Israeli forces have killed at least 115 Palestinians across Gaza, including 92 people who were shot dead while trying to get food at the Zikim crossing in the north and aid points in Rafah and Khan Younis in the south.

The killings on Sunday came as Israel’s continued siege of Gaza worsened a hunger crisis, with health authorities there announcing at least 19 deaths from starvation over the past day.

In Zikim, Israeli forces shot at least 79 Palestinians, according to medical sources, as large crowds gathered there in the hopes of getting flour from a United Nations aid convoy.

Nine more were killed near an aid point in Rafah, where 36 others had lost their lives just 24 hours earlier. Four more were killed near a second aid site in Khan Younis, according to the Palestinian Civil Defence.

Rizeq Betaar, a Palestinian man who survived the attack at Zikim, helped carry one young victim to the hospital.

“We saw this young man lying on the ground, and we were the ones who carried him on the bicycle. We’re trying to get him to help. But there is nothing,” Betaar said. “There are no ambulances, no food, no life, no way to live any more. We’re barely hanging on.”

Another survivor, Osama Marouf, also helped to transport an old man who was shot and wounded.

“We brought this old man from Zikim. He went just to get some flour,” Marouf said. “I tried to save him on the bicycle – I don’t even want the flour any more, he’s like my father, this old man. May God give me the strength to do good. And may this hardship not last much longer.”

Israel’s military acknowledged the attack, saying it had fired “warning shots to remove an immediate threat posed to the troops” in northern Gaza. It did not, however, provide evidence or details of the alleged threat.

The military went on to dispute the high number of casualties.

‘New levels of desperation’

The UN’s World Food Programme (WFP) issued a statement that disputed the Israeli account, saying the victims were simply people “trying to access food to feed themselves and their families on the brink of starvation”.

It said the Israeli shootings happened shortly after a convoy of 25 trucks carrying food assistance crossed the Zikim point.

“Shortly after passing the final checkpoint
 the convoy encountered large crowds of civilians anxiously waiting to access desperately needed food supplies,” the agency said. “As the convoy approached, the surrounding crowd came under fire from Israeli tanks, snipers and other gunfire.”

The violence came despite assurances from Israel that operational conditions for humanitarian agencies in Gaza would improve, the WFP said, including that armed forces would not be present nor engage along convoy routes.

“Gaza’s hunger crisis has reached new levels of desperation. People are dying from lack of humanitarian assistance. Malnutrition is surging with 90,000 women and children in urgent need of treatment. Nearly one person in three is not eating for days,” the WFP warned.

“Only a massive scale-up in food aid distributions can stabilise this spiraling situation, calm anxieties and rebuild the trust within communities that more food is coming,” it added.

Gaza’s Ministry of Health echoed that warning, saying that at least 19 Palestinians died of hunger on Sunday and hundreds more suffering from malnutrition could die soon.

“We warn that hundreds of people whose bodies have wasted away are at risk of imminent death due to hunger,” a spokesperson for the ministry said.

The ministry added that at least 71 children have died of malnutrition since the war began in 2023, while 60,000 others show signs of severe undernourishment.

Al Jazeera’s Hind Khoudary, reporting from central Gaza, said that a 35-day-old baby in Gaza City and a four-month-old child in Deir el-Balah had died of malnutrition at Al-Aqsa Martyrs Hospital.

“The mother was touching her body, saying, ‘I am sorry I could not feed you,’” Khoudary said.

“Parents go to the GHF [Gaza Humanitarian Foundation] distribution sites to risk getting killed or leave their children starving. We met a mother who is giving her children water just to fill their stomachs. She can’t afford flour – and when she could, she couldn’t find it.”

‘Heading into the unknown’

In southern Gaza, Israeli forces killed at least 13 people waiting for food near a distribution point run by the United States-backed GHF.

The killings brought the number of Palestinians killed at or near GHF sites since May to nearly 1,000 people.

Ahmed Hassouna, who was trying to bring food back from the GHF aid site, said an Israeli tank “came at us from the side”.

“There was a young man with me, too – and they started firing gas at us. They killed us with the gas. We barely made it out to catch a breath, they suffocated us with the gas,” Hassouna told Al Jazeera.

The UN and humanitarian aid agencies have long denounced the GHF for its “weaponisation” of aid in Gaza and called on Israel to allow the entry of other humanitarian assistance, which has been blocked from entering the enclave.

Philippe Lazzarini, the head of the UN agency for Palestinian refugees, UNRWA, said staff in Gaza are sending desperate messages about the lack of food.

“All man-made, in total impunity. Food is available only a few kilometres away,” he wrote on X, adding that UNRWA has enough supplies at the border to feed Gaza for three months.

But Israel has been blocking aid since March 2.

The US-based Council on American-Islamic Relations (CAIR) also denounced Israel’s continuous attacks on aid seekers.

“The escalating massacres of starving Palestinian women, children and men murdered with US-supplied weapons and with the complicity of our government as they desperately search for food to feed their families is not only a human tragedy, it is also an indictment of a Western political order that has enabled this genocide through inaction and indifference,” said Nihad Awad, CAIR’s national executive director.

“Western governments cannot claim ignorance. They are watching in real time as innocent civilians are intentionally starved, forcibly displaced, and slaughtered – and are choosing to do nothing. History will long remember the Western world’s indifference to the forced starvation, ethnic cleansing and genocide in Gaza.”

Doctors in Gaza, meanwhile, said there has been a surge in people showing up at hospitals weak and malnourished, but that they do not have the resources needed to treat them.

Dr Mohammed Abu Afash, the director of the Palestinian Medical Relief Society in Gaza, told Al Jazeera that women and children are collapsing from hunger.

“We are heading into the unknown. Malnutrition among children has reached its highest levels,” he said, warning of a looming disaster if aid is not allowed in immediately.