Israel has launched a ground offensive in Gaza with residents reporting heavy shelling in the area.
Palestinian health officials say 27 Palestinians, including a baby, two children and a 70-year-old woman, have been killed since Israel sent ground forces into the densely-populated strip of 1.8 million Palestinians.
Sirens and loud thuds and flashes of orange light lit the sky in the eastern Gaza strip as Israeli gunboats fired shells and tracer fire, while artillery and helicopters fired over the border, witnesses on both sides of the border said.
Gaza residents and medical officials reported heavy shelling along the eastern borders from the southern town of Rafah up to the north of the enclave.
Shells landed by the al-Wafa rehabilitation hospital east of Shejaia, an eastern suburb of Gaza.
Basman Alashi, head of the hospital, said: "We were not able to evacuate all the patients, the staff can barely evacuate themselves at this point It's a desperate situation.
"The hospital has been hit many times."
It's been an emotionally exhausting day in Israel and Gaza as hopes for peace were raised then dashed then raised then dashed again.
In the court of international opinion, this is how Israel wins a battle and still manages to lose the war.
Until the Israelis and the Palestinians find a way of resolving the underlining conflict this will not be more than a pause.