“We weren’t able to help him,” he said.

Mohammed Abu Teaima, 33, said he saw Israeli forces open fire and kill his cousin and a woman as they headed toward the distribution site. He said his cousin was shot in his chest and his brother-in-law was among the wounded.

“They opened heavy fire directly toward us,” he said.

An AP reporter arrived at the field hospital about 6am (1pm AEST) and saw dozens of wounded, including women and children. The reporter also saw crowds of people returning from the distribution point. Some carried boxes of aid but most appeared to be empty-handed.

Officials at the field hospital said at least 21 people were killed and another 175 were wounded, without saying who opened fire on them. The officials spoke on condition of anonymity because they were not authorized to speak to reporters.

Gaza’s Health Ministry provided the same toll and later updated it.

UN says new aid system violates humanitarian principles

Israel and the US say the new system is aimed at preventing Hamas from siphoning off assistance. Israel has not provided any evidence of systematic diversion, and the UN denies it has occurred.

UN agencies and major aid groups have refused to work with the new system, saying it violates humanitarian principles because it allows Israel to control who receives aid and forces people to relocate to distribution sites, risking yet more mass displacement in the coastal territory.

“It’s essentially engineered scarcity”, Jonathan Whittall, interim head in Gaza of the UN humanitarian office, said last week.

The UN system has struggled to bring in aid after Israel slightly eased its nearly three-month blockade of the territory last month. Those groups say Israeli restrictions, the breakdown of law and order and widespread looting make it extremely difficult to deliver aid to Gaza’s roughly 2 million Palestinians.

Experts have warned that the territory is at risk of famine if more aid is not brought in.

The war began when Hamas-led militants stormed into southern Israel on October 7, 2023, killing some 1200 people, mostly civilians, and abducting 251. They are still holding 58 hostages, around a third believed to be alive, after most of the rest were released in ceasefire agreements or other deals.

Israel’s military campaign has killed more than 54,000 people, mostly women and children, according to Gaza’s Health Ministry, which does not say how many of the dead were civilians or combatants. The offensive has destroyed vast areas, displaced around 90 per cent of the population and left people almost completely reliant on international aid.

The latest efforts at ceasefire talks appeared to stumble Saturday when Hamas said it had sought amendments to a US ceasefire proposal that Israel had approved, and the US envoy called that “unacceptable”.

Also on Sunday, Israel said its forces killed the commander of a militant cell it says was behind an attack that killed 21 soldiers in the war’s early months. It was among the deadliest single events for the military in nearly 20 months of fighting, excluding Hamas’ initial onslaught.

A blast from a rocket-propelled grenade fired by militants triggered explosives the soldiers were laying to blow up buildings.