Israel's army pushed Sunday with its campaign in southern Gaza to destroy Hamas as prospects dimmed for a ceasefire in the more than four-month-old war.
A total of 127 people died in 24 hours, Hamas-run Gaza's health ministry said, as the main battlefront edged closer to far-southern Rafah, where 1.4mn Palestinians live in crowded shelters and tent camps.
Fighting, fuel shortages and Israeli raids have put the Gaza Strip's second-largest hospital completely out of service.
The Nasser Hospital in the southern city of Khan Younis went out of action early Sunday.
Israel's top ally the United States signalled it would veto the latest push for a UN Security Council resolution demanding an immediate ceasefire, as Washington instead favours a temporary truce and hostage release deal.
And mediator Qatar acknowledged that separate ceasefire talks had also hit an impasse after Israeli Prime Minister Benjamin Netanyahu rejected some Hamas demands as "ludicrous".
Netanyahu vowed Saturday the ground invasion of Rafah would go ahead, arguing that failing to launch it would mean to "lose the war".
The military says it is working to move civilians from the area to minimise casualties, but has not revealed exact details of its evacuation plan.
Latest strikes and fighting killed at least 10 people in Rafah and in central Gaza's Deir al-Balah overnight.
Brazilian President Luiz Inacio Lula da Silva accused Israel of committing "genocide" in Gaza and compared its actions to Adolf Hitler's campaign to exterminate Jews.
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