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At least 13 people have been killed in a blast outside Gaza City's the biggest hospital, the Hamas-run health ministry in Gaza says.
The Israeli military has confirmed it struck an ambulance that it says was being used by Hamas operatives.
"An IDF aircraft struck an ambulance that was identified by forces as being used by a Hamas terrorist cell in close proximity to their position in the battle zone,"it said in a statement.
"We emphasise that this area is a battle zone. Civilians in the area are repeatedly called upon to evacuate southwards for their own safety,"it added.
In one video, people were filmed lying in pools of blood in the road next to vehicles - some were severely injured and some were not moving.
A Hamas government statement said Israeli forces targeted
"a convoy of ambulances which was transporting the wounded"from Al-Shifa hospital Gaza City towards Rafah in the south.
Egypt's health ministry said just 17 wounded Palestinians were evacuated for treatment in Egyptian hospitals on Friday instead of the 28 originally planned because of the "events" at Al-Shifa.
"We reiterate: patients, health workers, facilities and ambulances must be protected at all times. Always,"Tedros Adhanom Ghebreyesus posted on X.
"Some people lost their legs, lost their hands, people were trying to carry injuries,"she told the Vivax Media.
"People were crying, trying to find each other."
In addition to the patients at Al-Shifa, thousands more people are sheltering from Israeli air strikes there.
Ms Owda said many were unable to find space inside the hospital and were sleeping in nearby streets,
"They are sitting outside because there is no places in the Al-Shifa. They bomb the place outside. They bomb the door. I`ve been there just before, two minutes. It could be me,"she said.
Israel began bombing Gaza after Hamas killed more than 1,400 people in Israel and kidnapped more than 240 others.
It has also launched a ground operation and on Thursday said its forces had encircled Gaza City.
Continued Israeli air strikes in the southern Gaza Strip, where Israel had told Gazans to go, as well as overcrowded conditions there have prompted some Palestinians to return to their homes in northern Gaza,
The Hamas-run health ministry in Gaza says more than 9,000 people have been killed in the Gaza Strip since 7 October.
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