The United Nations has questioned whether shooting attacks on Palestinians near aid distribution sites in southern Gaza could amount to war crimes, and is demanding an independent investigation into the deadly incidents.
Early on Tuesday morning (local time), Palestinian authorities said Israeli forces opened fire on desperate Gazans trying to access a private aid distribution site near Rafah — the third such attack in as many days.
At least 27 were killed and dozens more wounded, according to Palestinian health authorities.
The International Red Cross said more than 180 people were brought to one of its field hospitals after the shooting.
Israeli authorities said they were investigating the latest incident, conceding troops did fire warning shots after some Palestinians deviated from the authorised route to the aid facility.
The Israel Defense Forces (IDF) said more shots were fired when the "suspects" failed to heed the warnings.
But Israeli officials have rejected allegations they deliberately targeted civilians, and have questioned the number of dead and injured as a result.
"Deadly attacks on distraught civilians trying to access the paltry amounts of food aid in Gaza are unconscionable," spokesperson for the United Nations High Commissioner for Human Rights Jeremy Laurence said.
"The wilful impediment of access to food and other life-sustaining relief supplies for civilians may constitute a war crime.
"The threat of starvation, together with 20 months of killing of civilians and destruction on a massive scale, repeated forced displacements, and intolerable dehumanising rhetoric and threats by Israel's leadership to empty the Strip of its population, also constitute elements of the most serious crimes under international law."
Israeli officials said warning shots were fired about 500 metres from the aid site.
"The IDF is doing everything in its power to allow Gazans to get to the humanitarian aid," Israeli government spokesperson David Mencer said.
"The IDF is not preventing the arrival of Gazans at humanitarian aid sites — indeed, we are encouraging it.
"The warning shots were fired away from the aid distribution point in response to the threats perceived by the IDF troops."
Hospitals can't treat any more of the wounded
Nasser Hospital in Khan Younis was among the facilities which received an influx of patients after the shooting.
"Unfortunately, 90 per cent of the casualties coming to an Nasser medical complex were injured in the upper parts of the body," director of nursing Dr Mohammed Saqer told the ABC.
"That indicates that most of them … were in a very serious situation.
"We can no longer deal with more cases because all of the hospital beds, in addition to ICU beds, are occupied now — we no longer can provide more care to patients if others came to the emergency department in the future."
One of Palestinian injured in the attack was 22-year-old Motaz Alfarati.
He said he had been forced to lie waiting for help for more than an hour, after a bullet ripped through his thigh and hit his pelvis.
"In one moment we heard the noise of Apache helicopters, they were throwing sound grenades around us and on the asphalt, and anyone who doesn't stand and who moved was shot at by a sniper in his head, in his leg, in his stomach," he told the ABC.
There are only a handful of the private aid sites in operation in Gaza — and none are running in the north of the strip.
Motaz said thousands had travelled long distances to reach the site, only to be attacked.
"There were thousands and thousands who came to the area in order to take aid, but there is not enough for a thousand," he said.
"There were people from Beit Lahiya, Jabalia and Gaza City in order to take aid — they come from the different districts and 90 per cent don't take any."
Israel points to video filmed kms from attack
The White House said it was aware of the reports of the shootings.
"We're going to look into reports before we confirm them from this podium or before we take action," press secretary Karoline Leavitt said.
"And I suggest that journalists who actually care about truth do the same to reduce the amount of misinformation that's going around the globe on this front."
The IDF blamed Hamas for the first attack on Sunday morning, which killed more than 30 people and injured dozens more.
Israeli authorities said Hamas was trying to undermine the new aid distribution model and fuel chaos in southern Gaza.
Senior officials and politicians, including Israel's deputy foreign minister Sharren Haskel, have pointed to video purporting to show armed gunmen firing upon civilians on Sunday.
But the video was recorded in southern Khan Younis, about 8 kilometres away from the aid distribution site.
The organisation running the operation, the Gaza Humanitarian Foundation (GHF), insisted food had been distributed without incident, with millions of meals provided to Palestinians.
But GHF said it was only commenting on what happened within the perimeter of its facilities, and that anything outside of the fence line was the responsibility of the IDF.
The three attacks happened on approach to the aid site.
Meanwhile, a consulting firm which had been helping establish GHF has cut ties with the organisation.
In a statement, Boston Consulting Group (BCG) said it provided "pro bono support to help establish an aid organisation intended to operate alongside multilateral efforts to deliver humanitarian support to Gaza".
"Unapproved follow-on work relating to Gaza lacked buy-in from multilateral stakeholders and was stopped on May 30," the company said.
"BCG has not and will not be paid for any of this work.
"BCG has begun a formal review of the work, and while that review continues, the partner who led this work has been placed on administrative leave."