At least 30 Palestinians, including women and children, were killed in Israeli attacks Gauzehospital officials said, recording one of the highest death tolls since a cease-fire it started in October.

The strikes, which came a day after Israel accused Hamas of another ceasefire violation, hit multiple locations across Gaza, including an apartment building in Gaza City and a tent camp in Khan Younis, hospital officials who received the bodies told The Associated Press. The airstrike also hit a police station in Gaza City, killing at least 14 and wounding others, Shifa Hospital director Mahamed Abu Selmiya said.

The Israel Defense Forces said in a statement that the strikes were in response to what it said was a ceasefire violation by Hamas after the army killed at least four terrorists emerging from tunnels in the Israeli-controlled Rafah area.

“Terrorist organizations in the Gaza Strip systematically violate international law, brutally exploiting the civilian infrastructure and population of Gaza as human shields for terrorist activities,” the IDF said, adding that it would continue to act against any violation of the ceasefire agreement.

Nasser Hospital said the strike on the tent settlement caused a fire that killed seven people, including a father, his three children and three grandchildren. Meanwhile, Shifa Hospital said an attack on a residential building in Gaza City killed three children, their aunt and grandmother on Saturday morning, while an attack on a police station killed at least 14 policemen, including four policewomen, civilians and prisoners held at the station. The hospital also said one man was killed in a strike on the eastern side of the Jabaliya refugee camp on Saturday.

Hamas called Saturday’s strikes “another flagrant violation” and called on the United States and other mediating countries to pressure Israel to end the attacks.

Saturday’s strikes are a reminder that the death toll in Gaza continues to rise even as a ceasefire agreement moves forward.

The Israeli army, which targeted targets at both sides of the separation line cease fireshe said her attacks since October were in response to violations of the agreement.

The number of people killed on Saturday was several times higher than the daily average since the beginning of the ceasefire. As of Friday, the Hamas-run Gaza Health Ministry recorded at least 520 Palestinians killed by Israeli fire since the October 10 ceasefire began. The Ministry maintains detailed data on victims that UN agencies and independent experts consider to be generally reliable.

Saturday’s strikes also came a day before the opening of the Rafah crossing along the border with Egypt in Gaza’s southernmost city. All border crossings in the area were closed during almost the entire war. Palestinians see Rafah as a lifeline for the tens of thousands who need treatment outside the territory, where most of the medical infrastructure has been destroyed.

The opening of the crossing, limited at first, marks the first major step in the second phase of the US-brokered ceasefire. Reopening the borders is one of the challenging issues on the agenda of the ongoing phase, which also includes demilitarizing the Strip after nearly two decades of Hamas rule and installing a new government to oversee reconstruction.