Palestinians were shot dead during a food distribution on Saturday at a center run by a U.S.- and Israeli-backed group in southern Gaza, hospital officials said.

DEIR AL-BALAH, Gaza Strip (AP) — Gaza saw its deadliest day yet for aid-seekers in over 21 months of war as at least 85 Palestinians were killed while trying to reach food on Sunday, the territory’s Health Ministry said.

Twenty-one months into Israel’s war in Gaza, the enclave is gripped by escalating scenes of death and hunger, with some killed while trying to reach aid, others dying of starvation and growing condemnation of Israel’s conduct even among many of its closest allies.