An Israeli strike on a school where displaced people were sheltering in the central Gaza Strip killed at least 16 people on Thursday, Palestinian medical officials said.

Another 32 people were wounded in the strike in the built-up Nuseirat refugee camp, according to the Awda Hospital, which received the casualties.

There was no immediate comment from the Israeli military.

Israel has carried out several strikes on schools-turned-shelters in recent months, saying it precisely targets Hamas militants hiding out among civilians. The strikes often kill women and children.

The war began when Hamas-led militants stormed into southern Israel on Oct. 7, 2023, killing some 1,200 people, mostly civilians, and abducting another 250. Around 100 hostages are still inside Gaza, a third of whom are believed to be dead.

Israel’s retaliatory offensive has killed over 42,000 Palestinians, according to Gaza’s Health Ministry, which does not say how many were combatants but says women and children make up more than half the fatalities. The Israeli military says it has killed over 17,000 fighters, without providing evidence.

The war has displaced around 90% of Gaza’s population of 2.3 million, often multiple times. Hundreds of thousands of people are crammed into tent camps along the coast after entire neighborhoods in many areas were pounded to rubble.

Months of cease-fire negotiations brokered by the United States, Egypt and Qatar sputtered to a halt over the summer. The war has meanwhile expanded to Lebanon, where Israel launched a ground invasion more than three weeks ago after trading fire with the Hezbollah militant group for much of the past year.