RAFAH, Gaza Strip (AP) — At least 21 people were killed on Sunday as they went to receive aid from an Israeli-backed foundation in the Gaza Strip, according to a nearby hospital run by the Red Cross that received the bodies.

Officials at the hospital said another 175 people were wounded, without saying who opened fire on them. An Associated Press reporter saw dozens of people being treated at the hospital.

The Gaza Humanitarian Foundation ’s distribution of aid has been marred by chaos, and multiple witnesses have said Israeli troops fired on crowds near the delivery sites. Before Sunday, at least six people had been killed and more than 50 wounded according to local health officials.

The foundation says the private security contractors guarding its sites did not fire on the crowds, while the Israeli military has acknowledged firing warning shots.

The foundation did not immediately respond to a request for comment. In an earlier statement, it said it distributed 16 truckloads of aid early Sunday “without incident.” It dismissed what it referred to as “false reporting about deaths, mass injuries and chaos.”

There was no immediate comment from the Israeli military.

The gunfire on Sunday erupted at a roundabout near the distribution site, in an area that is controlled by Israeli forces, witnesses said.

Ibrahim Abu Saoud, an eyewitness, said Israeli forces opened fire at people moving toward the aid distribution center.

“There were many martyrs, including women,” the 40-year-old man said. “We were about 300 meters (yards) away from the military.”

Abu Saoud said he saw many people with gunshot wounds, including a young man who he said had died at the scene. “We weren’t able to help him,” he said.

Israel and the United States say the new system is aimed at preventing Hamas from siphoning off assistance. Israel has not provided any evidence of systematic diversion, and the U.N. denies it has occurred.

U.N. agencies and major aid groups have refused to work with the new system, saying it violates humanitarian principles because it allows Israel to control who receives aid and forces people to relocate to distribution sites, risking yet more mass displacement in the territory.

The U.N. system has struggled to bring in aid after Israel slightly eased its total blockade of the territory last month. Those groups say Israeli restrictions, the breakdown of law and order, and widespread looting make it extremely difficult to deliver aid to Gaza's roughly 2 million Palestinians.

Experts have warned that the territory is at risk of full-blown famine if more aid is not brought in.

The war began when Hamas-led militants stormed into southern Israel on Oct. 7, 2023, killing some 1,200 people, mostly civilians, and abducting 251. They are still holding 58 hostages, around a third of them believed to be alive, after most of the rest were released in ceasefire agreements or other deals.

Israel's military campaign has killed over 54,000 people, mostly women and children, according to Gaza's Health Ministry, which does not say how many of the dead were civilians or combatants. The offensive has destroyed vast areas of the territory, displaced around 90% of its population and left people almost completely reliant on international aid.

___

Magdy reported from Cairo.

___

Follow AP’s war coverage at https://apnews.com/hub/israel-hamas-war