A Palestinian girl looks up as she watches an Israeli drone flying over her home in Gaza City. (AFP Photo)
Four people were killed by Israeli fire in Gaza on Thursday night as the Jewish state announced a ground operation in the coastal enclave, medics said.
The deaths raised the Gaza toll in 10 days of violence to 241, emergency services spokesman Ashraf al-Qudra said.
The deaths included one man killed in shelling in southern Khan Yunis, and three killed by tank fire in east Gaza.
The three were a four-year-old child, a 15-year-old, and a man aged 26, Qudra said.
Their deaths came after a strike that killed three children in the Sabra neighbourhood of central Gaza - Jihad, Waseem and Fulla from the Shuheiber family.
They were killed following the end of a five-hour humanitarian ceasefire, which brought some respite for residents of the besieged Palestinian territory.
Another strike shortly afterwards in the southern city of Khan Yunis killed four-year-old girl Rahaf al-Jubur, and a 29-year-old man, Hamza al-Abadleh.
And another child died of wounds sustained in an earlier strike in Gaza City, Qudra said.
Before the UN-requested ceasefire took effect at 10.00 (0700 GMT), Israeli tank fire killed three men in their twenties in the southern city of Rafah, Qudra said.
One Israeli has also been killed by rockets fired by Palestinian militants.
On the Palestinian side, 1,690 people have been injured during the conflict, Qudra said.
Israel and Hamas said they were observing the humanitarian lull but later they accused each other of violating the truce.
According to figures provided by the Gaza-based Palestinian Centre for Human Rights (PCHR), more than 80% of those killed have been civilians.
Since the latest violence began before dawn on July 8, at least 1,048 rockets fired from Gaza have struck Israel, and another 282 have been shot down by the Iron Dome air defence system, army figures show.
In its air war aimed at halting the rocket fire and "inflicting a significant blow to Hamas infrastructures," Israel has struck more than 1,750 "terror targets" across the coastal enclave, the army said.
Israeli tanks shelling Gaza rehab hospital: director
Israeli tanks are shelling Gaza's Al-Wafa hospital, whose 14 patients include some who are paralysed or in a coma, and several people have been hurt, the facility's director said Thursday.
"Israeli tanks are shelling the hospital, they have hit several of the floors, and several nurses have been injured," director Basman Alashi said.
The hospital in Gaza's Shejaiya district has come under Israeli fire several times before, and the Israeli military has called on Alashi and other doctors to evacuate it.
Alashi told AFP on Wednesday that it was almost impossible to move the patients, most of whom are immobile, and he questioned where they could go.
"There is no place safe in Gaza! If a hospital is not safe, where is?" he said.
On Thursday night, he said he was contacting other hospitals in Gaza to try to arrange ambulances to transport the 14 patients elsewhere after Al-Wafa came under renewed Israeli fire.
"But the ambulances are all in use, there is heavy shelling in many places," he said.
"And each patient has to be taken individually and carried because they cannot move."
"They are tearing the hospital apart, bit by bit."