Israeli tank shelling and airstrikes killed 23 Palestinians, including seven children, in Gaza on Wednesday, health officials said, the latest violence to undermine a truce in the enclave.

Among the dead was a medic who rushed to help victims of a strike in the southern city of Khan Younis and was then killed by a second attack on the same location, health officials said.

Other strikes hit Gaza City in the north, where health officials said a 5-month-old boy was killed. The attacks come three days after Israel reopened Gaza’s main border crossing with Egypt, a major step in the U.S.-backed truce.

“While we were sleeping in our house, the tank shelled us and the shells hit our house, our children were martyred - my son was martyred, my brother’s son and daughter were martyred… We have nothing to do with anything; we are peaceful people,” said Abu Mohamed Habouch, speaking at a funeral for his family.

Tents in Mawasi, a coastal area near Khan Younis, crowded with Gazans displaced by the conflict, had been ripped apart by the strikes. Nearly all of Gaza’s population of over 2 million has been forced to flee their homes.

The Israeli military said it had “launched the strikes in response to militants opening fire against Israeli troops” operating near its armistice line with Hamas. It said “an Israeli soldier was severely injured by the militant fire”, which it described as a violation of the ceasefire agreement.

A later statement said one of the Israeli strikes had targeted a senior Hamas commander.

A commander from the militant group Islamic Jihad and his 11-year-old daughter were among those killed in strikes on Wednesday, said relatives.

Hamas said Israel’s action undermined efforts to stabilise the ceasefire. In a statement, the group called for “immediate international pressure to halt violations.”

RAFAH REOPENING

Palestinian patients preparing to cross through the newly opened Rafah crossing to Egypt were told that Israel had postponed the passage of patients through the border. Since then, Palestinian health authorities said that the group of patients were on their way to the border.

The Israeli agency that controls access to Gaza, COGAT, said the Rafah crossing remained open, but it had not received necessary details from the World Health Organization to facilitate crossings. The WHO did not immediately respond to a request for comment.

An Egyptian security source told Reuters that Israel had cited security issues in the Rafah area as the reason for the temporary closure, but those had since been resolved and work had resumed at the border.

Reopening the crossing was one of the requirements under the October ceasefire that set out the first phase of U.S. President Donald Trump’s plan to stop fighting between Israel and Hamas fighters.

Sixteen patients from Gaza and 40 of their escorts crossed into Egypt on Tuesday, Gazan medics told Reuters. A Hamas police source told Reuters that at least 40 people crossed from Egypt to Gaza late on Tuesday.

On Saturday, before the Rafah reopening, Israeli strikes killed more than 30 Palestinians in Gaza. The military said it launched those strikes after gunmen emerged from a tunnel in a Gaza area under Israeli control.

SECOND PHASE OF CEASEFIRE

In January, Trump declared the start of the second phase of the ceasefire in which the sides would negotiate the shattered enclave’s future governance and reconstruction.

Key issues like the withdrawal of Israeli forces from over 50% of Gaza, which they currently occupy, and the disarmament of Hamas, remain unresolved, while the fragile ceasefire has been marked by near-daily violence.

Since the start of the ceasefire, Israeli fire has killed nearly 560 people, most of them civilians, according to Gaza health officials. Palestinian fighters have killed four Israeli soldiers in the same period, according to Israeli authorities.