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Palestinians said deadly salvos on Friday hit hospitals and a school where desperate civilians in Gaza City have sought refuge from intense combat that has sent many thousands fleeing.
The Israeli army has repeatedly accused Palestinian militant group Hamas of using hospitals, particularly Al-Shifa, to coordinate their attacks and also as hideouts for its commanders. Hamas authorities deny the accusations.
"There is no safe place left. The army hit Al-Shifa. I don't know what to do," said 32-year-old Abu Mohammad, who was among those seeking refuge at the hospital. "There is shooting... at the hospital. We are afraid to go out."
Al-Shifa's director and Gaza's Hamas government, which reported a death toll of 13, blamed Israeli forces for a strike on the hospital, while the Palestinian Red Crescent Society said Israeli snipers shot at Al-Quds hospital, killing at least one person.
Around 50 people were killed in strikes that hit Gaza City's Al-Buraq school, said the director of Al-Shifa hospital where the dead were taken.
Israel offered no comment on whether it was involved in the incidents, and AFP could not immediately confirm the tolls.
Heavy fighting was raging near Al-Shifa hospital, with Israel saying it had killed dozens of militants and destroyed tunnels that are key to Hamas's capacity to fight.
Israel launched an offensive in Gaza after Hamas fighters poured across the heavily militarised border on October 7, killing 1,400 people, mostly civilians, and taking around 240 hostages.
Vowing to destroy the militants, Israel retaliated with bombardment and a ground campaign that the health ministry in the Hamas-run Gaza Strip says has killed more than 11,000 people, mostly civilians and many of them children.
"Last night, I wasn't optimistic that any of my children or I would come out unharmed, given the intensity of the bombing and gunfire," said Jawad Haruda, who was among thousands walking south, in an exodus away from Gaza City.
"We couldn't wait for the morning, and everyone in Al-Shifa hospital left," he added.
Witnesses told AFP that hundreds of people sheltering at Gaza City's Al-Rantisi hospital fled on instruction from the Israeli military, which was surrounding it with armoured vehicles.
As the fighting raged in Gaza, medical services reported two women were wounded in rocket attacks in Tel Aviv. Hamas's military wing said it had targeted the Israeli commercial hub.
- 'No safe place' -
The United Nations called for an end to the "carnage" in Gaza, saying "razing entire neighbourhoods to the ground is not an answer for the egregious crimes committed by Hamas".
"To the contrary, it is creating a new generation of aggrieved Palestinians who are likely to continue the cycle of violence. The carnage simply must stop," Philippe Lazzarini, head of the United Nations' agency for Palestinian refugees UNRWA, wrote in an opinion piece.
He said on social media that over 100 UNRWA colleagues were confirmed killed in one month of war, noting that included parents, teachers, nurses, doctors and support staff.
The war in the densely populated coastal territory, which is effectively sealed off, has prompted repeated calls for a ceasefire to protect civilian lives and allow in more humanitarian aid.
Tens of thousands of people have fled to the south of the territory in recent days, often on foot and with only the things the could carry.
"Enough destruction, there's nothing left. We need a truce to see what will later happen to us, a truce to bring medicine or aid to the hospitals," said Mohammed Khader, who was displaced in Rafah.
"Those hospitals are now full of displaced people and not only injured and martyrs," he added.
Israeli Prime Minister Benjamin Netanyahu has repeatedly rejected halting the fighting, telling Fox News Thursday that a "ceasefire with Hamas means surrender to Hamas, surrender to terror".
He also said Israel does not "seek to govern Gaza" in the long run.
"We don't seek to occupy it, but we seek to give it and us a better future," he told the US broadcaster.
Almost 1.6 million people have been internally displaced since October 7, UNRWA said -- nearly two thirds of Gaza's population.
But the UN estimates hundreds of thousands of civilians remain in the fiercest battle zones in the north.
- Hostages -
Complicating Israel's military push is the fate of the hostages abducted on October 7.
CIA director Bill Burns and David Barnea, head of Israel's Mossad spy agency, were in Doha for talks on pauses that would include hostage releases and more aid for Gaza, an official told AFP on Thursday.
Four hostages have been freed so far by Hamas and another released in an Israeli operation. The desperate relatives of those still held in Gaza have piled pressure on Israeli and US authorities to secure the release of their loved ones.
The conflict has also stoked regional tensions, with cross-border exchanges between the Israeli army and Lebanon's Hezbollah, and Yemen's Iran-backed Huthi rebels saying they launched "ballistic missiles" at southern Israel.
Iran's Foreign Minister Hossein Amir-Abdollahian said the expansion of the Israel-Hamas war has become "inevitable".
The Islamic republic, which supports Hamas financially and militarily, has hailed the militant group's attack on Israel as a "success" but denied any involvement.
Saudi Arabia's de facto ruler Crown Prince Mohammed bin Salman denounced the conduct of Israeli forces in Gaza, saying "we stress the necessity of stopping this war and forced displacement".
US Secretary of State Antony Blinken wrapped up a marathon diplomatic push Friday, saying Israel's pauses in its Gaza offensive would "save lives" but more was needed.
"Far too many Palestinians have been killed," Blinken said in New Delhi, his last stop before heading home, where he repeated US support for ally Israel but was firm that more aid had to reach civilians in Gaza.
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W.Matthews--TFWP