DEIR AL-BALAH, Gaza Strip — At least 31 Palestinians were fatally shot on their way to an aid distribution site in the Gaza Strip on Saturday, while Israeli airstrikes killed at least 28 Palestinians, including four children, hospital officials and witnesses said.

The deaths came after no signs of a breakthrough in ceasefire talks following two days of meetings between U.S. President Donald Trump and Israeli Prime Minister Benjamin Netanyahu. Trump had said he was closing in on an agreement between Israel and Hamas that would potentially wind down the war.

The 31 shot dead were on their way to a distribution site run by the Israeli-backed American organization Gaza Humanitarian Foundation near Rafah in southern Gaza, hospital officials and witnesses said.

The Red Cross said its field hospital saw its largest influx of dead in more than a year of operation after the shootings, and that the overwhelming majority of the more than 100 people hurt had gunshot wounds.

The airstrikes in central Gaza’s Deir al-Balah killed 13, including the four children, officials at Al-Aqsa Martyrs Hospital said.

Fifteen other Palestinians were killed in Khan Younis in the south, according to Nasser Hospital. Israel’s military did not immediately respond to a request for comment.

Intense airstrikes continued Saturday night in the area of Beit Hanoun in northern Gaza.

The 21-month war has left much of Gaza’s population of over 2 million reliant on outside aid while food security experts warn of famine. Israel blocked and then restricted aid entry after ending the latest ceasefire in March.

“All responsive individuals reported they were attempting to access food distribution sites,” the Red Cross said after the shootings near Rafah, noting the “alarming frequency and scale” of such mass casualty incidents.

Israel’s military said it fired warning shots toward people it said were behaving suspiciously to prevent them from approaching. It said it was not aware of any casualties. The GHF said no incident occurred near its sites.

Mohammed Jamal al-Sahloo, a witness, said Israel’s military had ordered them to proceed to the site when the shooting started.

Sumaya al-Sha’er’s 17-year-old son, Nasir, was killed, hospital officials said.

“He said to me, ‘Mom, you don’t have flour and today I’ll go and bring you flour, even if I die, I’ll go and get it,’ ” she said. “But he never came back home.”

Until then, she said, she had prevented the teenager from going to GHF sites because she thought it was too dangerous.

Witnesses, health officials and U.N. officials say hundreds have been killed by Israeli fire while heading toward GHF distribution points through military zones off limits to independent media. The military has acknowledged firing warning shots at Palestinians.

The GHF denies there has been violence in or around its sites. But two of its contractors told The Associated Press that their colleagues have fired live ammunition and stun grenades as Palestinians scramble for food, allegations the foundation denied.

In a separate effort, the U.N. and aid groups say they struggle to distribute humanitarian aid because of Israeli military restrictions and a breakdown of law and order that has led to widespread looting.

Hamas-led militants killed some 1,200 people in their Oct. 7, 2023, attack on Israel that sparked the war and abducted 251. Hamas still holds some 50 hostages, with at least 20 believed to remain alive.

Israel’s retaliatory offensive has killed over 57,800 Palestinians, more than half of them women and children, according to Gaza’s Health Ministry. The ministry, which is under Gaza’s Hamas-run government, doesn’t differentiate between civilians and combatants in its count. The U.N. and other international organizations see its figures as the most reliable statistics on war casualties.