Israeli troops fired on a crowd of Palestinians awaiting aid in Gaza city on Thursday, witnesses said. More than 100 people were killed, bringing the death since 7 October to more than 30,000, according to Gaza's health ministry.

Hospital officials initially reported an Israeli strike on the crowd, but witnesses later said Israeli troops opened fire as people pulled canned goods and sacks of flour off of trucks.

Dr. Hussam Abu Safiya, the director of the Kamal Adwan Hospital, said it received at least 10 bodies and 160 wounded people after the incident.

Paramedics reported that there were not enough ambulances to collect all the dead and wounded and that some were brought to hospitals on donkey carts.

Dr Mohammad Salha, acting director of the Al-Awda Hospital in Gaza, said it received 90 wounded people and three bodies, who were transferred to Kamal Adwan.

“We expect a rise in the number killed,” he said. “There are many wounded still at the reception and the emergency room.”

He said Al-Awda is largely out of commission, with no electricity and the operating room running on battery power with only hours left. Gaza’s health sector is stretched severely thin nearly five months into the Israel-Hamas war.

The ministry said that 30,035 people have been killed and another 70,457 wounded since 7 October, when the war broke out.

Gaza's health ministry, which is part of the Hamas-run government, maintains detailed records of casualties. Records do not differentiate between civilians and combatants, but officials say women and children make-up around two-thirds of those killed in the Israel-Hamas war.