Israeli forces in Gaza killed a water engineer and two drivers who transported water to displaced families over four days in mid-April, exacerbating severe shortages of clean water that are fuelling the spread of preventable disease.

Israeli limits on the shipment of soap, washing powder and other hygiene products into Gaza have also forced prices up, adding to the challenge of keeping clean and avoiding infection in overcrowded shelters and tent encampments.

Over more than two and a half years of war, Israeli attacks have destroyed most of Gaza’s civilian infrastructure, including networks that provided clean water and removed and treated sewage. They have also repeatedly killed Palestinian civilians trying to maintain or restore them.

‘‘Since the beginning of the war, we have lost about 19 workers from water facilities who were carrying out repair and distribution work,” said Omar Shatat, the deputy director of Gaza’s coastal municipalities water utility. “Targeting has become part of the operational reality.’’