Marking the first day of Ramadan alone among the graves of his loved ones at a cemetery in Gaza, Ibrahim Hassouna listened to a voicemail message his mother left him before she was killed in Israel's military offensive on the Palestinian territory.

Normally a time of religious devotion and joyful family meals after each day's fasting, this year's Muslim holy month could not lift Hassouna from his deep sorrow at the loss of his mother, father, brothers and their families in the war.

Listening to his mother's voice on his phone was bittersweet, bringing back memories of how she used to fret about him incessantly.

"If I was gone for one, two, three hours, she would call, even though I am 30 years old," he said through tears as he knelt by her grave. She was known as Um Karam, or mother of Karam, her eldest son.

"No one will ask about me now. No one will comfort me. No one will check up on me. No one will worry about Ibrahim the way my mother would worry about me," said Hassouna, who has a tattoo on the inside of his wrist of the Arabic word ummi, or my mother.

A photo on his phone showed mother and son smiling, with their heads close together. She wore a blue dress and beige headscarf.

The voicemail message was a typical one from her: "Ibrahim my love, I want to check on you, I've been calling you since yesterday but you haven't answered, what's wrong?"

Hassouna prayed among the graves, holding his hands out in front of him with his palms facing upwards. He had prayer beads in the black, white, red and green colours of the Palestinian flag.

"The grave next to this one is my father's. The grave behind me is my brother Mohammed's. And this grave next to us is Karam and his family."

FALAFEL

In happier years, the brothers would squabble over small things as they shared food prepared by their mother, which Hassouna said was the most delicious food in the world.

"I wish we could have little problems again with my family, my brother. We used to fight about who would sit here and who would sit there."

The contrast between those memories and the present was so painful that Hassouna struggled to accept that this was Ramadan.

"Since waking up today, I keep thinking I don't want it to be Ramadan," he said.

He had stuffed his pockets with balloons to blow up for children, but this wasn't enough to lift his mood.

The war was triggered by fighters from the Palestinian Islamist group Hamas who attacked southern Israel from Gaza on Oct 7, killing 1,200 people and taking 253 hostage, according to Israeli authorities.

Israel has responded with an all-out war on Hamas in Gaza which has killed more than 31,000 Palestinians, according to the local health ministry. The war has reduced much of the enclave to rubble, displaced most of its population and caused hunger.

After sunset, Hassouna broke his fast with a plate of falafel he bought from a stall on the street in Rafah, the city in southern Gaza that is the last place of relative safety in the ruined strip of land.

Limited food aid has been reaching Rafah, which has a land crossing to Egypt. Elsewhere in Gaza, food is so scarce that starvation deaths have occurred and a wider famine looms, according to humanitarian organisations.

Hassouna ate his falafel sitting alone on a pavement.

"There is no table to gather around, there is no food, there is no house, there is no family. But we must adapt and live through this," he said with a smile.

"And we must say thank God, even though it is hard. We will eat falafel."