Health officials and witnesses say residential buildings have been reduced to rubble in Rafah and Khan Younis.

The Israeli army has escalated aerial attacks across the Gaza Strip, crushing families in the rubble of residential buildings, as health officials said dozens of Palestinians were killed overnight and medical facilities were shut down because of bomb damage and lack of power.

Across central and south Gaza, where Israel has told civilians to take shelter ahead of an expected ground offensive, there were multiple scenes of rescuers on Wednesday pulling the dead and wounded out of large piles of rubble from buildings destroyed by Israeli air attacks.

Buildings that collapsed on residents killed dozens at a time in several cases, witnesses told The Associated Press news agency. Two families lost a total of 47 members in a levelled home in Rafah, according to health officials in the enclave.

An air strike on a four-storey building in Khan Younis killed at least 32 people, including 13 members of the Saqallah family, Ammar al-Butta, a relative who survived the attack, told the AP. He said about 100 people were sheltering in the building, including many who had evacuated from Gaza City.

ā€œWe thought that our area would be safe,ā€ he said.

A Palestinian stands outside the building destroyed i the Israeli bombardment of the Gaza Strip in Rafah,
A Palestinian man stands outside a building in Rafah that was destroyed in the Israeli bombardment. [Hatem Ali/AP Photo]
Palestinians pray by the bodies of people killed in the Israeli bombardment of the Gaza Strip in Rafah
Palestinians pray by the bodies of people killed in Rafah. The Israeli military said it targeted ‘terror tunnel shafts, military headquarters, weapons warehouses, mortars and anti-tank missile launchers’. [Hatem Ali/AP Photo]
People search for survivors and the bodies of victims through buildings that were destroyed during Israeli bombardment, in Khan Yunis
People search for survivors and the bodies of victims in buildings that were destroyed during the Israeli bombardment in Khan Younis, southern Gaza. [Mahmud Hams/AFP]
Palestinians look on during a search for casualties at the site of Israeli strikes on houses, in Khan Younis
Palestinians search for casualties at the site of Israeli strikes on houses in Khan Younis. Overnight, at least 80 people were killed, the Hamas government said on Wednesday. [Ibraheem Abu Mustafa/Reuters]
People search for survivors and the bodies of victims through buildings that were destroyed during Israeli bombardment, in Khan Yunis
People search through buildings that were destroyed during Israeli air raids in Khan Younis. [Ahmad Hasaballah/Getty Images]
A Palestinian man reacts during a search for casualties following an Israeli strike on a house, in Khan Younis
A Palestinian man reacts during a search for casualties following an Israeli attack on a house in Khan Younis. [Ibraheem Abu Mustafa/Reuters]