A long line of blocked relief trucks on Egypt's side of the border with the Gaza Strip where people face starvation is a moral outrage, UN Secretary General Antonio Guterres said during a visit to the Rafah crossing on Saturday (March 23).

It was time for Israel to give an "iron clad commitment" for unfettered access to humanitarian goods throughout Gaza, said Guterres, who also called for an immediate humanitarian ceasefire and the release of Israeli hostages held in Gaza.

The UN would continue to work with Egypt to "streamline" the flow of aid into Gaza, he added in front of the gate of the Rafah crossing, an entry point for aid.

"We see the heartbreak and heartlessness of it all. A long line of blocked relief trucks on one side of the gates, the long shadow of starvation on the other," Guterres said. "That is more than tragic. It is a moral outrage."

The visit by Guterres comes as Israel faces global pressure to allow more humanitarian aid into Gaza, which has been devastated by more than five months of war between Israel and Hamas.

Israel is threatening to launch a major military operation in the southern Gaza city of Rafah, just over the border from Egypt, despite international appeals against such an attack.

A majority of Gaza's 2.3 million residents are sheltering around Rafah. Although conditions are worse in the north of the strip, the plight of civilians across the territory has deteriorated sharply as the conflict has ground on.

Meanwhile, fighting raged on Saturday around Gaza's main hospital where Israel says it has so far killed more than 170 gunmen in an extensive raid, which the Palestinian Health Ministry says has also resulted in the deaths of five patients.

The armed wing of Hamas and the Islamic Jihad said their fighters were engaged in battles with the Israeli forces outside and around the vicinity of Al Shifa hospital in Gaza City, though Hamas denies any presence inside the facility.

Israeli troops stormed Al Shifa last Monday (March 18) and have since been combing through the sprawling complex, which the military says is connected to a tunnel network used as a base for Hamas and other Palestinian fighters.

The Gaza health ministry said five wounded Palestinians "besieged" inside Al Shifa died as a result of being denied proper care, water and food for the past six days and that the condition of other injured patients was deteriorating.

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The Israeli military, which has lost two soldiers in combat at the hospital, says it is preventing harm to civilians, patients and medical staff there and providing them with food, water and adequate access to healthcare.

With hopes for a truce in Gaza during the Muslim holy month of Ramadan fading and the humanitarian situation in Gaza more desperate, various countries and NGOs have sought to use air drops and ships to deliver aid.

But humanitarians say only about one-fifth of the required amount of supplies has been entering Gaza, and that the only way to meet needs is to rapidly accelerate deliveries by road.

Israel, which has vowed to destroy Hamas and is worried the Palestinian militant group will divert aid, has kept all but one of its land crossings into the enclave closed. It opened its Kerem Shalom crossing close to Rafah in late December and denies accusations by Egypt and UN aid agencies it has delayed deliveries of humanitarian relief.

This week, a global food monitor warned that famine was imminent in northern Gaza and could spread to other parts of the territory if a ceasefire is not agreed.

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