The U.S.-based Gaza Humanitarian Foundation said food was handed out without incident on Sunday at the distribution point in Rafah and there were no deaths or injuries.

GHF released undated video to support its statement that showed dozens of people gathering around piles of boxes. Reuters could not independently verify the video or what took place.

Witnesses said the Israeli military opened fire as thousands of Palestinians gathered to receive food aid. Israel s military said that an initial inquiry found soldiers had not fired on civilians while they were near or within the distribution site.

The Hamas-controlled Gaza health ministry said 31 people were killed with a single gunshot wound to the head or chest from Israeli fire as they were gathered in the Al-Alam district aid distribution area in Rafah. It said 169 were injured.

In addition to Israeli gunshots, residents and medics said an Israeli tank had opened fire at thousands of people en route to the Rafah site.

The International Committee of the Red Cross said its field hospital in Rafah received 179 casualties, most with gunshot or shrapnel wounds.

"All patients said they had been trying to reach an aid distribution site. This is the highest number of weapon-wounded in a single incident since the establishment of the field hospital over a year ago," ICRC said.

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The United Nations has said most of Gaza s 2 million population is at risk of famine after an 11-week Israeli blockade on aid entering the strip.

The Gaza Humanitarian Foundation launched its first distribution sites last week and said it would launch more. The Israeli military has said GHF had established four sites so far.

The organization s aid plan, which bypasses traditional aid groups, has come under fierce criticism from the United Nations and humanitarian organizations which say GHF does not follow humanitarian principles.

There were chaotic scenes as hungry Gazans rushed its sites last last week. Hamas reported deaths and injuries in the tumult, and Israel said its troops fired warning shots.

Because the GHF distribution points are few and all in south Gaza, U.N. officials have said its plans force Palestinians, especially in the north, to relocate and face unsafe conditions.

Philippe Lazzarini, head of the UN s Palestinian relief agency, condemned Sunday s deaths and said in a statement on X that "aid distribution has become a death trap".

The Hamas-run Gaza government media office accused Israel of using aid as a weapon, "employed to exploit starving civilians and forcibly gather them at exposed killing zones, which are managed and monitored by the Israeli military".

At Nasser Hospital in nearby Khan Younis city where some casualties were brought, Gaza paramedic Abu Tareq said there was "a tragic situation in this place. I advise them that nobody goes to aid delivery points."

Israel denies that people in Gaza are starving because of its actions, saying it is facilitating aid deliveries and pointing to its endorsement of the new GHF distribution centres and its consent for other aid trucks to enter Gaza.

U.S. President Donald Trump said last month that a lot of people in Gaza were "starving".

Israel accuses Hamas of stealing supplies intended for civilians and using them to entrench its hold on Gaza. Hamas denies looting supplies and has executed a number of suspected looters.

Reda Abu Jazar said her brother was killed as he waited to collect food near the Rafah aid distribution centre. "Let them stop these massacres, stop this genocide. They are killing us," she said, as Palestinian men gathered for funeral prayers.

The Red Crescent reported that 14 Palestinians were injured on Sunday near a separate GHF aid site in central Gaza.