When the onetime director of a Gaza Strip hospital was killed by an Israeli airstrike, he joined a growing list of prominent Palestinian doctors who have died during 21 months of war that has devastated the territory’s health system.

Israel’s military did not immediately comment on the strikes. Five people were killed while outside sites associated with the Gaza Humanitarian Foundation, the newly-created, secretive American organization backed by Israel to feed the Gaza Strip’s population, while 40 others were killed waiting for aid in other locations across the Gaza Strip.

An Israeli strike hit Palestinians near a medical centre in Gaza on Thursday, killing 16 including children and wounding more people, local health authorities said, as ceasefire talks dragged on with no result expected soon.