The Gaza Strip is facing a deepening humanitarian crisis, with hospitals and essential services struggling, despite the ceasefire between Israel and Hamas that took effect on Oct. 10.

Fifty days into the agreement, most of the Strip's 2 million residents remain in tents and temporary shelters with little sign of improved living conditions. Water and sewage systems are failing, waste and rubble continue to pile up, and many roads remain blocked. Hospitals are also struggling with shortages of basic medical supplies.

The Union of Municipalities in the Gaza Strip warned Sunday that a worsening fuel shortage is crippling essential services as Israeli authorities continue to block fuel deliveries.

Israel "continues to prevent the entry of fuel needed to run vital facilities," Alaa al-Din al-Batta, the union's vice president, said at a news conference in Khan Younis. He said municipalities have received enough fuel for only five days of work since the ceasefire, hindering road clearing, debris removal, and services for displaced families.

He called for urgent shipments of generators, solar-power systems, spare parts, and heavy equipment, saying the crisis is threatening daily humanitarian operations.

Hospitals are also short on medicines and equipment, limiting treatment for the sick and wounded. Bassam Zaqout, director of medical relief in Gaza, said the health system is still operating with the same limited resources it had during the war, with no reconstruction of damaged facilities. He said Israeli restrictions on medical delegations are worsening shortages of staff, drugs, and laboratory tools.

Health authorities warned that specialized eye care is at risk due to damaged diagnostic and surgical equipment, limited medicines, and long delays for patients. They said 4,000 glaucoma patients are at risk of losing their sight without urgent supplies.

The humanitarian crisis is unfolding alongside renewed violence. Palestinian security sources said Israeli forces carried out heavy shelling and gunfire early Sunday east of the Bureij refugee camp in central Gaza, launched six airstrikes east of Rafah in the south, and fired artillery at a house in Bani Suheila near Khan Younis. No casualties were reported from the house strike.

Health officials said three people were killed in the past 24 hours, bringing the death toll since Oct. 10 to 357, with 908 wounded. Since Oct. 7, 2023, they said 70,103 people have been killed and 170,985 wounded.

The Hamas-run government media office accused Israel of 591 ceasefire violations, including shelling, shootings, and the destruction of infrastructure. It called the actions "a flagrant violation of international humanitarian law" and urged the United States, mediators, and the UN Security Council to intervene.

Gaza's Civil Defense Authority said about 10,000 bodies remain buried under destroyed homes, though the exact number is uncertain due to challenging working conditions. Spokesperson Mahmoud Basal said only one excavator has entered Gaza so far, far too few to recover the dead.

"We receive daily requests from families asking us to retrieve their loved ones," he said, urging the entry of more heavy equipment "as quickly and safely as possible."