Tens of thousands of Palestinians fled the fighting and bombardment in Gaza, as Israel said it was tightening the "stranglehold" around Hamas and again rejected a ceasefire without the release of hostages.

Calls for a ceasefire to protect civilians have built over a month into the war sparked when Hamas attacked Israel and, according to Israeli officials, killed about 1,400 people, mainly civilians, and seized 239 hostages.

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Aiming to destroy Hamas, Israel retaliated with a relentless bombardment and ground invasion of the Gaza Strip that, according to the Hamas-run health ministry in Gaza, has killed more than 10,500 people, many of them children.

But Israeli Prime Minister Benjamin Netanyahu again rejected the prospect of a ceasefire in Gaza, amid reports of negotiations for a temporary truce with Hamas to allow in humanitarian aid.

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The Israeli army said 50,000 people left north Gaza for the south of the narrow coastal strip on Wednesday as the fighting raged between Hamas's armed wing, the Ezzedine al-Qassam Brigades, and Israeli troops. "We saw today how 50,000 Gazans moved from northern Gaza to southern Gaza," said military spokesman Daniel Hagari. "They're leaving because they understand that Hamas lost control in the north, and in the south it's safer."

Around 15,000 people had fled on Tuesday, compared with 5,000 on Monday and 2,000 on Sunday, said the UN Office for the Coordination of Humanitarian Affairs (OCHA).

UN rights chief Volker Turk condemned Israel over the forced evacuations during a visit to the Rafah border crossing between Gaza and Egypt, the only way out of the besieged territory that is not controlled by Israel.

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"The collective punishment by Israel of Palestinian civilians amounts also to a war crime, as does the unlawful forcible evacuation of civilians," he told a news conference.

"The aid getting through is a trickle," Turk said, adding it was Israel's obligation to "ensure a maximum of basic necessities of life that can reach all who need it."

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A Hamas official told AFP that evacuations of wounded Palestinians and dual nationals were interrupted Wednesday despite a large crowd waiting at the crossing terminal, blaming what they said was Israel's refusal to approve the list of wounded to be taken across the border.

- 'Where can we go?' -

A source close to Hamas had said talks were underway for the release of a dozen hostages held by the group, including six Americans, in return for a three-day ceasefire in Gaza.

Earlier a separate source briefed on the talks said Qatar was mediating negotiations in coordination with the US to free "10-15 hostages in exchange for a one- to two-day ceasefire".

As the talks proceeded, the pace of Palestinian civilians fleeing south from northern Gaza accelerated in the face of Israel's intensifying air and ground campaign, according to UN observers.

"We've lost our homes, we've lost our children. Where is the global community? Where are our fellow Muslims? Look at us!" said Nouh Hammouda, who was among those fleeing. "We left our homes due to the relentless bombardment. Where can we go now?" he said as people streamed southward on the road.

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Israel has set an aim of destroying Hamas and said its ground forces were advancing in pursuit of the fighters who have a deep network of tunnels and underground bases.

"(Israeli troops) are tightening the stranglehold around the city of Gaza," Defence Minister Yoav Gallant said.

Israel has air-dropped leaflets and sent texts ordering civilians in northern Gaza to flee south, but potentially hundreds of thousands remained in the worst-hit areas.

Images taken by an AFP journalist embedded with Israeli troops showed them emerging from tanks to comb the shells of Gaza residential buildings destroyed in the fighting.

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Hamas accused the United Nations agency for Palestinian refugees (UNRWA) of "colluding" with Israel in the "forced displacement" of Gazans, after residents followed instructions to flee.

An UNRWA spokeswoman did not immediately respond when contacted by AFP about the Hamas accusation.

- Fierce streets battles -

G7 foreign ministers said they supported "humanitarian pauses and corridors" in the Israel-Hamas war, but stopped short of calling for a ceasefire.

As fighting intensifies in Gaza, families of people taken hostage by Hamas have been pushing on various fronts for help to bring their loved ones home.

"Every day is like eternity to me and I can't wait any longer," Doris Liber, whose 26-year-old son Guy Iluz was shot and taken hostage at a music festival, told reporters in Washington.

Military analysts warned of weeks of gruelling house-to-house fighting ahead in Gaza.

The operation is hugely complicated for Israel because of the hostages, including very young children and frail elderly people, who are believed to be held inside a vast tunnel network.

The Israeli army said it had uncovered around 130 tunnel entrances in Gaza. It also reported the deaths of two more soldiers, bringing to 33 the total number killed in the offensive.

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Hamas released video footage of fierce street battles between its armed wing, the Al-Qassam Brigades, and Israeli forces in the northern and southern axis of Gaza City.

In densely packed Gaza -- where more than 1.5 million people have fled their homes in a desperate search for safety -- the suffering is immense.

Hamas said several cemeteries in Gaza had "no more space for burials", while the UN Office for the Coordination of Humanitarian Affairs (OCHA) said most of the territory's sewage pumping stations were shut.

A rare delivery of emergency medical supplies and medicines on Wednesday reached Al-Shifa hospital in Gaza City, the UN and World Health Organization said.

But they highlighted the delivery of life-saving supplies was only the second to reach the hospital since the war erupted and was "far from sufficient to respond to the immense needs".

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Tom Potokar, chief surgeon at the International Committee of the Red Cross who entered Gaza on October 27, described the scene at the European hospital in Khan Yunis as "relentless" and "catastrophic".

"In the last 24 hours, I've seen three patients with maggots in their wounds," including a six-year-old child, he said in a telephone interview.

