At least 11 Palestinians were killed when an Israeli airstrike hit a tent in Rafah in the Gaza Strip, the Gaza health ministry said according to Reuters, in an area where people are seeking sanctuary from Israel’s devastating offensive.

The Gaza health ministry said another 50 people were wounded in the strike next to a hospital in the Tel Al-Sultan area of Rafah. One of the dead was a medic at the hospital. The Israeli military did not immediately respond to a request for comment.

“The strike hit one tent, where people took shelter, directly, shrapnel came inside the hospital where me and friends were sitting, we survived by a miracle,” a witness told Reuters by phone from the area, declining to be identified.

The Israeli military said its forces killed eight Palestinian fighters in Khan Younis, around 20 fighters in the central Gaza Strip and three more in Rimal, near Gaza City.

Three people searching for food in farmland in the northern Gaza Strip area of Beit Hanoun were killed by Israeli strikes, residents and medics said. The Israeli military did not immediately respond to a request for comment.

Thirteen children have died at the Kamal Adwan Hospital in northern Gaza in the last three days from dehydration and malnutrition, according to the Gaza Ministry of Health.

Doctors at the hospital said more were at risk of dying. “When a child is supposed to eat three meals a day and he only eats one, he obviously suffers from malnutrition, and all the diseases that come because of it,” said Doctor Imad Dardonah.