The municipality spokesperson said that 80% of Gaza City’s infrastructure had been damaged over nearly two years of Israeli attacks, while the four remaining hospitals there were operating at less than 20% of their capacity due to severe shortages of medicines and supplies.

At least 1.9 million people in Gaza – or about 90% of the population – have been displaced, according to the UN.

The international body has indicated there is widespread malnutrition in Gaza, with experts backed by the organisation warning last month in a report that the “worst-case scenario” of famine is playing out in Gaza.

On Saturday, Gaza’s hospitals reported 11 more deaths from malnutrition, including a child, bringing the total number of deaths from malnutrition to 251, including 108 children, according to the Hamas-run health ministry.

Meanwhile, a Gazan woman who was evacuated to Italy for treatment while severely emaciated has died in hospital. The 20-year-old, who was identified as Marah Abu Zuhri, flew to Pisa with her mother on an overnight flight on Wednesday under a scheme established by the Italian government.

The University Hospital of Pisa said that she suffered a cardiac arrest and died on Friday, less than 48 hours after arriving. The hospital said she had suffered severe loss of weight and muscle, while Italian news agencies reported she was suffering from severe malnutrition.

Earlier this week, the UK, EU, Australia, Canada and Japan issued a statement saying “famine is unfolding in front of our eyes” and urged action to “reverse starvation”.

Last week, more than 100 organisations signed a letter that said they had been unable to to deliver a single truck of humanitarian supplies to Gaza since 2 March.

Israel has drastically curtailed the amount of aid it allows into Gaza and continues to insist there is no starvation there. It accuses UN agencies of not picking up aid at the borders and delivering it.

The civil defence agency said at least 13 of the Palestinians killed on Saturday were shot by Israeli troops as they waited for food near distribution sites in the territory. The latest figures from the UN, released on Friday, indicate that at least 1,760 Palestinians have been killed seeking food since late May, mostly by Israeli forces.

In Israel, thousands have taken to the streets in a nationwide protest demanding a deal to secure the release of hostages in Gaza. Major roads are blocked and train services have been disrupted.

In Jerusalem and Tel Aviv, many businesses were shut.

“I think it’s time to end the war. It’s time to release all of the hostages. And it’s time to help Israel recover and move towards a more stable Middle East,” Doron Wilfand, a 54-year-old tour guide, told news agency AFP at a rally in Jerusalem.

The war was triggered by Hamas’s 7 October 2023 attack on Israel, which killed about 1,200 people and saw 251 others taken hostage.

Israel’s offensive has killed more than 61,000 Palestinians, according to figures from the Hamas-run Gaza health ministry, which the UN considers reliable.