By NAJIB JOBAIN, SAMY MAGDY and JACK JEFFERY (Associated Press)

RAFAH, Gaza Strip (AP) — Tens of thousands of Palestinians streamed into an already crowded town at the southernmost end of Gaza in recent days, according to the United Nations, fleeing Israel’s bombardment of the center of the strip, where hospital officials said dozens were killed Friday.

Israel’s unprecedented air and ground offensive against Hamas has displaced some 85% of the Gaza Strip’s 2.3 million residents, sending swells of people seeking shelter in Israeli-designated safe areas that the military has nevertheless also bombed. That has left Palestinians with a harrowing sense that nowhere is safe in the tiny enclave.

People arrived in Rafah in trucks, in carts and on foot. Those who haven’t found space in the already overwhelmed shelters put up tents on roadsides slick with mud from winter rains. With the new arrivals, the town and its surrounding area are now packed with some 850,000 people, more than triple the normal population, according to U.N. figures.

“People are using any empty space to build shacks,” said Juliette Touma, director of communications at UNRWA, the U.N. agency for Palestinian refugees. “Some are sleeping in their cars, and others are sleeping in the open.”

Israel’s widening campaign, which has already flattened much of the north, is now focused on the urban refugee camps of Bureij, Nuseirat and Maghazi in central Gaza, where Israeli warplanes and artillery have leveled buildings.

But fighting has not abated in the north, and the city of Khan Younis in the south, where Israel believes Hamas’ leaders are hiding, is also a smoldering battleground. Fighters have continued to fire rockets, mostly at Israel’s south. Hamas has been designated as a terrorist organization by the United States, Canada and the European Union.

The war has already killed over 21,500 Palestinians, most of them women and children, and sparked a humanitarian crisis that has left a quarter of Gaza’s population starving. The death toll, released by the Health Ministry in the Hamas-ruled territory, does not distinguish between civilians and combatants.

Israeli officials have brushed off international calls for a cease-fire, saying it would amount to a victory for Hamas, which the military has promised to dismantle. It has also vowed to bring back more than 100 hostages still held by the terrorists after their Oct. 7 attack on southern Israel that triggered the war. The assault killed some 1,200 people, mostly civilians.

The military says 168 of its soldiers have been killed since the ground offensive began.

A STREAM OF DISPLACED PEOPLE

The U.N. said late Thursday that around 100,000 people have arrived in Rafah, along the border with Egypt, in recent days. The town and its surrounding region had a prewar population of around 280,000 and was already hosting more than 470,000 people driven from their homes by the war.

The new arrivals enter a landscape of misery: Most available water is polluted. The sanitation system has broken down, and working toilets are a rarity. Illnesses run rampant among multiple extended families all squeezed together in shelters, homes or on the street — rashes, respiratory problems, diarrhea and other intestinal diseases.

“Everyone here is infected with a disease,” Dalia Abu Samhadana said of her family, who fled the fighting in Khan Younis earlier in the month and now shelter in Rafah’s Shaboura district in a house with 49 people. With little food available, her daily diet is mainly bread and tea.

Israel has told residents of central Gaza to head south, but even as the displaced have poured in, Rafah has not been spared.

A strike Thursday evening destroyed a residential building, killing at least 23 people, according to the media office of the nearby Al-Kuwaiti Hospital.

At the hospital, residents rushed in a baby whose face was flecked with dust and who wailed as doctors tore open a Mickey Mouse onesie to check for injuries.

Shorouq Abu Oun fled the fighting in northern Gaza a month ago and sheltered at her sister’s house, which is located near Thursday’s strike.

“We were displaced from the north and came here as they (the Israeli military) said it is safe,” said Abu Oun, speaking at the hospital where the dead and wounded were taken. “I wish we were martyred there (in northern Gaza) and didn’t come here.”

Almost the entire population of Gaza is dependent on international aid, including food, UNRWA head Philippe Lazzarini said Friday. Despite a U.N. resolution last week calling for an immediate and unhindered increase in the entry of aid, no increase has been seen, he said.

Lazzarini said the aid operation faces “severe restrictions” from Israeli authorities. Trucks entering at Egypt’s Rafah crossing and the newly reopened Kerem Shalom crossing from Israel face long delays, he said. Distribution within Gaza is further hampered by constant bombardment and fighting, Israeli military checkpoints and repeated cuts in telecommunications, he said, as well as by desperate crowds that often overwhelm arriving aid trucks and take supplies.

Lazzarini called on Israel to reduce bureaucratic delays on aid entry, refrain from attacks at crossing points and around aid deliveries, and to open safe routes to northern Gaza, where aid has only rarely reached.

In the latest delivery to the north, thousands of Palestinians massed outside a distribution center in Gaza City as aid trucks arrived. Footage from the scene showed people jumping onto the trucks and clinging to the sides, some throwing packages and cans of food to others on the ground.

Israeli soldiers fired on the aid convoy as it returned from the north along a route designated by the military, damaging one vehicle, UNRWA’s Gaza chief, Thomas White, said in an post on X.

STRIKES IN CENTRAL GAZA

Residents said Friday that many houses were hit overnight in Nuseirat and Maghazi and that heavy fighting took place in Bureij. The al-Aqsa Martyrs hospital in Deir al-Balah said it received the bodies of 40 people, including 28 women, who were killed in strikes.

“They are hitting everywhere,” Saeed Moustafa, a Nuseirat resident, said. “Families are killed inside their homes and the streets. They are killed everywhere.”

Israel said this week it was expanding its ground offensive into central Gaza, targeting a belt of crowded neighborhoods built to house some of the hundreds of thousands of Palestinian refugees from the 1948 war surrounding Israel’s creation.

Israel blames the high death toll on Hamas, which it accuses of embedding inside the civilian population, saying that its forces have uncovered weapons troves and underground tunnel shafts in residential buildings, schools and mosques.

ISRAEL REVIEWS STRIKE ON REFUGEE CAMP

Civilians are bearing a staggering toll in the fighting. On Sunday, an Israeli strike on the Maghazi camp killed at least 106 people, according to hospital records, one of the war’s deadliest.

In a preliminary review of the strike, the Israeli military said that buildings near the target were also hit, and that “likely caused unintended harm to additional uninvolved civilians.” In a statement Thursday, the military said it regretted the harm to civilians and that it would learn from the error.

Eylon Levy, a government spokesman, told Britain’s Sky News that the wrong munition was used in the strike, leading to “a regrettable mistake.”

“This should not have happened,” he said.

Israel seldom comments on specific strikes and has rarely acknowledged any fault, even when civilians are killed.

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Magdy reported from Cairo, Jeffery from London. Associated Press writer Tia Goldenberg contributed to this report from Tel Aviv, Israel.

Find more of AP’s coverage at https://apnews.com/hub/israel-hamas-war.