Tens of thousands of Palestinians have fled the fighting and bombardment in Gaza as Israel said it was tightening its "stranglehold" around Hamas and again rejected a cease-fire without the release of hostages.

Calls for a cease-fire to protect civilians have built over a month into the war sparked when Hamas attacked Israel and, according to Israeli officials, killed about 1,400 people, mainly civilians, and seized 239 hostages.

Aiming to destroy Hamas, Israel retaliated with a relentless bombardment and ground invasion of the Gaza Strip that, according to the Hamas-run health ministry in Gaza, has killed more than 10,500 people, many of them children.