A hospital was shelled, killing and injuring staff and patients, and up to 28 members of one family died in an air strike as Gaza endured another day of relentless bloodshed on Monday.
As heavy shelling and fighting on the ground continued, John Kerry, the US secretary of state, arrived in Egypt to seek a ceasefire that Barack Obama declared was needed immediately: "We don't want to see any more civilians killed," the US president said.
Kerry had been authorised to do "everything he can to help facilitate a cessation of hostilities", said Obama. The remarks were a sign that international diplomacy had been galvanised by weekend carnage in Shujai'iya.
Kerry is to meet key players in the region and on Tuesday held talks with the UN secretary general, Ban Ki-moon. The UN security council has called for an immediate ceasefire.
Kerry pledged that the US would provide $47m (£28m) in humanitarian aid to help Palestinians. He said: "Only Hamas now needs to make the decision to spare innocent civilians from this violence."
Israel was undertaking an "appropriate and legitimate effort" to defend itself but the consequences were of deep concern, Kerry said.
In Deir al-Balah in central Gaza, al-Aqsa hospital became the third to be struck in the 14-day conflict when three shells slammed into the intensive care unit, surgical and administrative areas. Five people were killed and 70 wounded, including about 30 medics, according to Gaza health officials. Ambulances tried to evacuate patients but were forced to turn back by continued shelling. Israel has claimed that Hamas hides weapons in hospitals.
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