The Qatari-mediated evacuation deal – reached between Egypt, Israel and Hamas, and in coordination with the United States – followed yet more bloodshed, including an Israeli air strike on Tuesday that killed at least 47 in a refugee camp, according to Palestinian health officials.

Israel said it hit a tunnel complex at Jabalia camp, killing “many Hamas terrorists”, including local battalion commander Ibrahim Biari.

03:21

Dozens killed as Gaza’s largest refugee camp hit by Israeli air strike targeting ‘Hamas terrorists’

Dozens killed as Gaza’s largest refugee camp hit by Israeli air strike targeting ‘Hamas terrorists’

The camp, in the northern Gaza Strip, with more than 100,000 inhabitants, is little different from a city, with tall buildings and infrastructure.

A large explosion tore facades off nearby buildings and left a deep, debris-littered crater. AFP witnessed at least 47 bodies being recovered.

The strike sparked condemnation from Qatar, Saudi Arabia and also further afield in Bolivia, which cut off diplomatic ties with Israel in protest.

Hamas said seven hostages had died in the bombing, a claim impossible to verify. On Wednesday, Israeli air strikes hit apartment buildings in the same refugee camp, Palestinian officials said.

Al-Jazeera television aired footage of devastation and of several wounded people, including children, being brought to a nearby hospital.

Gaza’s Hamas-run health ministry said there were “dozens of martyrs and injured in a bombing by the occupation planes”.

Images obtained by AFP showed major damage and rescuers said “whole families” were killed, but casualty details could not be immediately confirmed.

Meanwhile, the first group of evacuees began arriving in Egypt, an official told AFP on condition of anonymity, as television images showed parents with pushchairs and elderly people clambering off a bus.

“We’ve endured enough humiliation,” said Gaza resident Rafik al-Hilou, accompanying relatives including children aged one and four hoping to cross into Egypt.

“We lack the most basic human needs. No internet, no phones, no means of communication, not even water. For the past four days, we haven’t been able to feed this child a piece of bread. What are you waiting for?”

Hundreds assembled around the gates at the Rafah border crossing, controlled by Cairo.

AFP reporters saw 40 ambulances streaming through the crossing, as crowds of foreign and dual national families gathered, hoping to leave the catastrophic conditions of Gaza behind them.

In the transit area, exit formalities were completed and Gaza patients were handed over to Egyptian medics. Egyptian ambulances did not enter the Gaza Strip themselves.

Gaza resident Amen Al Aqlouk said three of his children had died in Israel’s bombardments and added that “when the border opens, everybody will leave and emigrate. We encounter death everyday, 24 hours a day”.

Jordanian citizen Saleh Hussein said she was told in the middle of the night that she was on the evacuation list.

“We’ve faced many problems … the least of which were the shortage of water and the power outage. There were bigger problems such as the bombardment. We were afraid. Many families were martyred,” she said.

Whole families rushed through the heavily fortified crossing. Egypt was expected to admit at least 400 foreign passport holders and 90 of the most seriously wounded and sick.

The patients were to be taken to several locations, including a field hospital in Sheikh Zuweid 15km (nine miles) from Rafah. Media reports said the most complex cases would be referred to Cairo.

Umm Yussef, a dual Palestinian-Egyptian national, speaking on the Gaza side of the crossing, said “we are overwhelmed … have mercy on us”, adding: “Let us in. We are exhausted. We can’t sleep or eat.”

Foreign governments say there are passport holders from 44 countries, as well as 28 agencies, living in Gaza.

Egypt is a lifeline for crucial humanitarian aid for Gaza’s 2.4 million residents, although only a fraction of the aid that entered the tiny enclave before the war is now going in.

The UN and other agencies have described the humanitarian crisis as “unprecedented”, with residents in desperate need of food, water, medicine and fuel.

Israel has pounded Gaza for over three weeks in retribution for the worst attack in the country’s history, when Hamas gunmen killed 1,400 people, mostly civilians, according to Israeli officials.

More tanks have poured over the border into northern Gaza, as Israel steps up its ground incursion.

Military images showed troops in bombed-out houses searching for militants or some of the 240 hostages seized by Hamas.

Israel said 11 of its soldiers were killed Tuesday in “fierce battles”, taking the number of troops to die since October 7 to 326.

Hamas’s armed wing, the Ezzedine al-Qassam Brigades, has vowed to turn Gaza into a “graveyard” for invading forces.

With fears mounting the violence could spiral into a regional war, US President Joe Biden called for “urgent mechanisms” to dial down tensions and said his top diplomat Antony Blinken would go on another Middle East tour from Friday.

Turkey and Iran called for a regional conference, as Israel faces a daily barrage of aerial attacks from Hamas and other Iran-backed groups around the Middle East, including Yemen’s Huthi rebels.

In the north, Israel trades near-daily fire with Lebanon’s Iran-backed Hezbollah movement.

Meanwhile, the families of hostages have an unbearable wait for news of relatives thought to be held deep below Gaza.

Ayelet Sella’s seven cousins were kidnapped from a kibbutz community. “I only ask for one thing, that they come back.”

Additional reporting by Bloomberg, Reuters