At least 27 people were killed and dozens wounded by Israeli fire near a food distribution site in southern Gaza, local health authorities said, in the third day of chaos and bloodshed to affect the aid operation.
The Israeli military said its forces had opened fire on a group of individuals who had left designated access routes near the distribution centre in Rafah.
It added it was still investigating what had happened.
The deaths came hours after Israel said three of its soldiers had been killed in fighting in northern Gaza, as its forces pushed ahead with a months-long offensive against Hamas militants that has laid waste to much of the territory.
A spokesperson for the International Committee of the Red Cross said that its field hospital in Rafah received 184 casualties, adding that 19 of those were declared dead upon arrival, and eight died of their wounds shortly after.
More than 35 patients required immediate intervention, the spokesperson added.
The US-backed Gaza Humanitarian Foundation launched its first distribution sites last week in an effort to alleviate widespread hunger amongst Gaza's war-battered population, most of whom have had to abandon their homes to flee fighting.
The GHF's aid plan, which bypasses traditional aid groups, has come under fierce criticism from the United Nations and established charities which say it does not follow humanitarian principles.
The private group, which is endorsed by Israel, said it distributed 21 truckloads of food early this morning and that the aid operation was "conducted safely and without incident within the site".
However, there have been reports of repeated killings near Rafah as crowds gather to get desperately needed supplies.
The United Nations human rights office said the impediment of access to food and relief for civilians in Gaza may constitute a war crime, describing attacks on civilians trying to access food aid as unconscionable.
"For a third day running, people were killed around an aid distribution site run by the 'Gaza Humanitarian Foundation'. This morning, we have received information that dozens more people were killed and injured," the spokesperson for the UN High Commissioner for Human Rights Jeremy Laurence told reporters in Geneva.
On Sunday, Palestinian and international officials reported that at least 31 people were killed and dozens more injured.
The Israeli military has denied targeting civilians gathering for aid and called reports of deaths during Sunday's distribution "fabrications" by Hamas.
This morning, it said IDF forces had identified "a number of suspects" moving towards them while deviating from the access routes.
"The forces fired evasive shots, and after they did not move away, additional shots were fired near the individual suspects who were advancing towards the forces," it said.
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UN Secretary-General António Guterres said yesterday that he was "appalled" by reports of Palestinians killed and wounded while seeking aid and called for an independent investigation.
The Israeli military issued new evacuation orders to residents of several districts in Khan Younis in southern Gaza late yesterday, warning that the army would act forcefully against militants operating in those areas.
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The military told residents to head west towards the Mawasi humanitarian area. Palestinian and United Nations officials say there are no safe areas in the territory, and that most of its 2.3million population has become internally displaced.
Gaza's Hamas-run health ministry said that the new evacuation orders could halt work at the Nasser Hospital, the largest, still-functioning medical facility in the south, endangering the lives of those being treated there.
Israel launched its military campaign in Gaza following the 7 October 2023 assault in which Hamas-led gunmen killed 1,200 people and took 251 hostages, by Israeli tallies.
In the subsequent fighting, more than 54,000 Palestinians have been killed, local health authorities say.
