Israel has killed at least 32 Palestinians waiting to get food at two aid distribution sites in Gaza, leaving more than 200 others injured.

Israeli tanks opened fire on thousands of civilians gathered at a distribution site in southern Gaza’s Rafah on Sunday morning, killing at least 31 people, according to Gaza’s Government Media Office.

Soon after, another person was killed in a shooting at a similar distribution point south of the Netzarim Corridor in Gaza City, said the office’s statement on Telegram.

The aid is being distributed by Gaza Humanitarian Foundation (GHF), a controversial group backed by Israel and the United States, which has completed a chaotic first week of operations in the enclave.

The United Nations and other aid groups have refused to cooperate with the GHF, accusing it of lacking neutrality and suggesting the group has been formed to enable Israel to achieve its stated military objective of taking over all of Gaza.

‘Killed for seeking one meal for children’

Ibrahim Abu Saoud, who witnessed the attack on aid seekers in Rafah, told The Associated Press news agency that Israeli forces opened fire on people as they moved towards the distribution point.

Abu Saoud, 40, said the crowd was about 300 metres (328 yards) away from the military. He said he saw many people with gunshot wounds, including a young man who died at the scene.

“We weren’t able to help him,” he said.

Al Jazeera’s Hind Khoudary, reporting from Deir el-Balah in central Gaza, said Palestinians are being killed while trying to secure “one meal for their children”.

“This is why Palestinians have been going to these distribution points, despite the fact that they know that they are controversial. They [distribution points] are backed by the US and Israel, but they do not have any other option,” she said.

“[Even] the food parcels that were distributed to Palestinians are barely enough. We are talking about one kilo of flour, a couple of bags of pasta, a couple of cans of fava beans – and it’s not nutritious. It’s not enough for a family in Gaza nowadays.”

The GHF told the AP that Israeli soldiers fired “warning shots” as Palestinians gathered to receive food. The group denied reports that dozens of people were killed, describing them as “false reporting about deaths, mass injuries and chaos”.

The Israeli army said in a statement on the Telegram messaging app that it was “currently unaware of injuries caused by [Israeli] fire within the humanitarian aid distribution site” and that the incident was still under review.

The Government Media Office in Gaza condemned the attacks, describing the GHF’s distribution points as “mass death traps, not humanitarian relief points”.

“We confirm to the entire world that what is happening is a systematic and malicious use of aid as a tool of war, employed to blackmail starving civilians and forcibly gather them in exposed killing points, managed and monitored by the occupation army and funded and politically covered by … the US administration,” it said in a statement.

Speaking from Gaza City, Bassam Zaqout of the Palestinian Medical Relief Society said the current aid distribution mechanism had replaced 400 former distribution points with just four.

“I think there are different hidden agendas in this aid distribution mechanism,” he told Al Jazeera. “The mechanism does not cater to the needs of the people, such as the elderly and people with disabilities.”

Palestinian group Hamas, which runs the enclave’s government, released a statement, saying the Israeli shootings were a “blatant confirmation of premeditated intent” as it held Israel and the US fully responsible for the killings.

The Popular Front for the Liberation of Palestine (PFLP) said the killings were a “full-fledged war crime” and demanded international intervention to “stop this ongoing massacre and impose strict accountability mechanisms”.

Sunday’s killings capped a deadly first week for the project’s operations, coming on the back of two earlier shootings at two distribution points in the south – the first in Rafah, the second west of the city – which saw a combined total of nine Palestinians killed.

In Gaza, crucial aid is only trickling in after Israel partially lifted a more than two-month total blockade, which brought more than two million of its starving residents to the brink of a famine.