In Gaza City, screams and flying debris enveloped Umm Majed al-Rayyes as explosions hurled her from her bed.

Groping in the dark, the 50-year-old grabbed her four children and ran as Israeli bombs struck their apartment building on Wednesday, shattering windows, ripping doors to splinters and blasting away concrete.

While casualties mounted this week in the most severe outbreak of violence between Israel and the Gaza Strip since a 2014 war, al-Rayyes and other Palestinians in the line of fire faced an all-too-familiar question: Where should we go?

“This whole territory is a tiny place. It’s a prison. Everywhere you go, you’re a target,” al-Rayyes said after the Israeli airstrike that she says came without warning.

In Gaza, a crowded coastal enclave of two million people, there are no air raid sirens or safe houses. Temporary United Nations shelters have come under attack in previous years of conflict.

In the past two days, Israeli airstrikes brought down three huge towers housing important Hamas offices and some businesses after the Israeli military fired warning shots, allowing occupants to flee.

Fighter jets targeted without warning multiple residential buildings, located in teeming neighbourhoods where Israel alleged militants lived.

In all, more than 83 Palestinians have been killed in Gaza since Monday, including 17 children. Among the dead were both militants and civilians, including at least two women and children who died during the apartment building strikes.

At a Gaza City hospital, distraught families told of pulling bloodied relatives from piles of rubble. One woman said her four-year-old grandson and pregnant daughter-in-law were killed when an Israeli air raid hit their building.

“They bombed them without any warning. The house had nothing but the kids,” Umm Mohammad al-Telbani said.

The Israeli government has long accused Hamas of using civilians as human shields, yet Israel received heavy criticism for its tactic of bombing buildings during the 2014 war.

Recalling the horror of past wars, Gaza residents say they feel nowhere is safe. They also cannot leave the narrow territory, one of the world’s most densely populated places.

It has been under a crippling Israeli-Egyptian blockade since Hamas seized control in 2007. On its borders, Gaza is encircled by sensor-studded fences, concrete walls, galvanised steel barriers and the Mediterranean, where Israel restricts boats from Gaza to 16 nautical miles offshore.

“There is nowhere to run, there is nowhere to hide,” said Zeyad Khattab, a 44-year-old pharmacist in Gaza City.

“That terror is impossible to describe.”