GAZA CITY, Palestinian Territories: Gaza’s civil defense agency said Israeli strikes and gunfire killed at least 18 Palestinians on Sunday, including seven people shot dead while waiting to collect food aid.

Civil defense spokesman Mahmud Bassal said that seven people were killed in an Israeli drone strike that hit a hospital courtyard in Gaza City, in the territory’s north.

Witnesses said the victims were members of a Hamas unit, which a source from the Palestinian militant group described as responsible for distributing aid and “fighting thieves.”

There was no comment from the Israeli military, which is preparing a broader offensive in Gaza City and has sent ground forces to the city’s Zeitun neighborhood in recent days.

After more than 22 months of war, UN-backed experts have warned of widespread famine unfolding in Gaza, where Israel has drastically curtailed the amount of humanitarian aid it allows in and convoys have been repeatedly looted.