Hundreds of injured residents and foreigners escaped Gaza to Egypt on Wednesday, the first evacuations from the war-torn Palestinian territory pounded by Israeli warplanes in retaliation for an unprecedented Hamas attack.

The brief glimmer of hope sparked by the temporary opening of the Rafah border crossing was quickly snuffed out as a new strike pulverized buildings in Gaza's biggest refugee camp for a second consecutive day, killing dozens according to the Palestinian health ministry.

Israeli Prime Minister Benjamin Netanyahu vowed to "continue until victory" over Hamas, whose brutal October 7 attack sparked the latest conflict, the deadliest in decades of unrest between the two sides.

His defense minister, Yoav Gallant, said Hamas had two options: to "die or to surrender unconditionally".

AFP reporters at Gaza's southern border saw ambulances whisking away the wounded to Egyptian field hospitals, including one young boy with heavy bandaging around his stomach.

Whole families, struggling to carry their worldly possessions, rushed through the heavily fortified crossing towards Egypt, which said it had admitted 335 foreigners or dual nationals and 76 seriously wounded and sick people.

The foreigners included 31 Austrians, five French nationals, four Italians, and some German and US citizens, their governments said.

Jordanian citizen Umm Saleh Hussein said water and electricity shortages were "the least" of the hardships Gazans were facing.

"There were bigger problems such as the bombardment. We were afraid. Many families were martyred," she told AFP.

A group of mostly women and children were the first to arrive in Egypt, with TV images showing parents with pushchairs and elderly people clambering off a bus.

"It's enough. We've endured enough humiliation," said Gaza resident Rafik al-Hilou, accompanying relatives including children aged one and four hoping to enter 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?"

'Slaughtered and killed'

The Jabalia camp in Gaza was struck for a second time in two days, with AFPTV images from Wednesday's strike showing extensive damage and rescuers clawing through rubble to extract bloodied casualties.

The Hamas-run health ministry said dozens were killed and wounded in the strike which came a day after Israeli jets hit the camp, killing at least 47 people, according to an AFP count.

Rescuers said "whole families" had died, but casualty details could not be immediately confirmed. Israel's military did not comment.

UN chief Antonio Guterres was "appalled" by the "Israeli air strikes in residential areas of the densely populated Jabalia refugee camp", a spokesman said, while the UN Human Rights Office said the attacks "could amount to war crimes".

Israel said Tuesday's raid was a successful hit on top Hamas commander Ibrahim Biari, but the large death toll drew a chorus of international condemnation as far afield as Bolivia, which severed diplomatic ties in protest.

Jordan recalled its ambassador to Israel "to condemn the Israeli war that is killing innocent people in Gaza".

Hamas said seven of the 240 hostages it is holding, including three foreign passport holders, died in Tuesday's bombing, a claim impossible to verify.

The group's leader Ismail Haniyeh accused Israel of committing "barbaric massacres against unarmed civilians", saying it was covering its own "defeats".

Israel has relentlessly pounded Gaza in retribution for the worst attack in its history, when Hamas gunmen stormed across the border, killing 1,400 people, mostly civilians, according to Israeli officials.

AFP reporters saw more tanks pour into northern Gaza, as Israel stepped up its ground incursion launched late last week. Its bombing campaign has killed 8,796 people, according to Gaza's health ministry.

Israel said 16 soldiers died in fighting since Tuesday in and near Gaza, bringing to at least 331 the number killed since the October 7 attacks, most of them in Hamas's initial cross-border rampage.

AFP images showed tearful Israeli women in uniform hugging each other at the funeral of one of those killed.

'No hope in Gaza'

The situation in Gaza remained desperate, with food, fuel and medicine for the 2.4 million residents all running short, according to aid groups.

The fuel shortage and damage due to air strikes meant "the Turkish-Palestinian Friendship Hospital, the main cancer center in the Gaza Strip, is no longer functional", the World Health Organization said on X, formerly Twitter.

A Gaza official said about 50 trucks carrying medical and food aid entered Gaza on Wednesday, among the biggest daily flows so far, but far fewer than humanitarian groups say is needed. 

Palestinian residents told AFP they had evacuated from northern Gaza, as demanded by Israel, but were still under threat.

"We've been told people are evacuating from Gaza City towards the central area of the strip beyond the valley, so we headed there," Amen al-Aqluk said.

"After 20 days, we were bombarded. Three of our kids lost their lives and we all got injured.

"There is no hope in the Gaza Strip. It is not safe any more here. When the border opens, everybody will leave and emigrate. We encounter death every day, 24 hours a day."

The head of the UN agency that works to help Palestinian refugees, Philippe Lazzarini, managed to reach Gaza on Wednesday via the Rafah border crossing.

"I was shocked by the fact that everyone there was asking for food, was asking for water," Lazzarini, the most senior UN official allowed into the besieged territory since the war began, told journalists in Gaza.

With fears mounting of a regional war, US President Joe Biden called for "urgent mechanisms" to dial down tensions and said top diplomat Antony Blinken would embark on another Middle East tour from Friday.

Turkey and Iran called for a regional conference to prevent a conflagration, 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 has traded near-daily fire with Lebanon's Iran-backed Hezbollah movement.

And the families of hostages kidnapped by Hamas have endured an unbearable wait for news of relatives thought to be held in the labyrinth of tunnels deep below Gaza.

Ayelet Sella, whose seven cousins were kidnapped by Hamas, said she could find "no rest" until her loved ones are returned.

"We have no more tears, our eyes are dry, we are empty three weeks on," Sella told AFP at the Great Synagogue in Paris. "I only ask for one thing, that they come back."

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