Israeli strikes have killed hundreds of Palestinians in Gaza since a cease-fire took effect in October, raising doubts about the durability of the truce as violence continues, aid stalls and both Israel and Hamas accuse each other of repeated violations.
As the bodies of two dozen Palestinians killed in Israeli strikes arrived at hospitals in Gaza on Wednesday, the director of one asked a question that has echoed across the war-ravaged territory for months.
"Where is the cease-fire? Where are the mediators?" al-Shifa Hospital's Mohamed Abu Selmiya wrote on Facebook.
At least 556 Palestinians have been killed in Israeli strikes since the U.S.-brokered truce, including 24 on Wednesday and 30 on Saturday, according to Gaza's Health Ministry.
Four Israeli soldiers have been killed in Gaza in the same period, with more injured, including a soldier whom the military said was severely wounded when Palestinian resistance groups allegedly opened fire near the cease-fire line in northern Gaza overnight.
Other aspects of the agreement have stalled, including the deployment of an international security force, Hamas' disarmament and the start of Gaza's reconstruction.
The opening of the Rafah border crossing between Gaza and Egypt raised hope of further progress, but fewer than 50 people were allowed to cross on Monday.
In October, after months of stalled negotiations, Israel and Hamas accepted a 20-point plan proposed by U.S. President Donald Trump aimed at ending the war unleashed by Hamas' Oct. 7, 2023, attack into Israel.
At the time, Trump said it would lead to a "Strong, Durable, and Everlasting Peace."
Hamas freed all the living hostages it still held at the outset of the deal in exchange for thousands of Palestinian prisoners held by Israel and the remains of others.
But the larger issues the agreement sought to address, including the future governance of the strip, were met with reservations, and the U.S. offered no firm timeline.
The return of the remains of hostages, meanwhile, stretched far beyond the 72-hour timeline outlined in the agreement. Israel recovered the body of the last hostage only last week, after accusing Hamas and other groups of violating the cease-fire by failing to return all of the bodies.
The groups said they were unable to immediately locate all the remains because of the massive destruction caused by the war – a claim Israel rejected.
The cease-fire also called for an immediate influx of humanitarian aid, including equipment to clear rubble and rehabilitate infrastructure. The United Nations and humanitarian groups say aid deliveries to Gaza's 2 million Palestinians have fallen short due to customs clearance problems and other delays. COGAT, the Israeli military body overseeing aid to Gaza, has called the U.N.'s claims "simply a lie."
Violence has sharply declined since the cease-fire paused Israel's genocidal war in which more than 71,800 Palestinians have been killed, according to the Gaza Health Ministry. The ministry maintains detailed records seen as generally reliable by U.N. agencies and independent experts.
Hamas-led groups caused some 1,200 deaths in the initial October 2023 incursion and took around 250 hostages.
Both sides say the agreement is still in effect and use the word "cease-fire" in their communications. But Israel accuses Hamas of operating beyond the truce line splitting Gaza in half, threatening its troops and occasionally opening fire, while Hamas accuses Israeli forces of gunfire and strikes on residential areas far from the line.
Palestinians have called on U.S. and Arab mediators to get Israel to stop carrying out deadly strikes, which often kill civilians. Among those killed on Wednesday were six children, including two babies. Hamas, which accuses Israel of hundreds of violations, called it a "grave circumvention of the cease-fire agreement."
In a joint statement Sunday, eight Arab and Muslim countries condemned Israel’s actions since the agreement took effect and urged restraint from all sides "to preserve and sustain the cease-fire."
Israel says it is responding to daily violations committed by Hamas and acting to protect its troops. "While Hamas’ actions undermine the cease-fire, Israel remains fully committed to upholding it," the military said in a statement on Wednesday.
"One of the scenarios the (military) has to be ready for is Hamas is using a deception tactic like they did before October 7 and rearming and preparing for an attack when it’s comfortable for them," said Lt. Col. Nadav Shoshani, a military spokesperson.
The return of the remains of the last hostage, the limited opening of the Rafah crossing, and the naming of a Palestinian committee to govern Gaza and oversee its reconstruction showed a willingness to advance the agreement despite the violence.
Last month, U.S. envoy Steve Witkoff, who played a key role in brokering the truce, said it was time for "transitioning from cease-fire to demilitarization, technocratic governance, and reconstruction."
That will require Israel and Hamas to grapple with major issues on which they have been sharply divided, including whether Israel will fully withdraw from Gaza and Hamas will lay down its arms.
Though political leaders are holding onto the term "cease-fire" and have yet to withdraw from the process, there is growing despair in Gaza.
On Saturday, Atallah Abu Hadaiyed heard explosions in Gaza City during his morning prayers and ran outside to find his cousins lying on the ground as flames curled around them.
"We don’t know if we’re at war or at peace," he said from a displacement camp, as tarpaulin strips blew off the tent behind him.
