DEIR AL-BALAH, Gaza Strip>> More than 46,000 Palestinians have been killed in the Israel-Hamas war, Gaza’s Health Ministry said Thursday, with no end in sight to the 15-month conflict.

The ministry said a total of 46,006 Palestinians have been killed and 109,378 wounded. It has said women and children make up more than half the fatalities but does not say how many of the dead were fighters or civilians.

The Israeli military says it has killed more than 17,000 militants, without providing evidence. It says it tries to avoid harming civilians and blames Hamas for their deaths because the militants operate in residential areas. Israel repeatedly has struck what it claims are militants hiding in shelters and hospitals, often killing women and children.

In recent weeks, Israel and Hamas have appeared to inch closer to an agreement for a ceasefire and the release of hostages. Secretary of State Antony Blinken said this week that a deal is “very close” and he hopes to complete it before handing over U.S diplomacy to the incoming Trump administration.

But he and other U.S. officials have expressed similar optimism on several occasions over the past year, only to see the indirect talks stall.

The war began when Hamas-led terrorists stormed into Israel on Oct. 7, 2023, killing some 1,200 people, mostly civilians, and abducting about 250.

Some 100 hostages are still inside Gaza. Israeli authorities believe at least a third of them were killed in the initial attack or have died in captivity.

The war has flattened large areas of Gaza and displaced about 90% of its 2.3 million people, with many forced to flee multiple times. Hundreds of thousands are packed into sprawling tent camps along the coast with limited access to food and other essentials.

Fatma Abu Awad lost six family members on Tuesday in two Israeli strikes 15 minutes apart. An Israeli strike on a vehicle killed her son, while a separate strike on a tent in Khan Younis wounded her son and killed his wife and four children.

“I swear we’ve been waiting for news about a truce every day — but there’s no truce, only news of my son and my daughter-in-law and her children being killed,” she said at a school in Khan Younis where she’s sheltering alongside many other displaced families.