Is­raeli forces opened fire near two aid dis­tri­b­u­tion sites run by the Is­raeli-backed Gaza Hu­man­i­tar­i­an Foun­da­tion as crowds of hun­gry Pales­tini­ans again sought food, killing at least 10 peo­ple, wit­ness­es and health work­ers said Sat­ur­day — a day af­ter U.S. of­fi­cials vis­it­ed a GHF site and the U.S. am­bas­sador called the trou­bled sys­tem “an in­cred­i­ble feat.”

Near­ly a week has passed since Is­rael, un­der in­ter­na­tion­al pres­sure amid grow­ing scenes of starv­ing chil­dren, an­nounced lim­it­ed hu­man­i­tar­i­an paus­es and air­drops meant to get more food to Gaza’s over 2 mil­lion peo­ple, who now large­ly re­ly on aid af­ter al­most 22 months of war.

But the Unit­ed Na­tions, part­ners and Pales­tini­ans say far too lit­tle aid is still com­ing in, with months’ worth of sup­plies piled up out­side Gaza wait­ing for Is­raeli ap­proval. Trucks that en­ter are most­ly stripped of sup­plies by des­per­ate peo­ple and crim­i­nal groups be­fore reach­ing ware­hous­es for dis­tri­b­u­tion.