Since May 27, at least 583 Palestinians have been killed and 4,186 injured while waiting for food at aid distribution sites operated by the Israeli- and United States-backed Gaza Humanitarian Foundation (GHF), according to the Gaza Strip’s Ministry of Health.

The killings have occurred daily as famine looms over the besieged enclave. International organisations have warned for weeks that Gaza’s 2.1 million residents face catastrophic food shortages with markets emptied, clean water scarce, and aid deliveries sporadic and dangerous.

In the first eight days of the GHF’s operation, more than 100 people were killed by gunfire from Israeli forces.

Al Jazeera’s Hani Mahmoud, reporting from Gaza City, said the GHF remains the only source of food in the Strip as Israel continues to place severe restrictions on the entry of supplies by other groups.

“A lot of people here are trying to stay away from the GHF’s centres because of the danger involved in going to them because of the ongoing and deliberate shootings of aid seekers there,” Mahmoud said. “But again, staying away is not an answer because if there are no food parcels, it means that children are going to go to bed hungry.”

Where are the aid distribution sites?

While the previous United Nations-led distribution network operated about 400 sites across the Strip, the GHF, guarded by armed private security contractors working for a US company, has set up only four “mega-sites”, three in the south and one in central Gaza – none in the north, where conditions are most severe.

GHF centres operate irregularly, sometimes opening for just an hour. In one instance, a site announced its opening on Facebook, only to post eight minutes later that supplies had already run out.

The centres function on a first-come, first-served basis, often fostering chaos as desperate crowds fight over limited resources.

How do people access these aid distribution sites?

Accessing these centres is perilous. Palestinians must sometimes walk many kilometres through active combat zones, navigate biometric checkpoints and carry heavy provisions back to their families.

The system in effect excludes the most vulnerable – including the elderly, injured and disabled people – who are least able to make the journeys.