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Five people were killed while outside sites associated with the the newly-created, secretive American organization backed by Israel to feed the Gaza Strip’s population, while 40 others were killed waiting for aid in other locations across the Gaza Strip.

Dozens of people were killed in airstrikes that pounded the Strip Wednesday night and Thursday morning, including 15 people killed in strikes that hit tents in the sprawling Muwasi zone, where many displaced Palestinians are sheltering. A separate strike on a school in Gaza City sheltering displaced people also killed 15 people.

Gaza’s Health Ministry said the number of Palestinians killed in Gaza has passed 57,000, including 223 missing people who have been declared dead, since the war began on Oct. 7, 2023. The ministry doesn’t differentiate between civilians and combatants in its death count but says that more than half of the dead are women and children.

The deaths come as Israel and Hamas inch closer to a possible ceasefire that would end the 21-month war.

that Israel had agreed on terms for a 60-day ceasefire in Gaza and urged Hamas to accept the deal before conditions worsen. But Hamas’ response, which emphasized its demand that the war end, raised questions about whether the latest offer could materialize into an actual pause in fighting.

The Israeli military blames Hamas for the civilian casualties because it operates from populated areas. The military said it targeted Hamas militants and rocket launchers in northern Gaza that launched rockets toward Israel on Wednesday.

The war began when Hamas-led militants attacked southern Israel, killing 1,200 people and taking roughly 250 hostages.

The war has left the coastal Palestinian territory in ruins, with much of the urban landscape flattened in the fighting. More than 90% of Gaza’s 2.3 million population has been displaced, often multiple times. And the war has sparked a humanitarian crisis in Gaza, leaving hundreds of thousands of people hungry.