Israel’s war on Gaza, one of the deadliest and most destructive in recent history, has killed nearly 42,000 people, a little over half of them women and children, and wounded more than 96,000, according to Palestinian health officials.

The death toll is likely to be much higher as thousands of people remain buried under rubble or in areas inaccessible to medical teams in a military operation many governments and rights groups have termed a genocide against the Palestinians.

The October 7, 2023 attack on Israel by the Palestinian group Hamas – in which, according to Israeli officials, 1,139 people were killed and about 250 were taken captive – was followed by Israel’s devastating offensive on Gaza.

In the year since, about 90 percent of Gaza’s 2.3 million population has been displaced, most of them multiple times, according to estimates by the United Nations.

Hundreds of thousands of Palestinian families are crowding in sprawling tent camps near the Mediterranean coast – with no electricity, running water or toilets. Hunger and diseases are widespread.

The Shelter Cluster, an international coalition of aid providers led by the Norwegian Refugee Council, says it has struggled to bring in basic supplies because of Israeli restrictions, the ongoing fighting and the breakdown of law and order in Gaza. It estimates that some 900,000 people need tents and bedding.

The UN says the war has damaged or destroyed over 92 percent of Gaza’s main roads and more than 84 percent of its health facilities. It estimates that nearly 70 percent of Gaza’s water and sanitation plants have been destroyed or damaged. That includes all five of the territory’s wastewater treatment facilities, plus desalination plants, sewage pumping stations, wells and reservoirs.

The UN also estimates that the war has left some 40 million tonnes of debris and rubble in Gaza, enough to fill New York’s Central Park to a depth of 8 metres (about 25 feet). It could take up to 15 years and nearly $650m to clear it all away, it said.

The World Bank estimated damage equivalent to $18.5bn in Gaza from the first three months of the war, before Israel launched most of its fierce operations. That figure is nearly equivalent to the combined economic output of the West Bank and Gaza in 2022.

Israel allowed the entry of construction materials inside Gaza before the war, but there were heavy restrictions and delays. The Shelter Cluster now estimates it would take 40 years to rebuild all of Gaza’s destroyed homes under that system.