DEIR AL-BALAH, Gaza Strip (AP) — The Palestinian death toll from the 20-month Israel-Hamas war has climbed past 55,000, the Gaza Health Ministry said Wednesday.

The ministry doesn’t distinguish between civilians and combatants, but has said that women and children make up more than half the dead.

It’s a grim milestone in the war that began with Hamas’ attack into southern Israel on Oct. 7, 2023, and shows no sign of ending. Israel says it only targets militants and blames civilian deaths on Hamas, accusing the militants of hiding among civilians, because they operate in populated areas.

The ministry says 55,104 people have been killed since the start of the war and 127,394 wounded. Many more are believed to be buried under the rubble or in areas that are inaccessible to local medics.

Israeli forces have destroyed vast areas of Gaza, displaced about 90% of its population and in recent weeks have transformed more than half of the coastal territory into a military buffer zone that includes the now mostly uninhabited southern city of Rafah.

A 2½-month blockade imposed by Israel when it ended a ceasefire with Hamas raised fears of famine and was slightly eased in May. The launch of a new Israeli- and U.S.-backed aid system has been marred by chaos and violence, and the U.N. says it has struggled to bring in food because of Israeli restrictions, a breakdown of law and order, and widespread looting.

Israel accuses Hamas of siphoning off aid, but the U.N. and aid groups deny there is any systematic diversion of aid to militants.

Hamas has suffered major setbacks militarily, and Israel says it has killed more than 20,000 militants, without providing evidence. The militants still hold 55 hostages — less than half of them believed to be alive — and control areas outside of military zones despite facing rare protests earlier this year.

The war began when Hamas-led militants killed around 1,200 people, mostly civilians, in the Oct. 7 attack and abducted 251 hostages. More than half the captives have been released in ceasefires or other deals. Israeli forces have rescued eight and recovered the remains of dozens more.

Israel’s military campaign, one of the deadliest and most destructive since World War II, has transformed large parts of cities into mounds of rubble. Hundreds of thousands of people are living in squalid tent camps and unused schools, and the health system has been gutted, even as it copes with waves of wounded from Israeli strikes.

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