GAZA, Sept. 13 (Xinhua) -- At least 45 Palestinian civilians, including 29 from Gaza City, were killed Saturday by Israeli gunfire and shelling in various parts of the Gaza Strip, the official WAFA news agency quoted medical sources as reporting.

Meanwhile, Palestinian officials reported widespread destruction in residential areas, a rising death toll and mounting pressure on hospitals as the Israeli military expanded its operations in Gaza City, warning residents to leave.

Gaza's Civil Defense agency accused Israel of targeting schools sheltering displaced people and crowded residential buildings, killing dozens and wounding hundreds. In a statement, it said the army was seeking to empty the city through "comprehensive destruction."

Also in the day, the Hamas-run Gaza government media office said in a statement that since the start of its ground offensive on Aug. 11, the Israeli army has destroyed more than 1,600 residential buildings and 13,000 tents for displaced families, forcing over 350,000 people to flee from eastern Gaza City to central and western areas.

It said major neighborhoods, including Shuja'iyya, Zaytoun, Tuffah, Rimal, and Sheikh Radwan, were facing systematic destruction, which it called a violation of international humanitarian law.

Israeli army spokesman Avichay Adraee stated on Saturday that more than 250,000 residents had left Gaza City "for their safety." He urged civilians to use Al-Rashid Street to head to the "humanitarian zone" in Al-Mawasi in southern Gaza or to "empty areas" in central Gaza. He said Gaza City has become "a dangerous combat zone" and that the army is determined to defeat Hamas there.

Ahmed al-Farra, head of the pediatric department at Nasser Medical Complex in Gaza, warned Saturday of severe shortages of medical equipment and therapeutic foods. He told Xinhua that the number of malnourished children has exceeded the hospital's capacity and that deaths are expected to rise.

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) described the situation in Gaza City as "catastrophic."

"Airstrikes are ongoing everywhere, including without prior warning. Almost every moment, a home is bombed. It is terrifying," UNRWA said in a statement. "People have nowhere to go. ... There is no safe place. This war must stop."

The war began Oct. 7, 2023, when Hamas fighters rampaged through southern Israel, killing 1,200 people and taking around 250 hostages, according to Israeli tallies. Israel's subsequent campaign in Gaza has killed nearly 65,000 Palestinians, according to the enclave's health authorities. ■