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Gaza's northern city of Beit Lahia was reeling on Wednesday from an onslaught of deadly Israeli strikes, with entire families killed by an attack on a home sheltering displaced Palestinians.
Saeed Al Gharbawi, 26, was nearby when the Israeli air force struck a five-storey building in the Beit Lahia housing project early on Tuesday.
“We heard a massive explosion, like an earthquake. We thought multiple homes had been destroyed due to the intensity,” he told The National.
Twenty-five children were among 93 people killed in the attack, according to Gaza's health ministry. Dozens more are missing.
Cries for help could be heard from under the rubble as rescue teams and civilians, including Mr Al Gharbawi, combed the wreckage for survivors.
But the Israeli military siege on northern Gaza – now in its 26th day – along with strikes on hospitals and emergency crews have left Palestinians in the area with no functioning ambulances and few ways to treat the wounded.
“Many people are still trapped. Some are possibly still alive, but time is running out,” said Mr Gharbawi.
More than 250 people are believed to have been in the building, which was owned by the Abu Nasr family. A relative, Mohammed Abu Nasr, 38, said the strike had wiped out entire families – mothers, fathers and children.
Victims were wrapped in makeshift shrouds and buried in Beit Lahia's market square, because travelling to the local graveyard was deemed too dangerous.
“They were a peaceful, civilian family with no connections to military groups or hostages to justify the attack,” Mr Abu Nasr told The National.
The strike has been widely condemned, with Unicef executive director Catherine Russell describing the continued killing of children in Gaza as “an outrageous norm”.
The Abu Nasr family had refused to comply with Israeli orders to leave their home and had sheltered many displaced people, strengthening the community's resilience, Mr Abu Nasr said. He believes this led to them being targeted.
Hours later, 10 people were killed in Israeli shelling elsewhere in the city, taking the total death toll to more than 100.
Gaza's already-fragile health sector has been pushed to breaking point, and recent Israeli attacks on the nearby Kamal Adwan Hospital – where almost all staff have been detained by the Israeli army – have left the facility struggling to treat Palestinians wounded in the war.
“The healthcare system in northern Gaza has completely collapsed,” hospital director Hussam Abu Safiya told The National. “Those injured in Israeli air strikes die because of the lack of resources and our inability to handle large numbers of casualties.”
Around 1,000 people have been killed and hundreds more wounded in Israel's lengthy siege on northern Gaza, where thousands have refused to leave their homes and shelters despite constant Israeli attacks and the obstruction of aid.
Israel's offensive has focused on Jabalia refugee camp and Beit Lahia, including Kamal Adwan – where children on oxygen machines have died after Israel bombed the hospital's generators.
Dr Abu Safiya said the bodies of 70 people had been brought to the hospital after Tuesday's strikes and at least 80 others had arrived wounded, with more trapped under the rubble.
“The hospital cannot assist due to a lack of equipment and staff,” he added. The director said there was an “immediate” need for ambulances and fuel after Israel destroyed northern Gaza's last functioning ambulance last week.
“This inability to respond is particularly evident in large-scale incidents like the massacre of the Abu Nasr family,” Dr Abu Safiya said. “There are international delegations in southern Gaza and abroad, but urgent global pressure on Israel is needed to allow these delegations, especially surgical teams, to reach northern Gaza with medical supplies.”
