At least 51 Palestinians were killed and more than 200 others injured after Israeli forces opened fire near an aid distribution site in southern Gaza, according to witnesses and rescuers. The shooting happened east of Khan Younis, where thousands had gathered in hopes of receiving flour from a World Food Programme site.

Witnesses said Israeli drones fired two missiles followed by a tank shell that landed near a road junction leading to Bani Suheila. The area has seen weeks of intense Israeli military operations. Videos verified by BBC show the chaotic aftermath, with casualties lying on the ground as survivors scramble for help.

Gaza's civil defence spokesperson Mahmud Bassal said, “Israeli drones fired at the citizens. Some minutes later, Israeli tanks fired several shells at the citizens, which led to a large number of martyrs and wounded.” He said the crowd had gathered near a community kitchen that serves people relying on food aid.

The Israeli military said it was reviewing the incident. In a statement, it said, “A gathering was identified adjacent to an aid distribution truck that got stuck in the area of Khan Younis, and in proximity to IDF troops operating in the area.” It acknowledged being “aware of reports regarding a number of injured individuals from IDF fire following the crowd’s approach.”

Nasser Hospital, the main medical facility in the area, was overwhelmed by the number of wounded. With limited space and resources, many of the injured lay on the floor as medics worked to save lives. The World Health Organization confirmed receiving reports of a mass casualty incident, with its trauma surgeon Thanos Gargavanis saying the injuries were mostly from gunshots.

“This is again the result of another food distribution initiative,” Gargavanis said, adding that the violence keeps occurring near the same four declared food distribution points.

The Gaza Humanitarian Foundation, backed by Israel and the US, has said the incidents are taking place outside its sites and should not be linked to its operations. However, videos show huge crowds rushing for aid with little control, forcing temporary shutdowns in efforts to improve security.

Despite IDF instructions warning people not to approach aid sites between 18:00 and 06:00, many Palestinians say they have no other option if they want to access the scarce food available. Hamas has described the aid distribution centres as death traps, and looting by armed groups, gangs and individuals has worsened the situation.

International access to Gaza remains blocked, making independent verification difficult. The UN and other humanitarian groups have warned repeatedly about the deteriorating aid situation. On Monday, UN human rights chief Volker Turk accused Israel of using food as a weapon and called for a full investigation into the shootings.

UNRWA head Philippe Lazzarini said, “Tragedies go on unabated while attention shifts elsewhere.”

More than 55,297 people have died in Gaza since Israel began its military campaign following the October 7 Hamas-led attacks that killed 1,200 people in Israel and saw 251 others taken hostage.