a statement. “These measures would allow humanitarian agencies to carry out relief operations, and people to purchase food and water and seek medical care.”

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