Gazans were fleeing their homes and rushing their dead and wounded to hospitals after fresh Israeli strikes on Friday, as combat resumed between Israel and Hamas following the expiry of a week-long truce.
An agreement on extending the pause in fighting -- under which aid flows into Gaza had increased and scores of Israeli hostages were exchanged for hundreds of jailed Palestinian prisoners -- could not be reached before the 7:00 am (0500 GMT) deadline, with hostilities resuming immediately.
Smoke billowed over the southern cities of Rafah and Khan Yunis following Israeli strikes, with deaths recorded in both places, according to hospital officials and AFP journalists at the scene.
In Khan Yunis, a group of men chanted "God is greatest" as they rushed through the streets carrying a body wrapped in a white shroud.
Sitting on a bed at the city's Nasser hospital, Amal Abu Dagga wept, her beige veil covered in blood.
"I don't even know what happened to my children," she said.
A relative, Jamil Abu Dagga, told AFP the family had been at home when the bombs started falling.
"My house was destroyed, so was my neighbour's," he said from the Nasser hospital, his head bandaged.
Another member of the family, Anas Abu Dagga, 22, said the "war has returned, even more fierce".
At the hospital reception, 10-year-old Lina Hamdan said: "We were getting ready to sleep when I heard a bomb. My brothers started screaming."
In Rafah, a young man rushed a badly wounded child out of a refugee camp hit by an explosion, while others could be seen pulling a motionless person from the rubble.
Marwan al-Hams, the director of Al-Najar hospital in Rafah, where many Palestinians fled after being told by Israel to leave the north of the territory, said strikes had killed at least nine people in the city, including four children.
In the north of the Gaza Strip, the fireball from a large explosion could be seen from across the border in the Israeli city of Sderot, and an AFPTV livecam broadcast rolling clouds of grey smoke and the sounds of automatic gunfire within the first 90 minutes of the truce expiring.
Speaking from an unnamed hospital in Gaza, UNICEF spokesman James Elder said in a video posted to X, formerly Twitter, on Friday that a bomb had landed "literally 50 metres (yards) away".
"This is a war on children," he added.
Marwa Saleh, 47, fled from her home in Gaza City in the first phase of the war to seek refuge in Khan Yunis.
"My family and me are civilians, we have nothing to do with this war," she said as the bombardments restarted. "I don't want to die and I don't want to lose anyone."