The attack at Al-Aqsa Martyrs Hospital in central Gaza’s Deir el-Balah city in the early hours of Monday hit tents where many displaced Palestinians had been sheltering.

Videos and photos showed rescuers scrambling to save people as they struggled to contain a major fire. The death toll is expected to rise further.

“What happened was that we woke up to smoke, flames, fire and burning pieces falling on the tents from every direction. The explosions terrified us in our tents and outside where we live behind Al-Aqsa Hospital,” Om Ahmad Radi, a survivor at the scene, told Al Jazeera.

“The fire trucks couldn’t get here. There were so many burned and charred bodies all over the place. The amount of fire and explosions was enormous. We witnessed one of the most horrible and brutal nights,”

Gaza’s Media Office announced it was the seventh time this year that Israel has hit the grounds of Al-Aqsa Hospital and the third in the past couple of weeks, killing Palestinians who were forced to flee their homes.

Israeli forces have repeatedly attacked medical facilities in Gaza since the assault began more than a year ago, with the enclave’s health sector already overwhelmed and infrastructure destroyed.

Last week, a United Nations Independent International Commission of Inquiry (CoI) released a report which found Israel perpetrating “a concerted policy to destroy Gaza’s healthcare system”.

Meanwhile, At least 10 Palestinians were killed and dozens injured in Israeli artillery shelling targeting a food distribution center in Jabalia in the northern Gaza Strip on Monday, according to medical sources.

Meantime, at least 22 more Palestinians were confirmed dead and 80 others wounded on Sunday when Israeli tanks shelled a school sheltering the displaced in Nuseirat, also in central Gaza.

Israel’s genocide has destroyed large areas of Gaza and displaced about 90 percent of its population of 2.3 million people, many of them multiple times.

In northern Gaza, Israeli air and ground forces have laid a siege on Jabalia for days, claiming the Hamas fighters have regrouped there. Over the past year, Israeli troops have repeatedly returned to the refugee camp in Jabalia, which dates to the 1948 war surrounding Israel’s creation.

The attack on Jabalia follows Israeli orders to fully evacuate northern Gaza, including Gaza City. An estimated 400,000 Palestinians remain in the north. The UN says no food has entered northern Gaza since October 1.

The military confirmed that hospitals were also included in its evacuation orders, adding that it had not set a timetable and was working with local authorities to facilitate patient transfers.

But Fares Abu Hamza, an official with Gaza Health Ministry’s emergency service, told The Associated Press news agency that bodies of a “large number of martyrs” remain uncollected from the streets and under the rubble in the north.

“We are unable to reach them,” he added, asserting that dogs were eating some remains.

Israel has continued a brutal offensive on Gaza following a cross-border attack by Hamas on October 7 last year, despite a UN Security Council resolution calling for an immediate ceasefire.

More than 42,200 people have since been killed, mostly women and children, and about 98,400 injured, according to local health authorities.