Palestinians queue for a portion of hot food distributed by a charity kitchen at the Nuseirat refugee camp in the central Gaza Strip. AFP
"Our current understanding is that 19 of the victims were trampled and one was stabbed amid a chaotic and dangerous surge," the US- and Israel-backed organisation said in a statement.
It was the first time the GHF acknowledged the killing of Palestinians at one of its distribution sites, following weeks of chaotic scenes and near-daily reports of hundreds being killed, by Israeli forces and contractors securing GHF sites, while waiting to collect food rations.
Gaza's civil defence agency said at least 20 people were killed in the incident by fire from Israeli troops.
Agency spokesman Mahmud Bassal told AFP that thousands had gathered at the site when "Israeli forces opened fire and used (tear) gas, causing panic and a stampede after aid centre guards closed the main gates in front of the hungry crowd".
AFP footage showed lifeless bodies taken to a nearby hospital in the city of Khan Younis, with some placed on the floor and others on already-bloodied beds.
Abdullah Alian, a witness, said that mayhem unfolded as the crowd of aid-seekers was hit with stun grenades and pepper spray.
"When they saw people starting to die on the ground and people on top of each other suffocating, they opened the gate and people started climbing on top of each other."
Paramedic Ziad Farhat said that after more than 21 months of Israeli genocidal war, "there are not enough hospitals for the injured or the martyrs".
"Enough of the tragedies that we are living."
The GHF claimed the stampede was "driven by agitators in the crowd", and attempted to to pin the blame on Hamas.
"For the first time since operations began, GHF personnel identified multiple firearms in the crowd, one of which was confiscated," the GHF said on Wednesday.
Spokesman Chapin Fay denied that tear gas was used or that shots were fired into the crowd, despite multiple eyewitness accounts from Palestinians at the scene.
"Limited use of pepper spray was deployed only to protect against additional loss of life," Fay claimed, adding that "warning shots were fired into the air at one point.
The medical source at Nasser Hospital said the victims were "heading to the aid distribution centre in northwest Rafah to receive food aid" but the main gate to the centre had been closed.
"The Israeli occupation forces and the centre's private security personnel opened fire on them, resulting in a large number of deaths and injuries," the source added.
The GHF, an officially private effort, began operations on May 26 after Israel had blocked all food and aid supplies into the Gaza Strip for more than two months, sparking warnings of imminent famine.
On Tuesday, the UN said it had recorded 875 people killed in Gaza while trying to get food, including 674 "in the vicinity of GHF sites", since late May.
Last week, UN rights office spokeswoman Ravina Shamdasani told reporters that "most of the injuries are gunshot injuries".
Israel has killed at least 58,573 Palestinians, most of them women and children, since the start of its genocidal war on Gaza in October 2023.
The Israeli mass killings, siege, starvation tactics, and systematic destruction of civilian infrastructure are the subject of a genocide case filed by South Africa at the International Court of Justice (ICJ), which issued interim rulings ordering Israel to prevent genocidal acts and allow humanitarian aid into the Strip.
In parallel, the International Criminal Court (ICC) is investigating war crimes and crimes against humanity committed in the occupied Palestinian territories. In May 2024, ICC Prosecutor Karim Khan applied for arrest warrants against Israeli Prime Minister Benjamin Netanyahu and Defence Minister Yoav Gallant, accusing them of using starvation as a weapon of war and deliberately targeting civilians
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