The Israeli army intensified shelling of northern Gaza and closed roads, preventing the delivery of aid, the war-torn Palestinian territory's civil defence agency said Wednesday.
The army, which said it surrounded Jabalia in northern Gaza at the weekend, issued new evacuation demands on Tuesday, as analysts suggested Hamas was regrouping, despite a year of strikes and fierce fighting.
"The shelling is intensifying, targeting civilians and their homes, causing significant fear and terror among the residents," said Ahmad al-Kahlut, the agency's director in north Gaza.
The director said the Israeli army also was targeting the northern towns of Beit Lahia and Beit Hanun along with Jabalia.
"Roads have been closed, and there has been a continuous siege for the fourth consecutive day, with no supplies entering the North Gaza Governorate," Kahlut said.
According to the director, "a large number" of people died in northern Gaza during the fighting.
But he said counting the casualties had been complicated by the "difficulty of recovery and access to all areas".
The Palestinian Red Crescent said its teams had transported three dead and 15 injured from the al-Rafai school in Jabalia, where displaced Gazans had sought shelter.
The civil defence's Kahlut said his agency had been receiving calls for help from various parts of northern Gaza, but staff had been unable to enter these areas for security reasons.
"So far, Kamal Adwan Hospital is still operational and is dealing with the injuries that the teams can recover," he said, referring to a hospital in Beit Lahia.
Hisham Abu Aoun, head of the intensive care unit for the Friends of the Patient Hospital, said at least six children were evacuated to his hospital in Gaza City.
Amal Nasr, a resident of Jabalia, said her daughter Dana and husband Rami were both injured by gunfire while fleeing the area.
"My daughter Dana was shot in the neck, and my husband was shot in his leg by the occupation forces", she said, adding her daughter was taken to a Gaza City hospital and was now in stable condition.
"I was injured while we were leaving our house. I was shot in the neck and started to bleed", Dana Nasr told AFP from the Al-Ahli Hospital.
"There were many injured people in the streets of Jabalia," she added.
Gaza's hospitals are struggling with limited supplies.
The health ministry appealed Tuesday for international help, warning fuel shortages could force hospitals to close.
The UN's agency for Palestinian refugees, UNRWA, said "intensified military operations" in northern Gaza forced it to halt services.
This included the evacuation of seven UNRWA schools used as shelters by displaced Gazans.
The Israeli army on Wednesday said operations were ongoing "throughout Gaza".
A man carries the blanket-wrapped body of a girl who was killed in bombardment on the Rafei school serving as a displacement shelter in the Jabalia camp for Palestinian refugees in the northern Gaza Strip on Wednesday. AFP
An evacuating woman walks carrying an infant child in the Jabalia camp for Palestinian refugees in the northern Gaza Strip on Wednesday. AFP
Men carry injured woman to be evacuated in the Jabalia camp for Palestinian refugees in the northern Gaza Strip on Wednesday. AFP
Evacuating people walk with belongings in the Jabalia camp for Palestinian refugees in the northern Gaza Strip on Wednesday. AFP
Mourners carry the body of Hussam al-Khalidi, who was killed in Israeli bombardment at his family home in the Bureij camp for Palestinian refugees in the central Gaza Strip, as they march past a collapsed building during his funeral in Bureij on Wednesday. AFP
A boy watches a smoke plume rise while standing in the balcony of the Rafei school, being used as a displacement shelter, in the Jabalia camp for Palestinian refugees in the northern Gaza Strip on Wednesday. AFP
Journalists film while standing before destroyed buildings in the Jabalia camp for Palestinian refugees in the northern Gaza Strip on Wednesday. AFP