At least 51 people were killed and more than 200 others injured by Israeli fire as they waited for aid trucks to arrive in Khan Younis in southern Gaza early Tuesday morning, the Palestinian Ministry of Health said.

Palestinian medics said at least 59 people were killed and 221 wounded in the incident, at least 20 of them in critical condition. Casualties were being rushed into the hospital in civilian cars, rickshaws and donkey carts.

At least 51 Palestinians were killed and over 200 wounded in the Gaza Strip while waiting for U.N. and commercial trucks to enter the territory with desperately needed food, according to Gaza’s Health Ministry and a local hospital.