Updated May 27, 2024 at 07:23 AM ET

RAFAH, Gaza — The Gaza health ministry said that an airstrike in Rafah on Sunday killed 45 Palestinians and injured dozens more. It said that there are still victims under the rubble and that the majority of those killed were women and children.

The Israeli military said it was targeting a Hamas installation and killed two senior Hamas militants. The strike caused a fire in an encampment just west of Rafah in a neighborhood called Tal al-Sultan, where dozens of Palestinians were sheltering. The area was not under Israeli evacuation orders.

The strike came days after the United Nations International Court of Justice ordered the Israeli military to end its operation in Rafah. The order was related to one of several provisional measures that South Africa added to a broader case it filed with the ICJ in December against Israel accusing it of genocide. It also ordered Israel to open its border with Egypt to let aid in and allow a U.N. fact finding mission to enter to investigate accusations of war crimes.

Abu Mohammed Abu el-Sebeh, 67, had taken shelter in the encampment and was surveying the damage after the strike.

“At around 6:30 p.m. yesterday, I heard a huge noise. I heard an explosion, it sounded like an earthquake,” he told NPR. “I couldn’t get out of the door so I jumped out of the window and saw injured children… one without a head.”

Before this month, Rafah had been the last refuge for Palestinians during the war, with so much of Gaza being devastated. Almost 1.3 million Palestininans were sheltering in Rafah at one time but the U.N. says more than 800,000 have fled since the Israeli military expanded its ground operations there. Rafah is still densely populated in the areas that are not under an evacuation order.

Dr. James Smith, an emergency doctor who is working just outside Rafah, said that the injured were taken to a trauma stabilization center in Tal al-Sultan and then referred to surrounding field hospitals for further treatment. Many hospitals in Rafah and neighboring cities were ordered to be evacuated and shut down by the Israeli military in the past months.

“People [were] literally burned alive in their tents,” Smith told NPR. “This is unlike anything I have seen in the six-plus weeks I have been back here in Gaza. Truly one of the most horrific massacres to have occurred in recent days here in Rafah and across the Gaza Strip.”

Israel’s war in Gaza has killed more than 36,000 Palestinians, according to health officials there. About 1,200 people were killed in Israel and more than 240 were taken hostage during the Hamas attack on Oct. 7. About 120 hostages remain in Gaza.

Prime Minister Benjamin Netanyahu is under increasing domestic pressure to negotiate a ceasefire deal to bring the remaining hostages home. Israel has been rocked by weekly protests by families of hostages and others calling for the resignation of Netanyahu. He is also under pressure by hard liners in his government that do not want a complete ceasefire.

Israeli media is reporting that officials say that negotiations are supposed to resume next week. There were some high level discussions in Paris this weekend between the Israeli Mossad’s David Barnea, the U.S. CIA’s William J. Burns and the Qatari Prime Minister Sheikh Mohammed bin Abdulrahma al-Thani.

Talks have been breaking down for months and Qatar as the U.S. and Egypt have been trying to bring Hamas and Israel closer to a deal.

NPR's Kat Lonsdorf contributed to this report.

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