DEIR AL-BALAH, Gaza Strip: Mohammed Abu Al-Qumsan had just picked up birth certificates for his newly-born twins when he found out they had been killed, along with his wife and her mother, by an Israeli strike on the Gaza apartment where they were sheltering.

He waved the laminated documents, supposed to signify rare joy in the besieged Palestinian enclave, as a man held him while he wept at the morgue where their bodies were brought.

"My wife is gone, my two babies and my mother-in-law. I was told it's a tank shell on the apartment they were in, in a house we were displaced to," said Abu Al-Qumsan, 31, recalling the devastating phone call from people in the neighbourhood.

He and others carried his boy and girl, Asser and Ayssel, who were wrapped in white shrouds - a common sight in Gaza, where Israel's land and air campaign has put hundreds of thousands of people regularly on the move in search of shelter.

A man prayed as the bodies were placed in the back of a car and a crowd gathered and people looked on from the balcony of one of Gaza's overwhelmed emergency rooms, at the Al-Aqsa Maryrs Hospital in Deir al-Balah in the centre of the coastal strip.

Ten months after the Gaza war erupted, air strikes, artillery shells and severe shortages of medicine, food and clean water have brought one of the world's most densely populated places to its knees.

"Today, it was registered in history that the occupation army targets newborn children who are barely four days old, twins along with their mother and grandmother," hospital doctor Khalil al-Daqran said.

Israel says it goes to great lengths to avoid civilian casualties and accuses arch-foe Hamas of using human shields, charges the fighters deny.

The Palestinian Iranian-backed group started the conflict in an Oct. 7 cross-border raid on Israel, killing 1,200 people and taking over 250 hostage, according to Israeli tallies.

Israel struck back with an offensive that has killed nearly 40,000 people and wounded more than 92,000, according to Israeli tallies, and reduced much of Gaza to rubble.