Israel has carried out its deadliest day of strikes across the Gaza Strip since it shattered a ceasefire in mid-March. Israeli attacks killed at least 143 people since dawn on Thursday, according to health officials, bringing the documented death toll in Gaza to over 53,000 — though thousands more are missing under the rubble and presumed dead. One in five Palestinians — some half a million people — are facing starvation, according to the U.N., with Israel’s total blockade of food, water and medicine now in its 74th day.

In Khan Younis, 13-year-old Palestinian Reem al-Zanaty narrowly survived an Israeli strike that collapsed her family’s home. After her father pulled her from the rubble, she learned that many of her relatives were dead.

Reem al-Zanaty: “The entire family of my uncle has been martyred. May they rest in peace. How would one feel to see all their loved ones come out as remains from under the rubble? My cousin’s name is Menna. She’s one year younger than me. She was just with me yesterday night. I swear, she bid farewell to me and told me goodbye, as if she felt it.”

The head of the U.N. Children’s Fund, Catherine Russell, condemned Israel’s attacks, writing, “It is unconscionable that over 45 children have reportedly been killed in airstrikes in Gaza in two days. This should shock the world but is largely met with indifference. Nowhere is safe for children in Gaza.”