Palestinians in Gaza were fleeing their homes and rushing their dead and wounded to hospitals as Israel resumed its bombardment of the besieged enclave.
Combat between Israel and Hamas was renewed on Friday following the expiry of a weeklong truce. An agreement on extending the pause in fighting was not reached before the 7am (05:00 GMT) deadline.
The deal, which started on November 24 and was twice extended, had produced a pause in the fighting and allowed an increase in aid flows into Gaza, while scores of Israelis taken prisoner on October 7 were exchanged for hundreds of jailed Palestinians.
However, hostilities resumed immediately as the latest deadline passed.
Smoke billowed over the southern cities of Rafah and Khan Younis following Israeli strikes, with deaths recorded in both places.
In Khan Younis, a group of men chanted “God is greatest” as they rushed through the streets carrying a body wrapped in a white shroud.
‘War on children’
At the hospital reception, 10-year-old Lina Hamdan said: “We were getting ready to sleep when I heard a bomb. My brothers started screaming.”
In Rafah, a young man rushed a badly wounded child out of a refugee camp hit by an explosion, while others could be seen pulling a motionless person from the rubble.
Marwan al-Hams, the director of al-Najjar Hospital in Rafah, where many Palestinians fled after being told by Israel to leave the north of the territory, said strikes had killed at least nine people in the city, including four children.
In the north of the Gaza Strip, the fireball from a large explosion could be seen from across the border in the Israeli city of Sderot.
Speaking from a hospital in Gaza, UNICEF spokesperson James Elder said on Friday that a bomb had landed “literally 50 metres away”.
“I cannot overstate how much the capacity of hospitals has been reduced,” he said. “We cannot see more children with the wounds of war, with the burns, with the shrapnel littering their body, with the broken bones.”
“This is a war on children,” he added.