Southern Gaza is turning into a “pressure cooker”, where the majority of people – faced with dwindling food, inadequate water sanitation, overcrowding and a crumbling hospital service – want to flee, the deputy director of the UN agency for Palestinians has said.

Scott Anderson of the United Nations Relief and Works Agency (UNRWA), who is engaged in daily negotiations to gain Israeli permissions for aid convoys to enter and move around Gaza, said it was in “a full-time emergency” and just six of the 21 planned convoys to the north of the territory had been granted access since January despite a UN security council resolution in December calling for relief to be stepped up.

“The truth is I have not seen any change in the reality on the ground since the passing of that UN resolution. There has been no reduction in either the number of Israeli or Egyptian inspection checks since the resolution was passed,” he told the Guardian.

“Sometimes it feels like the story of the little boy in the dyke – trying to plug a million holes is how it feels. Each day I feel like it’s very much a two steps forward, two steps back. It’s pretty much a full-time emergency.”

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