"It's almost like you can't find somebody who hasn't lost members of their family" from among the patients and staff, he said, adding there were "cases where you see a child come in where they have nobody, they've lost their whole family."

Attacks in Syria

Israeli air strikes on Wednesday killed three pro-Iran fighters as they hit sites belonging to the powerful Lebanese Hezbollah group near the Syrian capital Damascus, a war monitor said.

Israel has struck Syria several times in the past month as regional tensions simmer.

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Gaza civilian toll 'too high'

A US senator said Wednesday that it is "vital" for Israel to carry out a more targeted offensive against Hamas in the Gaza Strip to limit civilian casualties.

Chris Murphy, a Democrat on the powerful Senate Foreign Relations Committee, stressed that Israel has every right to defend itself from aggression, and that he opposes a ceasefire as it would give Hamas, the Islamist group responsible for the attacks against Israel, time to "regroup."

But "I am concerned that if Israel's strategy and end goal is to defeat Hamas, then this pace of civilian casualties, which certainly comes with a moral cost, also comes with a strategic cost," he told AFP in an interview.

"I think that the civilian death toll has been too high, and a more surgical approach would be important and vital," Murphy said, adding Israel "should be directing the strikes perhaps more so with ground forces than with airstrikes."

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Murphy and more than 20 of his peers sent a letter Wednesday to US President Joe Biden, a fellow Democrat, calling on Israel to "abide by the laws of war," including protection of civilians.

They also urged Israel to "learn from the mistakes the United States made in our fight against terrorism" two decades ago.

- 'Creating lots of terrorists' -

Avoiding unnecessary casualties is crucial, Murphy said. But Hamas is also to blame, he said, because the group is "burying itself under civilian institutions, hiding itself in hospitals, schools, and mosques."

Nevertheless, a response that does not limit civilian deaths may create disastrous problems after the war.

"The United States has a lot of experience in fighting terrorist groups like Hamas," according to Murphy.

"What we've learned is that when you are too permissive about civilian deaths, you end up providing bulletin board material to terrorist recruiters and end up killing lots of terrorists, but you end up creating lots of terrorists as well," Murphy said.

But the senator, who hails from the small northeastern state of Connecticut, next to New York, opposes a ceasefire, as does Biden.

"Hamas made it very clear that they are intent on attacking Israel again and destroying every single Jew they can find," Murphy said. "A ceasefire would allow for Hamas to regroup and start readying their next attack on Israeli civilians."

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With a year to go before US presidential elections, concern among some Democrats has swelled that Biden and the party could lose the support of young people, Arab Americans and the country's Muslim minority.

The United States was the scene this weekend of multiple demonstrations in favor of a ceasefire in Gaza, with some participants holding signs reading "Genocide Joe, You Lost My Vote."

"I don't think you can worry about elections when you're making key decisions about foreign policy and war and peace," Murphy said.

No Gaza evacuations into Egypt

No wounded Palestinians or dual nationals were evacuated Wednesday from the Gaza Strip to Egypt via the Rafah crossing, a Palestinian official said.

The crossing point remained closed due to Israel's refusal to approve the list of wounded who were to be evacuated, a Hamas official told AFP.

The Rafah terminal -- which connects the bombarded Gaza Strip to Egypt -- reopened on November 1 to allow the evacuation of foreigners and dual nationals stranded in the small Palestinian territory.

There was then a two-day closure after deadly Israeli strikes hit ambulances headed for the border, according to the Palestinian Red Crescent and the Hamas-run health ministry.

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Israel's military said it had targeted an ambulance used by a "Hamas terrorist cell".

An AFP journalist at the Rafah crossing point Wednesday saw a large crowd of people hoping to cross into Egypt during the day.

Mazen Danaf, who holds a German passport, told AFP that the situation in Gaza is "horrible".

"There is no electricity, no water, no fuel, the hospitals are crowded," he said.

Egypt has said it would help evacuate around 7,000 foreigners through the crossing.

- 'Stranglehold' -

Israeli troops were "tightening the stranglehold around the city of Gaza", Defence Minister Yoav Gallant said.

"Gaza is the largest terrorist base ever built," Gallant said, vowing to destroy Hamas as Israel marked a month since the group's October 7 attack.

As Israel relentlessly bombards Gaza, the health ministry in the Hamas-run territory said the death toll had reached 10,569, including more than 4,300 children.

- Hostage talks -

A source close to Hamas said talks were underway for the release of a dozen hostages in Gaza, including six Americans, in return for a humanitarian pause.

Earlier a source briefed on the process told AFP that Qatar was mediating negotiations between Israel and Hamas for the release of hostages.

"Negotiations mediated by the Qataris in coordination with the US are ongoing to secure the release of 10-15 hostages in exchange for a one- to two-day ceasefire," the informed source said, speaking on condition of anonymity because of the talks' sensitivity.

In response, Prime Minister Benjamin Netanyahu again rejected any talk of a ceasefire without the release of hostages.

"I'd like to put to rest all kinds of false rumours we're hearing from all kinds of directions, and reiterate one clear thing: There will be no ceasefire without the release of our hostages," he said.

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- US opposes 'reoccupation' -

US Secretary of State Antony Blinken has called on Israel not to reoccupy Gaza once its war with Hamas ends.

Earlier this week, Netanyahu said Israel would take "overall security responsibility" for the territory following the war.

On Wednesday, the Israeli government said it was "still very premature" to discuss post-war scenarios, but that Gaza would be demilitarised and "must never again" become a "terror nest".