The look on people's faces in Gaza reveals "the trauma, the stress, as if sorrow and sadness have taken root here in Gaza", according to James Elder, the UN Children's Fund (UNICEF) spokesperson who has joined the aid effort in the besieged enclave.
Mr. Elder met with children and their families in Gaza, during the humanitarian pause in fighting, which was called after weeks of intense shelling and bombardment that killed and injured thousands and displaced 1.7 million Palestinians.
The conflict erupted on 7 October, when Hamas attacked Israel, killed over 1,200 people and captured more than 200 hostages.
"The situation on the ground looks desperate, whether it's the physical structure - just seeing apartment block after apartment block, destroyed rubble on the ground, concrete, blown up cars, people fleeing their homes, or whether it's just the look on people's faces, just the trauma, the stress, as if sorrow and sadness have taken root here in Gaza.
It's an immensely difficult time right now, and, of course, this is actually the humanitarian pause. People are recovering from so much over the last seven weeks and are so frightful that things will start again.
But, 1.5 million people have lost their homes, people are in various shelters, hospitals are full of children with the wounds of war.
Horrendous reality
It's horrendous. Every single child here, I can say that with some certainty, they all will need some kind of mental support. The little boy I was speaking to just half an hour ago in what should be a technical college for young people but is now a camp for 30,000 or 40,000 people, lost his mum, lost his sisters in a bombing. He is not even aware yet that his mum had died.
This is the reality.
I've spoken to so many families, and they haven't yet told a child still recovering from the wounds of war that someone else that they love is also dead, that their life is actually even bleaker than they thought.
War zone
Hospitals are full. There are overflowing emergency wards with boys and girls with shrapnel wounds, horrendous burns. They're not just on hospital beds inside. These incredible health staff, incredible doctors, nurses are working around the clock and have now run out of space.
It's a war zone. You've got children in car parks and gardens, on beds everywhere. Then, of course, you've got hundreds of thousands of children who are not in school, who are in very overcrowded camps, who are cold, who do not have enough food, do not have enough water, who are now at risk of a disease outbreak. It's a horrendous situation.
Unfortunately, every time I turn around, someone has another story that would break my heart again just now in the last hour. They all stick in my head, particularly those ones who have suffered so much through the fighting.
Decomposing flesh
I was on a bus with children. It had taken four days to get from the hospitals in the north. This little boy had been on a bus for days, with the bottom of his foot blown off. Four days for the flesh to start decomposing, with broken shrapnel burns.
It's beyond any level of understanding how this has happened at such a scale, and therefore, one of the reasons we keep talking so much that this cannot continue.
A little boy, Omar, was seven years old when his family home was hit. His mother was killed, father was killed and Omar's twin brother was killed. Even as I spoke to him, he was able to just share what he's doing. He loves his auntie. She's being amazing and supporting him.
But, he kept closing his eyes, and I was trying to understand why. I asked the auntie why, and she said he's just so terrified that he'll forget what his mother and his father look like. This is his fear now. And so, he closes his eyes because he can't bear the thought that he's lost them in this world, but also might lose them in his imagination.
Pause in fighting brings relief
The last few days, all the UN agencies have just been remarkable.
UNICEF has brought in medical supplies, emergency kits for midwives because there were so many pregnant women giving birth in a war zone, oral rehydration salts, intravenous solution and multivitamins for children because we're desperately worried about their nutritional status.
UNWRA, the biggest agency here for the people of the Gaza Strip, is delivering food, fuel and water. The World Food Programme (WFP) is delivering food, the World Health Organization (WHO) medicines.
