The Israeli military has ordered more evacuations in southern Gaza after a deadly air strike on a school-turned-shelter in the north killed more than 100 Palestinians, according to local health authorities.

Hundreds of families carrying their belongings in their arms left their homes and shelters in Khan Younis early on Sunday, seeking elusive refuge.

Israel has repeatedly ordered mass evacuations as its troops have returned to heavily damaged areas where they had previously battled Palestinian fighters. The vast majority of Gaza’s 2.3 million people has been displaced by the 10-month war, often multiple times.

Hundreds of thousands have crammed into squalid tent camps with few public services or have sought shelter in schools like the one struck on Saturday in Gaza City. Palestinians say nowhere in the besieged territory feels safe.

The latest evacuation orders apply to areas in Khan Younis, including part of an Israeli-declared humanitarian zone from which the military said rockets had been fired. Israel accuses Hamas and other Palestinian armed groups of hiding among civilians and launching attacks from residential areas.

Khan Younis, Gaza’s second largest city, has suffered widespread destruction during Israeli air and ground attacks. Tens of thousands of people fled again last week after an earlier evacuation order.

Gaza’s Ministry of Health says the Palestinian death toll from the war is approaching 40,000 with more than 92,000 wounded. Aid groups have struggled to address the staggering humanitarian crisis in the territory while international experts have warned of famine.