Israeli strikes killed 19 people in Gaza on Sunday, including six children, Palestinian health authorities said, ahead of a visit to the region by U.S. Secretary of State Antony Blinken to try to push forward ceasefire talks.

The children and their mother were killed in an Israeli airstrike on a house in the central town of Deir Al-Balah, health officials said. There was no immediate comment from the Israeli military.

The Israeli military said it destroyed rocket launchers used to hit Israel from the southern city of Khan Younis, the scene of intense fighting in recent weeks, and killed 20 Palestinian fighters.

Diplomatic efforts to halt the Israel-Hamas conflict and secure a deal to return hostages held in Gaza have intensified in recent days. Talks mediated by the U.S., Egypt and Qatar are set to continue this week in Cairo, following a two-day meeting in Doha last week.

Blinken is making his 10th trip to the region since the war began days after the United States put forward bridging proposals that the mediating countries believe would close gaps between the warring parties.

There has been increased urgency to reach a ceasefire deal amid fears of a regional escalation. Iran has threatened to retaliate against Israel after the assassination of Hamas leader Ismail Haniyeh in Tehran on July 31.

Ten months after the war began, Palestinians in Gaza are living in constant desperation to find a safe place.

“There is nothing left to us but the sea,” said Tamer Al-Burai, who lives in Deir Al-Balah with several extended family members.

“We are tired of displacement. People are being pushed into narrow areas in Deir Al-Balah and Al-Mawasi, which have become pressure cookers,” Burai told Reuters via a chat app, adding that tanks were just 1.5 km (0.9 miles) away.

“No one knows where to go if the tanks keep coming.”

On Friday, the military ordered the evacuation of areas north of Khan Younis and east of Deir Al-Balah where hundreds of thousands of people displaced by the fighting had been sheltering in dire conditions.

The United Nations Office for the Coordination of Humanitarian Affairs said Friday’s orders, which included other enclave areas outside the humanitarian zones, had reduced the size of the “humanitarian area” designated as safe by Israeli forces to about 11% of the total area of the Gaza Strip.

Blinken Trip

In Israel, Blinken is expected to meet with Israeli Prime Minister and other senior officials. Netanyahu’s office said in a statement on Saturday there was “cautious optimism” a deal could be reached and U.S. officials have also been positive, while cautioning there was still work to be done.

However Hamas said optimistic U.S. comments were “deceptive” and accused Netanyahu of making new conditions in an attempt to “blow up” the negotiation.

Hamas wants a ceasefire deal to end the war, while Israel wants a temporary pause. Hamas official Osama Hamdan told Qatar’s Al Jazeera TV English on Saturday that Israel wants the right to come back to the fight even if they agreed to a prisoner exchange. “They want to have the right to attack Gaza whenever they want.”

The war erupted on Oct. 7 when Hamas fighters rampaged into Israel, killing around 1,200 people and seizing around 250 hostages, according to Israeli tallies.

Israel’s subsequent military campaign has killed more than 40,000 Palestinians, mostly civilians, according to Palestinian health authorities, and reduced much of Gaza to rubble. Israel says it has killed 17,000 Hamas fighters.