By Abeer Salman, Mohammad al Sawalhi, Eyad Kourdi and Tim Lister

(CNN) — Dozens of Palestinians were shot dead by the Israeli military near an aid distribution site in Gaza on Sunday according to Palestinian officials and eyewitnesses, with Israel’s military denying that its troops fired “within or near” the aid site.

The Palestinian health ministry, hospital officials and a half-dozen eyewitnesses said the Israeli military was responsible for the gunfire. Palestinian officials said 31 Palestinians had been killed. The Israeli military said its forces “did not fire at civilians while they were near or within” the aid site, but an Israeli military source acknowledged that Israeli forces fired toward individuals about 1 kilometer (1093 yards) away, before the aid site opened.

The incident is the latest in which Palestinians have been killed while attempting to receive aid from the Gaza Humanitarian Foundation (GHF), a controversial US-backed mechanism to distribute aid to the embattled and hungry enclave after a months-long Israeli blockade.

The GHF has been criticized by the United Nations and others, who warn it risks further displacing Palestinians and endangering civilians and last week. Previous distributions of aid at its sites have been marred by chaos and violence.

Multiple eyewitnesses told CNN they were fired upon at what is known as the “Al-Alam” roundabout approximately 800 meters (874 yards) from the site run by the GHF in southern Gaza.

The health ministry said that more than 200 casualties had reached hospitals, including dozens with serious injuries. It added that all those killed had been shot in the head or chest. The International Committee of the Red Cross said that it received “an influx of 179 cases, including women and children” at its nearby field hospital, including 21 who were declared dead upon arrival. Other dead and wounded were taken to Nasser Hospital.

“This is the highest number of weapon-wounded in a single incident since the establishment of the field hospital over a year ago,” the Red Cross said in a statement.

Thousands of Palestinians were headed toward the aid distribution site in Rafah in the pre-dawn hours of Sunday, hoping to be among the first in line to obtain aid ahead of the site’s opening, a paramedic from the Palestine Red Crescent Society (PRCS), the only medical professionals present in the area at the time, told CNN.

One medical official told CNN that it was impossible to identify who was shooting “but those areas of the distribution are all under Israeli army responsibility in regards to security. Whether they shoot or others who are working for them, it is still their responsibility.”

CNN cannot independently verify who was responsible for the shooting. Israel prevents international media from entering Gaza.

The Israel Defense Forces (IDF) said allegations that Israeli soldiers fired on Gazans near or within the aid distribution site were “false reports.” It added: “Findings from an initial inquiry indicate that the IDF did not fire at civilians while they were near or within the humanitarian aid distribution site and that reports to this effect are false.”

An Israeli military source said IDF forces did fire warning shots towards suspects approaching their position approximately a kilometer (1,100 yards) away from the aid distribution site in an incident that happened several hours before the site opened.

In a post on X, Philippe Lazzarini – executive director of UNRWA, the main United Nations agency in the Palestinian territories – said “aid distribution has become a death trap. Mass casualties including scores of injured & killed among starving civilians due to gunshots this morning. This is according to reports from international medics on ground.”

Dr. Ahmed Abu Sweid, an Australian working at the Nasser medical complex, said the victims brought in from the area of the aid hub had gunshot and shrapnel wounds. Some had gunshot wounds to the head and thorax, he said.

The Gaza Humanitarian Foundation (GHF), which runs the site, insisted: “There was no gunfire in the (distribution) center and also not in the surrounding area.”

“All aid was distributed today without incident. We have heard that these fake reports have been actively fomented by Hamas. They are untrue and fabricated.”

Later Sunday, the foundation released surveillance video showing hundreds of people running towards the distribution point at dawn. One 4-minute video, which was without sound, showed no violence or injuries but there were what appeared to be two bursts of tracer fire nearby. Other GHF videos released later showed hundreds of people carrying away boxes of food.

Witnesses told CNN of chaotic scenes as people were trampled amid what they said was random gunfire. One man said: “It’s not a humanitarian point — it’s a death trap.”

CNN video showed thousands of people streaming away from the site. Some were carrying plastic bags and empty cardboard boxes, but none appeared to have received any aid.

One man, Ghassan Eid Al-Aghan, told CNN: “We couldn’t even reach the place where the aid was being handed out.”

“The situation there is terrifying. Heavy gunfire. I won’t risk my life to go. Things can’t go on like this,” he added.

Mohammad Qdeih said people had been told the gates would open at 5:30 a.m. local time, but then there was intense gunfire.

“The amount of aid the Americans bring is tiny,” Qdieh said. “Whoever manages to push forward might get something. Those who can’t get nothing.”

“They’re sniping everyone — women, children, innocent civilians who have nothing to do with anything,” Qdieh said.

Basel Abu Alwan said he had arrived at the site on Saturday night. Instructions had been given via a drone telling people to come back at 6 a.m., he said. “No distribution happens. People move forward and fall. Gunfire is sprayed randomly at everyone,” he said.

“Whoever can grab something does. If not, they may get trampled,” he added.

Many of the civilians told CNN that they had left wherever they were staying around midnight to make the long trek to the distribution site – but most left empty-handed.

Abdul Majid Al-Zayti said that he had walked for seven hours to reach the site. “Many people didn’t get anything. The large crowds that came from Gaza City and other areas got nothing,” he said.

“I couldn’t get any aid. I’m an old man. I have hungry children. No-one in this world wants to help them.”

One man who declined to give his name said that the Gaza Humanitarian Foundation “place four or five wooden boards with aid on them and open the gates for people to storm and fight over it.”

Near the same Al-Alam junction on Monday morning, three Palestinians were shot dead and dozens wounded as they made their way to the aid distribution point, according to the Ministry of Health, which said Israeli forces opened fire as they approached the location. The IDF said that Israeli forces fired warning shots “towards several suspects who advanced toward the troops” in Rafah.

The GHF was set up amid Israeli accusations that Hamas is stealing aid in Gaza and profiting from sales, though Israel hasn’t presented any evidence publicly.

UN aid groups, such as UNRWA, typically check identification and rely on a database of registered families when distributing aid.

But the GHF is not screening Palestinians at aid distribution sites, despite Israeli officials saying that additional security measures were a core reason for the creation of the new program.

United Nations aid agencies have criticized the GHF’s aid mechanism, saying it violates humanitarian principles and raises the risks for Palestinians.

Criticism has been mounting against both Israel and the GHF after chaos broke out last week when tens of thousands of starving Palestinians arrived at two new food distribution sites.

According to Palestinian Ministry of Health figures, 11 people had been killed and dozens injured since the aid distribution sites opened last week – before Sunday’s casualties.

In a statement issued Sunday, the GHF said it would “continue scaling, with plans to build additional sites across Gaza, including in the northern region, in the weeks ahead.”

The statement added that it had provided more than 4.7 million meals in six days, including delivering 16 truckloads of food on Sunday morning, providing over 887,000 meals.

The interim executive director of GHF, John Acree, acknowledged Sunday that “the flow of humanitarian relief into Gaza remains far below what’s needed. The demand is overwhelming — and growing by the day.”

He added that GHF was “currently the only organization able to deliver food in a secure manner, but we are still operating under immense constraints and at the mercy of factors beyond our control.”

This story has been updated with additional developments.

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