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Israel's top ally the United States said it began air-dropping aid into war-ravaged Gaza on Saturday, as the Palestinian territory's health ministry reported more than a dozen child malnutrition deaths.

The start of the US relief operation came hours after President Joe Biden, who has pushed Israel to allow more aid in, announced the move and spoke of the "need to do more" after nearly five months of devastating conflict.

It also comes as negotiations continue for a ceasefire between Israel and Hamas in the Gaza Strip, which has been under siege since October 7.

"We conducted a combined humanitarian assistance airdrop into Gaza" involving three US Air Force C-130 transport planes to provide "relief to civilians affected by the ongoing conflict," a US military official told AFP on condition of anonymity.

US Central Command, in a post on social media platform X, said the operation was conducted together with Jordan and saw planes drop "over 38,000 meals along the coastline of Gaza allowing for civilian access to the critical aid".

The dire humanitarian situation in Gaza has led to the deaths of at least 13 children from "malnutrition and dehydration" in recent days, according to Gaza's health ministry.

In an incident that has thrown a spotlight on the crisis, more than 100 Palestinians were killed before dawn on Thursday in a chaotic rush for aid from a convoy of trucks in Gaza City.

The Gaza health ministry said Israeli forces shot them, but the Israeli army insisted most died in a stampede or crush without providing any evidence for its claim.

A United Nations team that visited the city's Al-Shifa Hospital reported seeing "a large number" of gunshot wounds among Palestinians in the aftermath of the aid truck incident.

The health ministry said 116 people were killed and more than 750 wounded in the incident, which drew widespread international condemnation.

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'Famine almost inevitable'

The European Union's foreign policy chief Josep Borrell said the shooting "against civilians trying to access foodstuff is unjustifiable". He joined calls for an "impartial international investigation on this tragic event".

British foreign minister David Cameron said Israel had "an obligation to ensure that significantly more humanitarian aid reaches" Gazans.

On Friday a UN team visited some of the wounded from the aid incident, in Gaza City's Al-Shifa Hospital, and saw a "large number of gunshot wounds", UN chief Antonio Guterres's spokesman said.

The hospital received 70 of the dead, and around 200 wounded were still there during the team's visit, spokesman Stephane Dujarric said.

Not a teaspoon of sugar': As Gaza starves, Israeli protesters are blocking vital aid ⬇

— °®Âþµº (@The_NewArab)

Hossam Abu Safiya, director of Gaza City's Kamal Adwan Hospital, said all the casualties it admitted were hit by "bullets and shrapnel from occupation forces".

Gaza has faced dwindling supplies of humanitarian relief across its land borders, which aid groups blame at least in part on Israel - the recipient of billions of dollars in US military aid.

Jens Laerke, spokesman for the UN humanitarian office OCHA, said on Friday that "a famine is almost inevitable" in Gaza unless things change.

Laerke cited the near-total closure of commercial food imports, the "trickle of trucks" coming in with food aid, and the "massive access constraints" to moving around inside Gaza.

The United Nations has spoken of particular problems accessing northern Gaza, where residents have been reduced to eating animal fodder.

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'Everyone is suffering'

Jordan first announced an aid airdrop in November and has carried out multiple missions since then, some with the cooperation of European countries, including Britain, France and the Netherlands. Egypt and the United Arab Emirates have also begun working together on airdrops.

AFPTV images showed people running and pedalling fast on bicycles past bomb-damaged buildings on a rutted dirt road to reach aid floating down to Gaza City.

Hisham Abu Eid, 28, of Gaza City's Zeitun area, said he got two bags of flour from an aid distribution and gave one to his neighbours.

Israeli assault has crippled Gaza's healthcare system, leaving 1,100 kidney patients at risk. And when patients have no access to dialysis, it can result in death within days or weeks ⤵

— °®Âþµº (@The_NewArab)

"Everyone is suffering from famine. Aid that is getting into Gaza is rare and not enough for even a small number of people. Famine is killing people," Abu Eid said.

The International Rescue Committee said the very fact airdrops were "being considered is testament to the serious access challenges".

The group said parachuting aid mostly distracts "time and effort from proven solutions to help at scale".

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Truce talks

The aid convoy deaths helped push the number of Palestinians killed in Gaza to 30,320, mostly women and children, according to Gaza's health ministry. Israel's unprecedented bombardment has also destroyed much of the enclave.

The war began on October 7 with a surprise Hamas attack in southern Israel that resulted in the deaths of about 1,160 people, Israeli figures show. Hamas says its attack came in response to decades of Israeli aggression and the blockade of Gaza.

Biden's administration has been working with mediators from Qatar and Egypt to try to secure a truce between Israel and Hamas.

A Hamas delegation was expected in Cairo Saturday for talks, a source close to the group told AFP, the latest move in a flurry of diplomacy aiming for a truce before Ramadan, the Muslim fasting month which begins on March 10 or 11.

An AFP journalist reported air strikes and tank shelling during the night on the southern cities of Rafah and Khan Younis.

The Gaza health ministry said at least 11 people were killed and "about 50 others injured" in Israeli bombardment that hit a makeshift displacement camp near a Rafah hospital.

As mediators continue pushing for a deal that may include more aid into Gaza and the release of hostages, the Hamas source said the group would submit its "official answer" to a proposal that resulted from recent talks in Paris.

Israeli Prime Minister Benjamin Netanyahu is under domestic pressure to bring home the 130 hostages that Israel says remain in Gaza after their capture on October 7, a figure including 31 presumed dead. Hamas on Friday said an additional seven hostages were killed in Israeli strikes.