DEIR AL-BALAH, Gaza Strip — Israeli forces and drones opened fire toward hundreds of Palestinians waiting for aid in separate incidents in southern and central Gaza early Tuesday, killing at least 44, witnesses and hospitals said, as health authorities announced the number of Palestinians killed in the war has risen above 56,000.

Palestinian witnesses and health officials say Israeli forces have repeatedly opened fire on crowds heading toward desperately needed food, killing hundreds in recent weeks. The military says it has fired warning shots at people it said approached its forces in a suspicious manner.

In central Gaza, three witnesses told The Associated Press that Israeli forces opened fire as people advanced east toward aid trucks south of Wadi Gaza.

“It was a massacre,” said Ahmed Halawa. He said tanks and drones fired at people, “even as we were fleeing. Many people were either martyred or wounded.”

Hossam Abu Shahada said drones were flying over the area, watching the crowds, then there was gunfire from tanks and drones as people were moving eastward. He described a “chaotic and bloody” scene as people tried to escape.

He said he saw at least three people lying motionless and many others wounded.

Israel’s military said it was reviewing the incident, which took place near the Netzarim corridor, a road that separates northern and southern Gaza.

The Awda hospital in the urban Nuseirat refugee camp, which received the victims, confirmed 25 deaths and said 146 others were wounded. It said 62 were in critical condition and transferred to other hospitals.

In the central town of Deir al-Balah, the Al-Aqsa Martyrs hospital said it received the bodies of six people from the same incident.

In the southernmost city of Rafah, witnesses said Israeli troops opened fire as crowds tried to reach a food distribution site run by the Gaza Humanitarian Foundation. At least 19 were killed and 50 others wounded, according to Nasser hospital and Gaza’s Health Ministry.

The new distribution sites run by an American contractor, with U.S. and Israeli government support, have been plagued by scenes of violence and chaos since opening last month. The GHF sites are in Israeli military zones where independent media have no access.

The Trump administration has authorized providing $30 million to the GHF, a U.S. official said Tuesday.