In her tent in Khan Younis, Samar Surai places a bucket of water and a small dish on the ground. Six-year-old Noor stands in the centre of the tent as her mother gently unties her hair and prepares her for a bath. 

Crouching on the ground, Surai gathers some sand and adds water to it to make a paste. Noor watches her mother as she stirs the mixture with her fingers to get the right consistency. 

The mother of four has been bathing her children this way for months, as Palestinians still face trouble accessing aid, including shampoo and soaps.

"They have the right to have a bath, they have the right to use soap," Surai told CBC freelance videographer Mohamed El Saife from her tent. "They have the right to use shampoo." 

As the Israel-Hamas war stretches into its 10th month, parents in Gaza like Surai are struggling to meet their kids' basic hygiene needs.

Issues with aid delivery

Surai and her four children were displaced from Khan Younis to Rafah, where they had stayed for the last four months. But since the Israeli military took over the town bordering Egypt, Surai has had to move back to Khan Younis.

Her home was bombed in the fighting, so she and her family are taking refuge in a tent in the internally displaced people's camps in the central part of the Gaza Strip. 

WATCH | Samar Surai bathes her daughter with sand: 

With few options for hygiene products, displaced Gazans resort to bathing with sand

Basic supplies like soap and shampoo have become difficult for some Gazans to come by. Even products made in Gaza aren't necessarily available, says the owner of a cleaning supply store. With no other recourse, some parents have resorted to using sand to clean their children, which in itself has its own problems.

The war has been ongoing since Oct. 7, when Hamas led a devastating assault in southern Israel, killing about 1,200 and taking around 250 hostage into Gaza, according to Israeli figures. Israel's subsequent offensive in Gaza has killed over 38,000, according to Palestinian officials, and devastated the territory.

Though aid has been arriving, much of it has piled up at the Israel-Gaza border. Aid organizations have cited the ongoing Israeli military operation, severe fuel shortages and armed looting by some Palestinians as some reasons for the backlog. United Nations officials have accused Israel of blocking access to aid, saying the territory faces widespread famine. 

Meanwhile, Israel has denied such claims. It has instead blamed the UN for failing to adequately distribute the shipments, and Hamas for manipulating their flow. 

During a UN Security Council briefing on July 2, Sigrid Kaag, UN senior humanitarian and reconstruction co-ordinator for Gaza, stressed the importance of pushing for unimpeded delivery of aid to the strip.

'The people are desperate' 

On a main road near Surai's tent in Khan Younis, Muhammad Barbakh runs a cosmetics shop. It's standing with the help of cinder blocks, wood beams and tarps. Demand for soap and shampoo is high, he says, and he's having difficulty meeting it. 

"Even the Gaza-made [soaps] are not available," he says. "The people are desperate." 

Some families have had to resort to other ways of bathing, like heading to the coast and cleaning themselves in the ocean. But moving around the strip remains dangerous as the war continues. 

There have also been reports of skin infections, from scabies to chicken pox and lice, spreading in camps because of the difficult conditions and a lack of hygiene products and clean water. 

The internally displaced people's camps across Gaza are overcrowded, with millions of people seeking refuge in schools and in tents — some line massive garbage dumps, leading to extremely unhygienic circumstances for those living nearby. 

Another round of ceasefire talks began last week, with representatives meeting in Egypt. An American representative was present to help moderate the talks. 

Last week, in a post on X, U.S. President Joe Biden announced that Hamas and Israel had agreed to the "framework" of a ceasefire agreement, although much work was still left to be done. 

'There's nothing we can clean with'

In their tent, Surai rubs the sand paste all over her daughter's little body. Noor cries, squirming to escape her grasp. But Surai says the need to keep clean is essential, even if it's not in the most ideal of circumstances. 

"Her hair is ruined from the sand," she says, pointing at Noor's matted hair. "How do you want us to live in the Gaza Strip?" 

Surai worries about the spread of skin diseases because using sand is so rough on the children. Although it acts as an exfoliant, it's too abrasive, she says. 

"[Their skin is] filled with pimples on their bodies from the sand we bathe them in," she said. "There's no soap, no shampoo.... There's nothing we can clean with."

When she's done, she rinses her daughter in water from a nearby bucket. The little girl's cries quickly become giggles; her once-quivering lips curl into a smile. 

Surai helps Noor into a pyjama set — white with blue anchors, a few sizes too big for her. The top is stained from not being properly cleaned in a while.

The little girl wipes water from her face and moves her dripping wet hair away from her eyes. 

Bath time is finally over for today.