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Smoke rises in the air as flame spread across buildings after Israeli strikes in Shijaiyah neighbourhood in Gaza City, Sunday, July 20, 2014. Escalating their ground offensive, Israeli troops backed by tanks and warplanes battled Hamas militants in the crowded neighborhood early Sunday. The fighting, including heavy Israeli tank fire, killed scores of Palestinians, forced thousands to flee and damaged or destroyed dozens of homes. (AP Photo/Khalil Hamra)

JERUSALEM (AP) — Sunday was the bloodiest day in the conflict between Israel and Hamas as the nearly-two week offensive surged on across the Gaza Strip. In one Gaza City neighborhood, at least 65 Palestinians — many of them children — and 13 Israeli soldiers were killed. Conditions on the ground grew worse as tens of thousands fled.

Here's a look at where things stand in the Gaza Strip:

DEATH TOLL

Gaza health officials say at least 435 Palestinians have been killed since the beginning of Israel's campaign on July 8, although the exact number of militants and civilians killed is not clear. The Israeli military says it has killed 178 militants. The United Nations says a majority of the dead are civilians. A quarter of the total deaths occurred since Israel launched its ground offensive late Thursday. Twenty Israelis have been killed so far, including 18 soldiers and two civilians who died from the constant Hamas rocket and mortar attacks on Israeli territory.

INTERNAL DISPLACEMENT

Some 83,000 Palestinians have fled their homes and are staying in 61 United Nations shelters, according to UNRWA, the U.N. refugee agency for Palestinians. The number of people who have been forced to seek shelter has more than quadrupled since the start of Israel's ground operation.

CHILDREN CAUGHT IN CROSSFIRE

Children make up nearly a quarter of the dead in Gaza, according to an Associated Press count based on information provided by Palestinian health officials. Upwards of 60,000 children in Gaza will be in need of psycho-social support as a result of the current round of violence, and that number is likely to increase as the conflict continues, according to UNICEF, the U.N. children's agency. Israeli children stressed by rocket fire also have been traumatized.


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STRESSED MEDICAL CARE

As thousands of wounded and hundreds of dead continue arriving at hospitals across Gaza, doctors have warned of shortages of basic medical supplies to fuel for emergency generators.

WATER AND ELECTRICITY

More than half of Gaza's population remains without access to a water supply, according to the U.N. agency for humanitarian affairs. Some 80 percent of Gaza's population is receiving electricity for about four hours a day, down from 12 hours before the conflict.

CIVILIAN ASSISTANCE

Israel's military say it has permitted more than 670 trucks carrying humanitarian aid, such as baby food, water and fruits and vegetables, to enter into Gaza, including 25 trucks with medicine and other medical supplies. But the military says that deliveries have decreased significantly since the start of the conflict because of the threat of rocket fire and militant activity near the border. On Sunday, the Israeli military established a field hospital for Palestinians from Gaza at one border crossing.