Medics said 29 of those killed in Gaza City on Wednesday were brought to al-Ahli hospital, in the southern Zeitoun neighbourhood.
A video filmed overnight appeared to show four severely injured men wearing high-visibility jackets receiving treatment inside a tent there.
The Hamas-run Civil Defence agency alleged that a team of its paramedics and firefighters were “directly targeted” by an Israeli strike as they responded to a strike on nearby al-Falah school, which was being used as a shelter for displaced families.
It said the rescuers had been performing humanitarian work, wearing uniforms, and driving marked vehicles, and that the attack constituted a flagrant violation of international law.
The agency initially said seven rescuers were injured and two were in a critical condition. Later, it announced that one of them, Munther al-Dahshan, had died.
Palestinian media reported that six people were killed in the initial strike on the school. One Civil Defence member said on social media that the casualties included children, and posted a video of a severely injured boy lying on a hospital bed frame.
When asked to comment, the Israel Defense Forces (IDF) said in a statement that it “struck a Hamas terrorist” and that “steps were taken in order to mitigate harm to civilians”.
Israeli media cited the IDF as saying on Monday that about 800,000 residents had fled Gaza City since the plans for the offensive were announced in August, and that between 250,000 and 350,000 people remained.
However, the UN and its humanitarian partners said they had only monitored 397,000 people crossing into southern Gaza as of Saturday.
Many families have said they are unable to move due to high costs while others are unwilling to leave after being displaced repeatedly during the war.
Some who followed the military’s orders to evacuate have said they found no space to pitch their tents and so returned north.
The IDF’s Arabic spokesman announced on Wednesday that people in the south would no longer be able to use the al-Rashid coastal road to travel north to Gaza City. The road would remain open for those fleeing south, he said.
Gaza’s Hamas-run Government Media Office condemned the decision, which it said was “part of the ongoing policy of suffocation, siege, and genocide perpetrated by the occupation [Israel] against our Palestinian people in the strip”.