ISRAELI forces opened fire on thousands of starving Palestinians near a United States and Israeli-controlled aid site in western Rafah today, killing at least 40 and injuring over 150. 

Palestinians accused the Israelis of targeting and blocking ambulances, which delayed medical help reaching those who needed it. 

Thousands of Palestinians were heading toward the distribution site hours before dawn. As they headed toward the site, Israeli forces ordered them to disperse and come back later, witnesses said. 

When the crowds reached the Flag Roundabout, around 1,000 yards (914 metres) away, Israeli forces opened fire, the witnesses said.

“There was fire from all directions, from naval warships, from tanks and drones,” said Amr Abu Teiba, who was in the crowd.

Mr Teiba said he saw at least 10 bodies with gunshot wounds and several other wounded people, including women. People used carts to ferry the dead and wounded to the field hospital.

“The scene was horrible,” he said.

Ibrahim Abu Saoud, another eyewitness, provided a nearly identical account. He said the military fired from about 300 yards (274 meters) away.

Mr Saoud said he saw many people with gunshot wounds, including a young man who he said had died at the scene. “We weren't able to help him,” he said.

Mohammed Abu Teaima said he saw Israeli forces open fire and kill his cousin and another woman as they were heading toward the distribution site. He said his cousin was shot in his chest and died at the scene. 

Sameh Hamuda, a displaced resident from northern Gaza’s Beit Lahiya city, said he had walked more than 20 miles from Gaza City and spent the night with relatives in a tent near Rafah before heading to the aid centre at dawn to wait among a crowd of people.

He explained soon after aid began to be distributed that “quadcopter drones opened fire on the people, and tanks started shooting heavily. Several people were killed right in front of me.

“I ran and survived. Death follows you as long as you’re in Gaza.”

Abdullah Barbakh described a scene of “overcrowding, chaos and screaming.”

“The army opened fire from drones and tanks. Chaos broke out, and the area was filled with martyrs and wounded. I don’t understand why they call people to the aid centres and then open fire on them,” he said. “What are we supposed to do?”

Mr Barbakh said he witnessed many people injured from Israeli fire, including his brother-in-law.

Eyewitnesses also reported seeing crowds of people returning from the distribution point. Some were carrying boxes of aid but most appeared to be coming back empty-handed.

The Israelis released a brief statement saying it was “currently unaware of injuries caused by [Israeli military] fire within the humanitarian aid distribution site. The matter is still under review.”

The Gaza Humanitarian Foundation, brought in by the US and the Israelis to co-ordinate aid distribution, claimed in a statement that it had delivered aid “without incident” on Sunday and has denied previous accounts of chaos and gunfire around its sites, which are in Israeli military zones where independent access is limited.

The foundation dismissed what it referred to as “false reporting about deaths, mass injuries and chaos.”

Communist Party international secretary Kevan Nelson said: “As negotiations continue on a hostage exchange, the Israeli killing machine continues unchallenged by its Western sponsors.

“The refusal of the US and Israel to countenance a permanent end to the war reveals an agenda to ethnically cleanse Palestinians from the Gaza Strip.”

There was also condemnation from US activists.

Eugene Puryear, an organiser with the Party for Socialism and Liberation, told the Morning Star: “Israeli barbarism is on full display with the most recent attacks on Palestinians seeking desperately needed food. 

“That this took place at an aid distribution site set-up by Israel itself further reveals that the idea of a ‘safe humanitarian zone’ is a complete sham.”

Mr Puryear accused the Israelis of engaging in “a cruel cover designed to appease Western governments worried about how the aid blockade they have done nothing to stop is deepening their complicity with crimes against humanity.

“Israel is using every possible method to ethnically cleanse Palestinians and steal their land.”

He added: “In the US and Britain we must continue to organise against our governments facilitation of genocide. We cannot let up on our demands for Palestinian liberation.”

Executive editor of Black Agenda Reports Margaret Kimberley said: “The leaders of the collective West cannot be absolved with their half-hearted expressions of concern. 

“Israel could not carry out its war crimes without their military and financial support.”

Bassam Zaqout, director of the Palestinian Medical Relief Society, said: “People walk for miles from early morning, trying to reach the limited aid points, now just four across Gaza and all surrounded by Israeli soldiers. 

“When they sense the crowds grow and are not controllable, soldiers open fire on those waiting for supplies.” 

The Popular Front for the Liberation of Palestine (PFLP) describes the Israeli massacre of Palestinians at aid sites as “a genocide with international complicity and American participation.”

“What happened constitutes a full-fledged war crime,” and the aid distribution points were “death traps.”

“We demand urgent international and Arab intervention to stop this ongoing massacre and impose strict accountability mechanisms on the criminal occupation, in addition to immediately breaking the siege,” the PFLP said.

Meanwhile, a senior Hamas official said on Saturday that the organisation was seeking amendments to the latest US ceasefire proposal for Gaza.

But US envoy Steve Witkoff called the Hamas response “totally unacceptable.”

The Hamas official, speaking on condition of anonymity, said proposed amendments focused on “the US guarantees, the timing of hostage release, the delivery of aid and the withdrawal of Israeli forces.” 

A separate Hamas statement said the proposal aims for a permanent ceasefire, a comprehensive Israeli withdrawal from Gaza and an ensured flow of aid. 

It said 10 living hostages and the bodies of 18 others would be released “in exchange for an agreed-upon number of Palestinian prisoners.”

Some 58 hostages remain and Israel believes 35 are dead.

But Mr Witkoff on social media instead described a 60-day ceasefire deal that would free half the living hostages in Gaza and return half of those who have died. 

He urged Hamas to accept the framework proposal as the basis for talks that he said could begin next week.

Israeli officials have approved the US proposal for a temporary ceasefire. 

A top Hamas official, Bassem Naim, accused Israel of disagreeing with agreed-upon provisions and alleged a “complete bias toward the other side" that he said violates the fairness of mediation.