Crouched inside her makeshift tent at a camp in Rafah, Samah El-Nazli fidgets as she recalls what her living conditions have been like since the war began. The mother of four is among millions of Gazans struggling to access food, water and sanitation in the overcrowded camp after losing their own homes in the strip.

“There’s no way to keep clean, there’s no way to be comfortable — we’re living a completely destroyed life,” she said.

Many women and girls living in the strip have opted to start taking birth control as a way to stop their periods as the conflict nears its eighth month.

El-Nazli, 34, said she tried everything to manage her cycle — from adult diapers to dirty cloth — before seeking out medication to stop her period altogether.

“None of these things are good,” she said in an interview while she reorganized the pots and pans lining the nylon walls of her tent.