Deadly fighting raged on in Gaza on Sunday, with no truce in sight on the eve of the Muslim holy month of Ramadan and a dire humanitarian crisis gripping the besieged Palestinian territory.

A Spanish charity ship carrying food aid was expected to soon set sail from the Mediterranean island-nation of Cyprus to help alleviate the suffering in the coastal Gaza Strip, now in its sixth month of war.

The non-governmental group Open Arms said its boat would carry 200 tonnes of food, which its partner the US charity World Central Kitchen would then unload on the shores of Gaza where it had constructed a basic dock.

As famine looms in parts of besieged Gaza, US, Jordanian and other planes have also airdropped food aid there, but UN agencies warn this falls far short of the needs of its 2.4 million people.

The war, started by the October 7 attack on Israel, has killed more than 31,000 Palestinians, according to the health ministry in Hamas-ruled Gaza, where vast swathes have been reduced to a bombed-out wasteland.

Weeks of talks involving US, Qatari and Egyptian mediators have aimed for a six-week truce and the release of many of the about 100 hostages Hamas is still holding in return for Palestinian prisoners held in Israeli jails, with no result so far.

The widely shared target had been to halt the fighting by the start of Ramadan, which is expected to begin Monday depending on the first sighting of the crescent moon.

Both sides have blamed each other for failing to reach a ceasefire deal so far, after Israel had demanded a full list of surviving hostages, and Hamas had called for Israel to pull out all its troops from Gaza.

Israel's government accused Hamas of "entrenching its positions like someone who is not interested in a deal and is striving to inflame the region during Ramadan".

- 'We have sick children' -
US President Joe Biden reiterated Saturday that Israel has "a right to continue to pursue Hamas", but also stressed his growing impatience with Israel's right-wing Prime Minister Benjamin Netanyahu.
As the civilian death toll has surged, Biden told broadcaster MSNBC Netanyahu "must pay more attention to the innocent lives being lost as a consequence of the actions taken".
At this stage, said Biden, Netanyahu's approach to the war was "hurting Israel more than helping Israel".

The comments came after Israeli protesters again took to the streets of Tel Aviv in growing anti-government rallies, joined by some of the desperate families and friends of the remaining captives.

Biden also signalled he would be willing to speak directly to the Israeli people through an address to the Knesset legislature, but without revealing any further plans or details.

The war started when Hamas launched their unprecedented October 7 attack on Israel that resulted in about 1,160 deaths, mostly civilians, according to Israeli official figures.

The militants also took 250 hostages, dozens of whom were released during a week-long truce in November. Israel believes 99 hostages remain alive and that 31 have died.

Israel's withering bombardment and ground offensive have killed 31,045 people, mostly women and children, the health ministry in Hamas-run Gaza said Sunday.

It has also said at least 23 children have died from malnutrition and dehydration.

Inside Gaza, displaced Palestinians were lining up at a truck carrying scarce drinking water, which they filled into jerry cans and plastic containers.

"Now, on regular days, we can barely get water, so what about the upcoming Ramadan?" said one woman, Nesreen Abu Yussef.
"In the camp we have sick children who need sugar and protein, our children are getting dizzy," she said. "I swear, for the last five months we haven't seen a single egg or meat."

- 'Close-quarter combat' -
Fighting and bombardment again rocked Gaza, where 81 bodies arrived overnight at barely functioning hospitals, according to the health ministry.

The Israeli military said its troops had killed 13 militants in air strikes and with tank and sniper fire in central Gaza over the past day.
Troops were also engaged in "close-quarter combat" in the southern city of Khan Yunis, where strikes had killed 17 militants.

The army has reported that 248 of its forces have died in Gaza, where it claims to have killed more than 10,000 militants.

Israeli military spokesman Rear Admiral Daniel Hagari said Israel was preparing for "all possible operational scenarios" during Ramadan.
"Shortly before Ramadan, Hamas is preventing a deal and is acting against what was raised by the mediators," he said.
The army earlier dropped leaflets with pictures of Hamas leaders enjoying a lavish meal and Palestinians with near-empty plates.

One Gaza man, Attallah al-Satel, said: "What is the purpose of this leaflet? We want a solution, to stop the war. We are just exhausted citizens."

Qatar-based Hamas chief Ismail Haniyeh called for the speedy distribution of aid and the full opening of border crossings "to end the siege of our people".

Biden last Thursday announced that the US military would build a temporary pier on Gaza's coast to facilitate larger aid shipments by sea, but the Pentagon warned this would take about 60 days.

The US Central Command said a ship had left Joint Base Langley-Eustis in Virginia on Saturday carrying the "first equipment to establish a temporary pier" to receive aid off Gaza.

International Committee of the Red Cross chief Mirjana Spoljaric again called for a ceasefire and for both sides to respect international law and protect civilians.

"It is the line between humanity and barbarity," she said, adding that the situation was degenerating "by the hour" in a war that had "ruptured any sense of a shared humanity".