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Iman al-Masry is simply exhausted after giving birth to quadruplets in a hospital in southern Gaza, miles away from her home in the north of the war-torn Palestinian territory.

Days into Israel's war on Gaza on 7 October the young woman fled the family home in Beit Hanun on foot with her three other children seeking safety.

They walked five kilometres (three miles) to the Jabalia refugee camp, looking for a means of transport that would take them to Deir al-Balah further south.

Iman was six months pregnant and "the distance was too long", she told AFP.

"It affected my pregnancy," added the 28-year-old mother, who gave birth by C-section on December 18 to daughters Tia and Lynn and sons Yasser and Mohammed.

But Iman was quickly asked to leave the hospital with the newborns -- minus Mohammed who was too fragile to go with them -- to make room for other patients of the war.

Now, with Tia, Lynn and Yasser, they live in a cramped schoolroom turned shelter in Deir al-Balah along with around 50 other members of their extended family.

"Mohammed weighs only one kilogramme (2.2 pounds). He cannot survive," she said of the child she left behind at a hospital in the Nuseirat refugee camp.

Lying on a foam mattress in a schoolroom turned shelter for her and her extended family, Iman recounts her journey from hell.

"When I left home, I had only some summer clothes for the children. I thought the war would last a week or two and that afterwards we would go back home," she said.

More than 11 weeks later, her hope of ever going back are shattered.

The Gaza Strip, home to 2.4 million people, lies in ruins from the north to the south. According to UN estimates, the fighting has displaced 1.9 million Palestinians internally.

Israel's military campaign has killed at least 21,110 people, according to the latest toll issued by Gaza's health ministry, about two thirds of them women and children.

Like other mothers, Iman had hoped to follow tradition and celebrate the birth of her babies by "dousing them with rose water", she said.

But 10 days on "we have not even been able to bathe them", she said, because of the difficulty of finding clear water in the devastated territory, where there is a dire shortage of basic food stuff, including milk, medicine and hygienic supplies such as diapers.

"Normally I would change babies' diapers every two hours. But the situation is difficult and I must be thrifty," she said, adding that the newborns get only a fresh diaper in the morning and another in the evening.

Her husband Ammar al-Masry, 33, said he is devastated because he cannot provide for his family.

"I feel helpless," he said, surrounded by his six children in the foul-smelling schoolroom.

"I fear for my children. I don't know how to protect them," he said, adding that he spends most of his days outdoors searching for food.

"Tia (who has jaundice) must be breastfed and my wife needs nutritious food that contains protein. The children need milk and diapers. But I cannot get any of that."