An Israeli strike hit a displaced camp near Al-Aqsa Hospital in central Gaza on Monday afternoon, killing at least one person and wounding at least four others, the hospital said.

Plumes of smoke rose from the camp as emergency teams rushed the wounded into ambulances, with family members running frantically behind them.

Israel launched airstrikes across the Gaza Strip on Monday, killing at least 31 people, more than half of them women and children, as it continues a major offensive in the territory’s largest city, health officials said.

Airstrikes and artillery shelling have reverberated through Gaza City since Israel declared it a combat zone last week. On the city’s outskirts and in the Jabalia refugee camp, residents reported seeing explosive-laden drones demolishing buildings.

Israel says it only targets militants and blames Hamas for civilian casualties because the militant group — now largely reduced to a guerrilla organization — operates in densely-populated areas.