A little girl in pink pyjamas has been settled on a bloodied bed at Kuwait Specialty Hospital in Gaza’s southern city of Rafah, her face bewildered as she blinks repeatedly.

Shrapnel tore a gaping wound on her torso, which was hastily bandaged when she first arrived at the hospital. Now medics are frantically trying to decide whether to remove some of the gauze to treat her further.

Her parents hover around her, holding their two other young children, as they try to call the attention of the overworked medics.

Nearby, a girl dressed in a sodden red hoodie shrieks and shudders in pain as a medic tries to find a vein in her emaciated arm.

An elderly woman by her side tries to console the screaming girl, but the girl’s eyes are closed as she writhes in agony, clenching her jaw between shrieks.

A few beds over, a toddler, whose hair is matted with blood, breathes in and out of consciousness as doctors hurriedly stitch her head. She is heaving deeply, intermittently letting out a small cry.

In the vicinity, several medics carry the lifeless body of a little boy wearing shorts and a matching blood-soaked T-shirt onto a hospital bed, before he is shrouded in a white cloth, bundled for burial.

An elderly man approaches the boy, now covered in the white cloth, and kneels by his bed, beating his crown of white hair repeatedly in despair.

These are the scenes at the Gaza hospital following Israeli air strikes late on Sunday on a camp housing displaced Palestinians in the Tal as-Sultan area near Rafah – an area designated a safe zone.

As Israeli missiles struck the camp in the night, a fire spread rapidly, razing the encampment to the ground and killing at least 45 people, according to Gaza officials.

In the midst of medics frantically trying to help the injured and shroud the dead, reports of an Israeli drone strike on the hospital’s entrance emerged, stating that two staff members were killed.

Charred bodies, limbs blown off

When Dr Muhammad al-Mughayer, from the Palestinian Civil Defence, arrived at the site of the attack, the fires were still burning.

“The fires were very big and they were spreading all over the place,” al-Mughayer told Al Jazeera.

Most of those who were killed had severe burns on their bodies, he added.

As al-Mughayer’s team worked to rescue survivors and retrieve corpses, they encountered charred bodies and people whose limbs had been blown off.

The Wafa news agency, quoting the Palestine Red Crescent Society (PRCS), said that many of those who died were “burned alive” inside their tents.

According to the Israeli military, it used high-precision munitions in the attack. and they struck a Hamas compound in Rafah “on the basis of precise intelligence”.

In addition to the other Palestinians killed, the attack also took out Hamas’s chief of staff for the West Bank, as well as another senior Hamas official, the military said.

The army has said it is “aware” of reports that “several civilians in the area were harmed”.

According to a review of Israeli military evacuation orders in Rafah, by Al Jazeera’s fact-checking agency Sanad, the displaced Palestinians at the camp had not been instructed to leave for elsewhere.

Satellite imagery, which Sanad also reviewed, shows that the shelter at the site of the attack was established in January, coinciding with the arrival of hundreds of thousands of displaced people to the area from various other parts of the Strip.

‘The people were burned! They were burned!’

Many of those who were in Tal as-Sultan seeking refuge from the fighting find themselves in anguish.

Back at the Kuwaiti Hospital, among the panicked cries of the injured and the frenetic activity of the doctors and nurses, a man lies on a hospital bed with an uncanny air of calm.

His right leg is propped up, bandaged tightly after it was injured in the attack. He is scrolling on his phone, wounded children writhing in pain on beds on either side of him.

“We were just walking around [an] hour before [the attack]. Then there was the explosion …and I didn’t understand anything,” he told Al Jazeera, saying he, his brother, and his son were all injured in the air strike.

“I saw that my leg was [wounded] … [but] I didn’t know how bad it was.”

The man, like many Palestinians, has been displaced multiple times in the besieged strip during the war. One of his brothers was killed during the near-eight-month conflict.

“What happened is really hard and there is nothing we can do,” he said.

As he speaks, a friend rushes to his side.

“The people burned! they were burned! They were all burned! What else am I supposed to say?” his friend shouts, throwing his hands in the air.

“The missile[s] came down, and exploded, and all the people burned.”

Near the now-burned camp, a trembling boy named Amr blinks back tears. He was in the bathroom when the attack took place, he says between sobs.

“It happened so fast,” Amr says, a pained expression on his face.

“It just went like this,” the little boy said, using his hands to depict an aeroplane. “None of us knew what happened”.

“We’re scared, we’re scared,” the boy, still reeling, repeated.