RAFAH, Gaza Strip — Israeli military strikes killed multiple civilians Saturday at a U.N. shelter and hospital in the main combat zone in the Gaza Strip as the assault intensified on the besieged enclave’s Hamas rulers, while the United States and Arab partners disagreed on the need for an immediate cease-fire.

Large columns of smoke rose from Gaza as Israel’s military said it had encircled Gaza City, the target of its offensive to crush Hamas.

U.S. Secretary of State Antony Blinken met with Arab foreign ministers in Jordan a day after talks in Israel with Prime Minister Benjamin Netanyahu, who insisted there could be no temporary cease-fire until all hostages held by Hamas are released.

Jordan’s Foreign Minister Ayman Safadi said Arab countries seek an immediate cease-fire. “The whole region is sinking in a sea of hatred that will define generations to come,” Safadi said.

Blinken, however, said that “it is our view now that a cease-fire would simply leave Hamas in place, able to regroup and repeat what it did on Oct. 7.” He said the U.S. believes that humanitarian pauses can be a “critical mechanism in protecting civilians, in getting aid in and getting foreign nationals out, while still enabling Israel to achieve its objective, the defeat of Hamas.”

Egyptian officials said they and Qatar were proposing humanitarian pauses for six to 12 hours daily to allow aid in and casualties to be evacuated. They were also asking for Israel to release a number of women and elderly prisoners in exchange for hostages held by Hamas, suggestions Israel seems unlikely to accept. They spoke on condition of anonymity because they were not authorized to brief the press on the discussions.

On Saturday, Israel offered a three-hour window for trapped residents to flee south, but as the window closed, there was no immediate information on how many fled. The Israeli military asserted that Hamas “exploited” the window to move south and attack its forces. There was no immediate Hamas comment on that claim, which was impossible to verify.

Israel has repeatedly demanded that northern Gaza’s 1.1 million residents flee south as it escalates bombardment of the north. However, some of those traveling south were killed in recent days, and Israel has continued bombing in the south, saying it is striking Hamas targets.

With wide swaths of residential neighborhoods leveled in airstrikes, most of northern Gaza’s remaining residents, estimated at around 300,000, have sought shelter in U.N.-run schools and in hospitals where they hope they’ll be safe. But deadly Israeli strikes have also repeatedly hit and damaged those shelters. The U.N. agency for Palestinian refugees has said it has lost contact with many in the north.

On Saturday, two strikes hit a U.N. school-turned-shelter sheltering thousands just north of Gaza City, killing several people in tents in the schoolyard and women who were baking bread inside the building, according to the U.N. agency.

Initial reports indicated that 20 people were killed, but the agency has not yet been able to verify the figure, said spokeswoman Juliette Touma.

The Health Ministry in Gaza reported that 15 people were killed at the school and another 70 wounded.

Also Saturday, two people were killed in a strike by the gate of Nasser Hospital in Gaza City, according to Medhat Abbas, Health Ministry spokesman.

The World Health Organization on Saturday called attacks on health care in Gaza “unacceptable.”

About 1.5 million people in Gaza, or 70% of the population, have fled their homes, according to the U.N.

With food, water, and the fuel needed for generators that power hospitals and other facilities running out, U.N. Secretary-General Antonio Guterres late Friday urged an immediate cease-fire to allow aid in, calling the humanitarian situation in Gaza “horrific.” He also said civilians must not be used as human shields and called upon Hamas to release all of the roughly 240 hostages it has.

Incoming aid trucks in recent days have contained far more body bags than canned food, said Wael Abu Omar, a spokesperson for the Rafah crossing, Gaza’s only portal to the outside world.

The family home of Hamas’ exiled leader Ismail Haniyeh, in the Shati refugee camp on the northern edge of Gaza City, was hit Saturday morning by an airstrike, according to the Hamas-run media office in Gaza. It had no immediate details on damage or casualties.

Another strike hit near the entrance to the emergency ward of Al-Quds Hospital in Gaza City on Saturday afternoon, injuring at least 21, the Palestinian Red Crescent said.

In the town of Khan Younis in southern Gaza, an airstrike early Saturday destroyed the home of a family, with first responders pulling three bodies and six injured people from the rubble.

Among those killed was a child, according to an Associated Press cameraman at the scene.

Raed Mattar, who was sheltering in a school in Khan Younis after fleeing the north, said he regularly heard explosions.

“People never sleep,” he said. “The sound of explosions never stops.”

The Israeli military said ground forces were also now operating in the south, with an armored and engineering corps working to remove booby traps from buildings.

Anger over the civilian deaths in Gaza sparked large demonstrations in Paris, London, Pakistan, and elsewhere. “Against apartheid, free Palestinians,” a banner in Rome read.

Skirmishes along Israel’s northern border continued Saturday as the Israeli military said it had struck militant cells in Lebanon trying to fire at Israel, as well as an observation post for Hezbollah, an ally of Hamas.

Throughout the war, Israel and Hezbollah have traded fire almost daily along the Lebanese border, raising fears of a new front opening there.

After touring Israel’s northern border, Minister of Defense Yoav Gallant said “we are not interested in a northern front, but we are prepared for any task. The Air Force is preserving most of its might for the Lebanon front,” according to a video statement released by his office Saturday.

DIPLOMACY

On Friday in Tel Aviv, on his third trip to Israel since the war began on Oct. 7, Blinken pushed President Joe Biden’s calls for a brief halt in the fighting to address the worsening humanitarian crisis. But Netanyahu said there could be no humanitarian pause until Hamas releases all the hostages it holds.

On Saturday, Blinken held meetings in Amman with diplomats from Jordan, Egypt, Saudi Arabia, Qatar, the United Arab Emirates, and the Palestinian Authority, who remain angry and deeply suspicious of Israel.

Senior Hamas official Osama Hamdan told reporters in Beirut that Blinken “should stop the aggression and should not come up with ideas that cannot be implemented.”

There was consensus among Arab governments involved in discussions with the U.S. to resist “any talks” on the postwar period in Gaza before establishing a cease-fire and allowing the delivery of more humanitarian aid and fuel to Gaza, according to the Egyptian officials.

CASUALTIES RISING

More than 9,400 Palestinians have been killed in Gaza, including more than 3,900 Palestinian children, the Gaza Health Ministry said, without providing a breakdown between civilians and fighters.

More than 1,400 people have died on the Israeli side, mainly civilians killed during Hamas’ initial attack.

Twenty-four Israeli soldiers have been killed in Gaza since the start of the ground operation.

The overall toll is likely to rise dramatically as the assault on densely built-up Gaza City continues.

More than 386 Palestinian dual nationals and wounded exited Gaza into Egypt on Friday, according to Wael Abou Omar, the Hamas spokesperson for the Rafah border crossing. That brings the total who have gotten out since Wednesday to 1,115.

Matthew Lee in Amman, Jordan, Julia Frankel and Isabel DeBre in Jerusalem and Eric Tucker in Washington contributed to this story.

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