An aid delivery in Gaza descended into chaos on Saturday with shots fired and a Red Crescent paramedic reporting five people killed, as almost six months of Israeli bombardment has left hundreds of thousands in the Palestinian territory in desperate need.
Israel's siege, sparked by a deadly militant attack on October 7, brings nightly air strikes and in recent days major operations around several hospitals, which it says are used by Palestinian militant groups -- claims denied by Hamas.
The World Health Organization warned on Saturday that Gaza had just 10 "minimally functioning" hospitals for its more than two million people, with its chief Tedros Adhanom Ghebreyesus saying around 9,000 patients urgently needed treatment abroad.
UN agencies have warned repeatedly that the northern part of Gaza is on the verge of famine and called it a man-made crisis because aid lorries are backed up on the Egypt-Gaza border awaiting long checks by Israeli officials.
The top UN court has ordered Israel to allow in aid and the UN Security Council has adopted a resolution demanding an "immediate ceasefire" but neither has affected the situation on the ground.
A Red Crescent paramedic at a nearby hospital said five people were killed and dozens injured by gunfire and a stampede during a rare aid distribution in north Gaza, which has received the least help.
Witnesses told AFP shots were fired both by Gazans overseeing the aid delivery and Israeli troops nearby, and panicked lorry drivers drove quickly away, hitting people trying to get the food. The Israeli military told AFP it had "no record of the incident described".
Aid deliveries have become increasingly fraught as the needs of Gazans increase.
Foreign powers have ramped up airdrops of aid but several people have been killed by falling crates, or stampedes or drowned trying to retrieve packages from the Mediterranean.
Two charities have organised aid deliveries by sea, with their second mission in just over two weeks setting sail from Cyprus on Saturday.
Their flotilla is carrying around 400 tonnes of supplies.
"There is not enough aid getting through to Gaza and we need to open as many ways as possible," Juan Camilo of World Central Kitchens, one of the charities, said in a video shot from the flotilla and posted on social media.
UN agencies have said repeatedly that overland deliveries are the only way of supplying aid in the volume needed.
Palestinian Dalia al-Afifi, displaced to Deir el-Balah in central Gaza, has constructed a home from the cans received in aid packages to "make a point to the world" about the plight of the territory.
"This must stop. Our lives are not just cans," she told AFP.
The Israeli bombardment continued apace into Saturday with the health ministry in the Hamas-run Gaza Strip saying at least 82 people were killed overnight.
The Hamas press office said "civilian houses" had been hit by dozens of Israeli strikes.
With the health situation increasingly dire, Tedros said roughly 9,000 patients needed to leave Gaza for "lifesaving health services, including treatment for cancer, injuries from bombardments, kidney dialysis and other chronic conditions".
The WHO said Gaza had 36 hospitals before the war but now had only 10.
Hamas said Saturday Israeli troops were also continuing their "aggression" against Nasser Hospital and were besieging Al-Amal Hospital, both in the southern city of Khan Yunis.
Humanitarian aid falls through the sky towards the Gaza Strip after being dropped from an aircraft as seen from Israel on Friday. REUTERS
Humanitarian aid for Gaza is seen outside a US air force aircraft at an unidentified location in this handout image released on Friday. US Central Command Via X/Handout via REUTERS.
Palestinian children react at the site of an Israeli strike on a house in Khan Younis in the southern Gaza Strip Saturday. REUTERS
Israeli tank maneuvers along Israel-Gaza border in southern Israel, Saturday. REUTERS