Israeli gunfire and airstrikes killed more than 50 Palestinians in Gaza on Saturday, including some who were waiting overnight for aid, according to local health officials, continuing a pattern that has drawn international criticism as the country’s “drip-feeding of aid” into the enclave continues to claim lives.

Israel has long restricted or completely blocked aid to Gaza on the argument that Hamas steals it to use as a weapon of control over the population.

A State Department spokesperson disputed the findings, saying there is video evidence of Hamas looting aid, but provided no such videos.