AT least 20 people have been killed at an aid distribution site in Gaza after a “chaotic and dangerous” crowd surge.

Nineteen were trampled to death with one person stabbed in the “tragic accident,” the Gaza Humanitarian Foundation (GHF) said.

The US and Israel-backed GHF said it believed the harrowing surge was “driven by agitators in the crowd” who were affiliated to Hamas.

Nasser Hospital in Khan Younis reported that it had taken in the bodies of 10 individuals who passed away from “suffocation” after the closure of an aid site by US private security contractors operating for the GHF.

The GHF stated, “We have credible information suggesting that some in the crowd—armed and connected with Hamas—intentionally incited the disorder.”

However, a medical source from Nasser Hospital contended that they received “nine martyrs, including several children” due to “Israeli forces” firing on people who were trying to obtain aid.

The source added the victims were “heading to the aid distribution centre in northwest Rafah to receive food aid” but the main gate to the centre had been closed.

The GHF started its operations on May 26 after Israel had halted supplies into the Gaza Strip for more than two months, sparking warnings of imminent famine.

On Tuesday, the UN said it had recorded 875 people killed in Gaza while trying to get food, including 674 “in the vicinity of GHF sites”, since the end of May.

Last week, UN rights office spokeswoman Ravina Shamdasani said that “most of the injuries are gunshot injuries”.

The GHF has denied deadly shootings have occurred in the immediate vicinity of its aid points.

The Israeli army has accused Hamas of being responsible for firing at civilians.

The GHF said on Wednesday: “For the first time since operations began, GHF personnel identified multiple firearms in the crowd, one of which was confiscated.

“An American worker was also threatened with a firearm by a member of the crowd during the incident.”

It added that it was part of a “deeply troubling pattern”, including “false messages” about aid site openings.

The Israeli military last week said it recognised incidents had occurred where civilians had been harmed and that it was working to minimise “possible friction between the population and the [Israeli] forces as much as possible”.

The GHF uses private security contractors to distribute aid from sites in Gaza.

The UN does not co-operate with it, having previously described its set up as unethical.