DEIR AL-B, Gaza Strip — At least 34 Palestinians were killed Monday in new shootings on the roads leading to Israeli- and U.S.-supported food distribution centers in the Gaza Strip, the local Health Ministry said.

The toll was the deadliest yet in the near-daily shootings that have taken place as thousands of Palestinians move through Israeli military-controlled areas to reach the food centers. As on previous days, witnesses said Israeli troops opened fire in an attempt to control crowds. The ministry says several hundred people have been killed and hundreds more wounded in such shootings since the centers, run by the private contractor Gaza Humanitarian Foundation, opened three weeks ago.

There was no immediate comment by the Israeli military. It has said in previous instances that troops fired warning shots at what it calls suspects approaching their positions.

Gaza’s Health Ministry said 33 Palestinians were killed trying to reach the GHF center near the southern city of Rafah and another on route to a GHF hub in central Gaza. It said four other people were killed elsewhere.

Israeli troops started firing as thousands of Palestinians massed around 4 a.m. at the Flag Roundabout before the scheduled opening of the Rafah food center, according to Heba Jouda and Mohamed Abed, two Palestinians in the crowd. People fell to the ground to take cover, they said.

“Fire was coming from everywhere,” said Jouda, who has repeatedly made the journey to get food for her family over the past week. “It’s getting worse day by day.”

The Red Cross field hospital nearby received some 200 injured Monday, the highest single mass casualty event, the International Committee of the Red Cross said in a statement. Only a day earlier, it said, around 170 were brought to the facility, most of them wounded by gunshots while trying to reach the GHF center.

The Health Ministry toll made it the deadliest day around the food sites since June 2, when 31 people were killed.

The Flag Roundabout, hundreds of yards from the GHF center, has been a repeated scene of shootings. It is on the route designated by the Israeli military for people to take to reach the center.

Palestinians over the past weeks have said Israeli troops open fire to prevent people from moving past a certain point on the road before the scheduled opening of the center or because people leave the road.

A GHF spokesperson told The Associated Press on Sunday that “none of the incidents to date have occurred at our sites or during operating hours.” It said the incidents have involved aid-seekers who were moving “during prohibited times ... or trying to take a short cut.” It said it was trying to improve safety measures, including by recently moving the opening times from nighttime to daylight hours.

Israel and the United States say the new GHF system is needed to prevent Hamas from siphoning off aid. GHF says there has been no violence in or around the sites themselves.