An aid delivery in Gaza descended into chaos on Saturday with shots fired and a Red Crescent paramedic reporting five dead, as almost six months of Israeli bombardment has left hundreds of thousands in desperate need.

The World Health Organization warned that Gaza had just 10 "minimally functioning" hospitals for its more than two million people, with its chief Tedros Adhanom Ghebreyesus saying around 9,000 patients urgently needed treatment abroad.

UN agencies have warned repeatedly that northern Gaza is on the verge of famine and called it a man-made crisis because aid lorries are backed up on the Egypt-Gaza border awaiting long checks by Israeli officials. Israel has denied responsibility.

Two charities have organised aid deliveries by sea from Cyprus, with their second mission in just over two weeks setting sail on Saturday.

Organisers said the flotilla, which had been repeatedly delayed by bad weather, was carrying around 400 tonnes of supplies, a fraction of Gaza's needs.

The top UN court has ordered Israel to allow in aid and the UN Security Council has adopted a resolution demanding an "immediate ceasefire" but neither has affected the situation on the ground.

Israel and Hamas have been unable to agree a truce in indirect talks in Qatar, with each side blaming the other.

But Israeli Prime Minister Benjamin Netanyahu gave the go-ahead Friday for a new round of talks with negotiators expected to resume their work on Monday.

‘This must stop’

A Red Crescent paramedic at a nearby hospital said five people were killed and dozens injured by gunfire and a stampede during a rare aid distribution in north Gaza.

Palestinian medics treat a girl wounded at a building of an UNRWA vocational training centre, Gaza Strip. File/AP

Witnesses told the media shots were fired both by Gazans overseeing the aid delivery and Israeli troops nearby, and panicked lorry drivers drove quickly away, hitting people trying to get the food. The Israeli military told AFP it had "no record of the incident described".

Aid deliveries have become increasingly fraught as the needs of Gazans increase.

Foreign powers have ramped up airdrops of aid but several people have been killed by falling crates, or stampedes or drowned trying to retrieve packages from the Mediterranean.

UN agencies have said repeatedly that overland deliveries are the only way of supplying aid in the volume needed.

Palestinian Dalia al-Afifi, displaced to Deir el-Balah in central Gaza, has constructed a home from the cans received in aid packages to "make a point to the world" about the plight of the territory.

"This must stop. Our lives are not just cans," she told AFP.

The Israeli bombardment continued apace into Saturday with the health ministry in the Hamas-run Gaza Strip saying at least 82 people were killed overnight.

The Hamas press office said "civilian houses" had been hit by dozens of Israeli strikes. The Israeli military said it had struck dozens of targets including fighters and their compounds.

The war began with Hamas's October 7 attack that resulted in about 1,160 deaths in Israel, mostly civilians, according to an AFP tally of Israeli official figures.

Israel's retaliatory campaign against Hamas has killed at least 32,705 people, mostly women and children, according to the health ministry.

Agence France-Presse