The official media office in Gaza said the dead included 4,609 children and 3,100 women, whilst a further 28,200 people have been wounded.

In Gaza City, Al-Shifa hospital is caught in Israel's ground offensive, and the compound has been repeatedly hit by strikes, one of which Gaza health officials said destroyed the cardiac ward on Sunday.

The Israeli military has denied deliberately targeting hospitals and has accused the Islamist militant group of using medical facilities or tunnels underneath them as hideouts -- a charge Hamas denies.

Fears intensified for Palestinians seeking shelter and patients needing treatment after Gaza City's Al-Quds hospital went out of service due to a lack of generator fuel, the Palestinian Red Crescent said.

"The hospital has been left to fend for itself under ongoing Israeli bombardment, posing severe risks to the medical staff, patients and displaced civilians," it added.

The bloodiest-ever Gaza war broke out after Hamas fighters poured through the militarized border with Israel on October 7, killing around 1,200 and taking about 240 captives, according to Israeli figures.

Israel's relentless campaign in response has killed at least 11,180 people, mostly civilians and including 4,609 children, according to Gaza's media officials.

Despite growing calls for a ceasefire, Israeli Prime Minister Benjamin Netanyahu has flatly rejected an end to the fighting before the release of the captives.

White House National Security Council spokesman John Kirby told MSNBC that there has been "active negotiation" on a potential deal but kept mum on any details.

A Palestinian official in Gaza, speaking on condition of anonymity, said Netanyahu was to blame for the lack of progress on freeing captives.

"Netanyahu is responsible for the delay and obstacles in reaching a preliminary agreement on the release of several prisoners," the official told AFP.

'No one can leave'
 

Witnesses at Al-Shifa hospital told AFP by phone on Sunday that "violent fighting" had raged around the hospital the whole night.

And inside, doctors said Saturday that two babies had died in the neonatal unit after power to their incubators was cut off, and a man had also died when his ventilator shut down.

The Israeli military has pledged to aid the evacuation of babies from the hospital, but a Palestinian official denied that it had happened.

"No one can enter or leave" the hospital, said Mohammad Zaqut, who oversees all hospitals in the Gaza Strip.

A "safe passage" was to be opened from Al-Shifa to allow people to flee toward the south, the Israeli military said Sunday.

But "the situation in Al-Shifa is catastrophic", Zaqut told AFP.

Twenty of Gaza's 36 hospitals are "no longer functioning", according to the UN's humanitarian agency.

Very little aid has made it into Gaza during the war, with the densely populated coastal territory effectively sealed off by a total blockade that Israel has vowed to maintain until the captives are freed.

The Israeli military confirmed that a Jordanian plane dropped medical equipment and food to the Jordanian Hospital in the Gaza Strip.

Only a handful of trucks carrying fuel have been let into Gaza since October 7, with Israel concerned fuel deliveries may be used by Hamas fighters.

As fighting raged, around 800 foreigners and dual nationals, as well as several wounded Palestinians, were evacuated from the besieged Gaza Strip to Egypt on Sunday, a Gaza border official said.

Rafah is the only crossing out of Gaza not controlled by Israel and had been closed on Friday and Saturday.

Since November 1, dozens of wounded Palestinians have been evacuated to Egyptian hospitals, with hundreds of dual nationals and foreigners also leaving through Rafah.

Thousands flee south
 

Perched on trucks, crammed in cars, pulled by donkeys on carts and on foot, many thousands of Palestinians have fled Israeli occupation army strikes on the territory squeezed between Israel, Egypt and the Mediterranean.

Youssef Mehna, one of many who moved south, said his sick wife is in a wheelchair so he had to rent "donkey carts, trucks, and cars" to transport her.

Sometimes, between rides, they were forced to go on foot. "So it was me who pushed my wife's chair," he told AFP.

Almost 1.6 million people -- about two-thirds of Gaza's population -- have been internally displaced since October 7, according to the UN agency for Palestinian refugees UNRWA.

However, people arriving in the south were no longer able to find tents or improvised shelter, with some sleeping in the streets, according to AFP journalists.

Strikes were also hitting buildings at the southern end of Gaza in Rafah, the area to which civilians have been urged to evacuate.

A strike in southern Bani Suheila destroyed a dozen houses on Sunday, killing at least four people and wounding at least 30, said an AFP reporter at the scene.

Regional tensions
 

The aggression's intensity has stoked regional tensions.

Israeli fighter jets pounded Hezbollah hideouts in southern Lebanon with air strikes on Sunday, after an incoming anti-tank missile wounded Israeli civilians near the border, the army said.

The Israel Electric Corporation said the missile from Lebanon had "hit employees" who were repairing power lines downed by earlier strikes.

The Iran-backed militant group Hezbollah claimed responsibility and said it fired on an Israeli team installing "spying devices" near the border.

Israel's top ally Washington has offered some criticism of the civilian toll in Gaza but has voiced support for the offensive and opposed a ceasefire.