At least 20 Palestinians were killed in Israeli tank shelling and airstrikes across the Gaza Strip, including four children and a medic responding to earlier attacks, health officials reported Wednesday—in what critics say is another breach of the fragile US-backed ceasefire.

The latest violence struck Khan Younis in the south and Gaza City in the north, where a five-month-old baby also lost his life. The medic was killed in a secondary strike on the same site after attempting to assist the initial victims.

These deadly strikes came just three days after Gaza’s Rafah border crossing with Egypt was reopened—a key provision of the truce aimed at easing humanitarian access. Weeks of intermittent ceasefire violations have left hundreds of Palestinians dead since the truce began, even as both sides accuse each other of breaches.

Israel says its actions respond to attacks on troops near the armistice line, while critics warn the cycle of violence jeopardises peace efforts and civilian protection.