It is difficult to see through the dust inside the cramped, low-roofed tent on the eastern edge of Khan Younis. Ibrahim al-Aloul works alongside four others, with a piece of fabric tied over his mouth and nose as his only shield against the toxic grey powder as he sifts and grinds.

Outside, a skinny donkey waits with a cart to carry the finished product to the next tent along, where it will be mixed with gypsum, calcium and binding agents before being bagged in flour sacks and sold.

This is Gaza’s cement industry, improvised out of desperation and for now the only construction operating in the besieged Palestinian coastal strip. The health risks of these compounds are severe, but in Gaza, where the death toll of the past two years of Israeli bombardments has reached more than 71,000 and a steady toll of killings continues despite the eight-month ceasefire, options are limited.

“We work long hours and the dust is suffocating,” Aloul says, stepping outside into the street of tents to breathe – endless rows that have become the only homes Palestinians can find. “But there is no other work, and no other cement. We have no choice.”