Israel resisted US calls for a pause in fighting and pressed its siege of Gaza City Saturday, after deadly strikes hit an ambulance convoy and a school-turned-refugee shelter.
As Israeli Prime Minister Benjamin Netanyahu rebuffed pressure from visiting US Secretary of State Antony Blinken to enact a temporary humanitarian truce, the nearly month-old war in Gaza raged unabated.
Israeli ground forces have encircled Gaza's largest city, trying to rout Hamas in retaliation for October 7 raids that killed an estimated 1,400 people inside Israel, most of them civilians.
At the Osama bin Zaid Boys School north of Gaza City, AFP saw the aftermath of what Hamas authorities said was Israeli tank shelling that killed 20 people.
Ambulance teams rushed into the debris-littered building to aid the injured and remove the dead.
Stunned onlookers wept and wandered the scene with hands clasped above the head in horror and disbelief.
A long row of washing still hung from windows on the building's first storey, evidence that the school had become a temporary home for some of the hundreds of thousands displaced by the war.
Israel's military describes Gaza City as "the centre of the Hamas terror organisation" and says it is targeting Hamas operatives, weapons stores, tunnel complexes, drone launching posts and command centres there.
Spokesman Richard Hecht said forces were engaged in "very intense, close quarters combat" with Hamas fighters.
But with strikes and ground fighting taking place in densely populated urban areas, many civilians have died.
Hamas-run health authorities claim more than 9,200 Gazans, mostly women and children, have been killed.
Speaking in Tel Aviv, Blinken accused Hamas of "cynically and monstrously" using civilians as human shields, and of deliberately locating military assets "beneath residential buildings, schools, mosques, hospitals."
A key focus of his trip was to convince Israel to enact "humanitarian pauses", which the United States believes could help secure the release of roughly 240 hostages thought to be in Hamas captivity, and to allow aid to be distributed to Gaza's beleaguered population.
Netanyahu, who has made a political career out of hawkish security policies, warned that there could be no "temporary truce" in Gaza until Hamas releases the hostages.
'Utterly shocked'
Israel says it has struck 12,000 targets across the Palestinian territory since "Operation Iron Swords" began on October 7, one of the fiercest bombing campaigns in recent memory.
In Gaza City's centre, there was another strike Friday, this one on the doorstep of the territory's largest hospital Al-Shifa.
Israel's military said it had targeted an ambulance used by a "Hamas terrorist cell" and had "neutralized" those inside.
"We emphasise that this area in Gaza is a war zone. Civilians are repeatedly called upon to evacuate southward for their own safety," the Israel Defense Forces said.
The Hamas government said 15 people were killed, mirroring figures released by the Palestinian Red Crescent.
An AFP journalist saw multiple bodies beside the blood-splattered Palestinian Red Crescent vehicle.
A child was carried away and a dead horse lay nearby, still tethered to a cart.
The Red Crescent said a convoy of five vehicles had been destined for the Rafah border crossing with Egypt, when they were struck multiple times.
One vehicle had been transporting a 35-year-old woman with shrapnel wounds.
World Health Organization chief Tedros Adhanom Ghebreyesus said he was "utterly shocked" by the strike.
"We reiterate: patients, health workers, facilities and ambulances must be protected at all times. Always", he said.
A senior White House official said that Hamas had tried to use a US-brokered deal opening the Egyptian border crossing to get its cadres out.
Hamas provided a list of wounded Palestinians for evacuation with one-third of the names those of Hamas members and fighters, the official said.
"That was just unacceptable to Egypt, to us, to Israel," the official added.
Egypt's health ministry said just 17 wounded Palestinians were evacuated for treatment in Egyptian hospitals Friday instead of the 28 originally planned because of the "events" at Al-Shifa.
Shuttle diplomacy
On Saturday, Blinken is due to hold talks in Amman with the foreign ministers of Jordan, Egypt, Saudi Arabia, the United Arab Emirates and Qatar.
That meeting comes amid mounting Arab anger over the civilian death toll from war, and increasing fears that the conflict could spread.
The leader of Lebanon's powerful Iran-backed Hezbollah movement, Hassan Nasrallah, on Friday broke weeks of silence to warn Israel that the possibility of "total war is realistic".
Israel's Netanyahu warned Hezbollah it would "pay an unimaginable price" for any misstep.
Saturday's six-nation talks in Amman is also likely to touch on the question of Gaza's future beyond the war.
The United States has renewed calls for the creation of a Palestinian state, but few expect success now after decades of failure.
In Tel Aviv, Blinken said the two-state solution -- a Palestinian state that sits alongside Israel -- was "best viable path -- indeed, the only path" to peace and security for both communities.
Netanyahu has spent decades vehemently opposing that vision. And it is unclear what appetite still-shocked and grieving Israelis will have for reconciliation or concessions.
The United States has also urged the Palestinian Authority, which ceded power to Hamas in Gaza more than 15 years ago, to retake control.
A representative of the Palestinian Authority led by president Mahmud Abbas will also attend the meeting in Amman.
Inside Israel, authorities began forcing thousands of Palestinian workers to return to Gaza.
"Thousands of workers who were blocked in Israel since October 7 have been brought back," the head of Gaza's crossings authority, Hisham Adwan, told AFP.
The United Nations Human Rights Office said it was "deeply concerned" about the expulsions.
Before the war started, some 18,500 Gazans held Israeli work permits, according to Israeli defence officials, but it was not clear how many were in the country on October 7.