At least 21 people have been killed in Gaza as they went to receive aid from an Israeli-backed foundation, according to a nearby hospital run by the Red Cross.
The hospital, which received the bodies, said another 175 people had been wounded in the incident in Rafah on Sunday morning.
The Associated Press also reports seeing dozens of people being treated at the hospital.
Witnesses have said those killed and injured were struck by gunfire which broke out at a roundabout near the distribution site.
The area is controlled by Israeli forces.
Ibrahim Abu Saoud, an eyewitness, said Israeli forces opened fire at people moving toward the aid distribution centre.
“There were many martyrs, including women,” the 40-year-old man said. “We were about 300 meters (yards) away from the military.”
Abu Saoud said he saw many people with gunshot wounds, including a young man who he said had died at the scene. “We weren’t able to help him,” he said.
The Gazans had been trying to receive aid from the Gaza Humanitarian Foundation – an American organisation backed by both the US and Israeli governments.
It operates as part of a controversial aid system which Israel and the US claims is aimed at preventing Hamas from siphoning off assistance.
Israel has not provided any evidence of systematic diversion, and the UN denies it has occurred.
Earlier, Hamas-linked media had also reported more than 20 deaths in Rafah, saying they were as a result of an Israeli strike on an aid distribution point. Israel is yet to comment.
The Gaza Humanitarian Foundation’s distribution of aid has been marred by chaos, and multiple witnesses have said Israeli troops fired on crowds near the delivery sites.
UN agencies and major aid groups have refused to work with the new system, saying it violates humanitarian principles because it allows Israel to control who receives aid and forces people to relocate to distribution sites, risking yet more mass displacement in the territory.
Before Sunday, at least six people had been killed and more than 50 wounded, according to local health officials.
The foundation says the private security contractors guarding its sites did not fire on the crowds, while the Israeli military has acknowledged firing warning shots.
The foundation did not immediately respond to a request for comment following the hospital’s claims.
In an earlier statement, it said it distributed 16 truckloads of aid early on Sunday “without incident”. It dismissed what it referred to as “false reporting about deaths, mass injuries and chaos”.
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