New ground and air offensive comes after dozens of Palestinians seeking aid were killed in one of the deadliest incidents in months.

More than 100 charity and human rights groups say Israel’s blockade and ongoing military offensive are pushing Palestinians in the Gaza Strip toward starvation. Israeli strikes meanwhile killed another 21 people overnight and into Wednesday, according to local health officials.

Israel launched an air and ground offensive into the only Gaza city that had not seen major military operations since the war began.