Saleem Abdul Kareem walked for hours just to get a food handout Tuesday morning at a traffic circle in the southern Gaza Strip city of Khan Younis. When he arrived, he came upon a scene of carnage.

“I saw so many dead and injured; all I could think about was running,” Kareem, 32, told The New York Times in a telephone interview. “This was my second attempt to get aid. I got nothing either time, and after what I saw, I’ll never try again.”

More than 50 Palestinians were killed waiting for aid in Khan Younis on Tuesday, according to the Gaza Ministry of Health, which blamed Israel for the deaths. The Israeli military said that a crowd had gathered near a stranded aid truck in the city and that it was aware of reports that people had been wounded by Israeli fire when they approached the truck.

On Monday, the Health Ministry said, at least 20 Palestinians were killed by Israeli forces and more than 200 wounded when a crowd gathered early near an aid distribution site in southern Gaza. Israel said it was still looking into those reports.

Nearly every day, large crowds of desperate and hungry Palestinians flock to the few aid distribution points left in Gaza, waiting for hours and jostling for a place in the line to get food handouts before they run out.

Some of the aid sites began operating a few weeks ago under a controversial new Israeli-backed system run by an American-led company, the Gaza Humanitarian Foundation, which largely replaces a system overseen by the United Nations.

Israel says the aim of the new system is to provide food to civilians without it falling into the hands of Hamas militants. And the U.N. and other aid groups are also still sending some limited aid into Gaza.

International relief organizations, including the U.N., have said the amount of aid getting through is woefully inadequate, a shortage that is only increasing desperation in the enclave. They have also condemned the new system for forcing civilians to pass Israeli soldiers on the perimeter of the sites to reach the food, putting them in greater danger.

Deadly force

In recent weeks, Israeli forces have repeatedly used deadly force to control crowds on the approaches to the new aid sites, forcing many Gaza residents to choose between letting their families go hungry or risking getting shot.

“The danger is too high for me to go to these centers,” Awni Abu Hassira, 38, from Gaza City, said in a phone interview. “I don’t want to face death this way.”

In Tuesday’s episode, the Israeli military said that “a gathering was identified adjacent to an aid distribution truck that got stuck in the area of Khan Younis” near Israeli forces conducting operations. It was not immediately clear which aid group the truck was linked to.

Videos shared on social media and verified by the Times showed the aftermath of the violence Tuesday in Khan Younis, where crowds of people had gathered around the Tahlia traffic circle to wait for aid early in the day.

In one video by a local photographer, at least 20 bodies are visible on darkened ground where blood is pooling. Two of the bodies are severely mangled, and two other people have bleeding head wounds.

Other footage circulating on social media and reviewed by the Times shows people screaming and yelling as crowds run through the area.

Asked about the deadly incidents Monday and Tuesday, the Gaza Humanitarian Foundation said in a statement that its distribution sites were not involved. Other aid organizations, the statement said, “struggle to deliver aid safely” and are at risk of looting.

The Israeli statement, using the abbreviation for the Israel Defense Forces, said it was “aware of reports regarding a number of injured individuals from IDF fire following the crowd’s approach.” It said the military “regrets any harm to uninvolved individuals.” Israel also said that two of its soldiers had been killed in combat in southern Gaza in recent days.

On both Monday and Tuesday, some victims were taken to a hospital in Khan Younis.

On Monday, Naseem Hassan, a medic at a hospital in Khan Younis, described the difficulty of aiding people who were shot as they tried to collect food from a nearby aid distribution point. He said scores of Palestinian victims had been rushed to his hospital.

“People who are injured have to crawl or be carried for over a kilometer to reach us,” said Hassan, who works at Nasser Hospital. “We couldn’t reach the aid centers; ambulances can’t get there,” he said.