Thousands of Palestinians are continuing to flee Gaza City, a day after Israel said it had begun a major ground offensive aimed at occupying the city. Amid large-scale bombing overnight, Gaza's Hamas-run health ministry said al-Ranitisi children's hospital was targeted in three separate attacks, forcing half of its patients and their families to flee. The Israeli military said it was looking into the reports. Earlier, it announced that it had struck more than 150 'terror targets' across Gaza City in two days. Israel says its aim is to defeat up to 3,000 Hamas fighters in what it describes as the group's 'last stronghold' and free its hostages.

But the offensive has drawn widespread international condemnation. The heads of more than 20 aid agencies have called on world leaders to act, saying 'the inhumanity of the situation in Gaza is unconscionable' and calling for 'urgent intervention'. For days, huge columns of Palestinians have streamed southwards from Gaza City in donkey carts, rickshaws, vehicles strapped high with belongings, and on foot. Until now, they have been forced to flee down a single coastal road to an Israel-designated 'humanitarian area' in al-Mawasi. But on Wednesday, the Israel Defense Forces (IDF) announced that it would open a second route to leave, down the central Salah al-Din road. It said the route would be open for 48 hours from 12:00 local time (10:00 BST).

Many Palestinians say they are unable to move south due to the rising costs associated with the journey. Some say renting a small truck now costs around 3,000 shekels ($900; £660), while a tent for five people sells for about 4,000 shekels. Lina al-Maghrebi, 32, a mother of three from the city's Sheikh Radwan neighbourhood, told the BBC: 'I was forced to sell my jewellery to cover the cost of displacement and a tent.' 'It took us 10 hours to reach Khan Younis, and we paid 3,500 shekels for the ride. The line of cars and trucks seemed endless.' Aid groups, UN agencies, and others say the 'humanitarian area' they are expected to move to is heavily overcrowded and insufficient to support the roughly 2 million Palestinians who are expected to cram into it.

Some Palestinians who followed the military's orders to evacuate to the zone say they found no space to pitch their tents and so returned north. The IDF said on Tuesday that around 350,000 people had fled Gaza City, while the UN put the figure at 190,000 since August. Estimates suggest at least 650,000 remain. As part of its operations, the IDF is reportedly utilizing old military vehicles loaded with explosives that have been modified to be controlled remotely. They are being driven to Hamas positions and detonated, according to Israeli media.

Meanwhile, families of the 48 remaining hostages held by Hamas - 20 of whom are believed to be alive - protested near Israeli Prime Minister Benjamin Netanyahu's residence in Jerusalem on Tuesday and Wednesday, arguing that the offensive would endanger their loved ones. The offensive has drawn widespread international condemnation, with UN human rights chief Volker Türk describing it as 'totally and utterly unacceptable' and UK Foreign Secretary Yvette Cooper calling it 'utterly reckless and appalling'. But US Secretary of State Marco Rubio appeared to offer tacit support for Israel's operation during a joint press conference with Netanyahu on Monday. He said the US preferred a negotiated end to the war, but that 'sometimes when you're dealing with a group of savages like Hamas, that's not possible'.

It came as a United Nations Commission of Inquiry concluded that Israel had committed genocide against Palestinians in Gaza. Amid dire humanitarian conditions, with famine declared in Gaza City, the UN warns that an escalation of the offensive will lead to further catastrophe for civilians.