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The death toll from Israel’s war on Gaza climbed to more than 34,000 on Saturday, with the majority of victims women and children, including at least six killed by an overnight airstrike on a house in Rafah.

The latest grim milestone comes as hope of a ceasefire has dimmed, and global attention has shifted to the dangerous exchange of missile and drone strikes between Iran and Israel.

Nearly 77,000 people have also been wounded, according to health authorities under the Hamas-run Gaza government. The figures exclude tens of thousands of dead who are believed to be buried in the bombed-out ruins of homes, shops, shelters and other buildings.

The figures do not differentiate between civilians and Hamas fighters; Israel’s military says it has killed more than 13,000 militants.

With talks in effect on hold, Israel has signalled it plans to push ahead with a ground operation in southern Rafah, the only part of Gaza where it has not sent in troops. Air strikes have continued there, and one on Friday night hit a home in western Tel al-Sultan neighbourhood, killing nine people.

Ahmed Barhoum lost his wife, Rawan Radwan, and their five-year-old daughter Alaa. “They bombed a house full of displaced people, women and children,” he told Associated Press on Saturday, crying as he cradled Alaa’s body, wrapped in a white shroud, and gently rocked her. “This is a world devoid of all human values and morals.”

Israel’s international allies and humanitarian organisations working in Gaza have warned that a full-scale ground offensive in a town filled with people displaced from the north of Gaza would be devastating.

The US president, Joe Biden, has said Israel should not go into Rafah without credible plans to protect civilians, and foreign ministers from the G7 countries said on Friday they opposed a full-scale military operation on the grounds it would be catastrophic for people sheltering there.

Israeli prime minister Benjamin Netanyahu says four brigades of Hamas fighters are hiding there and must be tackled. His government has vowed to “destroy” the group, after the 7 October cross border attacks when militants killed about 1,200 people inside Israel and took 250 hostage.

More than a hundred hostages were released in November as part of a temporary ceasefire deal, but talks on another pause in fighting and freeing more of those held have stalled.

Qatar, the Gulf state that has been a key broker in talks between Hamas and Israel, is reconsidering its role as mediator because its work had been subject to “political exploitation”, its prime minister, Sheikh Mohammed bin Abdulrahman Al Thani, said last week.

The country is often criticised for its links to Hamas and allowing the group’s leaders to create a base in Doha, even though it did so a decade ago at the request of the US.

The Hamas leadership is now looking into moving elsewhere, the Wall Street Journal reported on Saturday. That would likely further disrupt faltering talks on a deal to end fighting in Gaza and release hostages, even though suffering in the enclave deepens by the day.

Famine looms, made worse by acute shortages of shelter, medicine and clean water. Almost everyone in the enclave now depends on donated food, after more than six months of war has destroyed homes and decimated Gaza’s economy.

Daily aid shipments are still not even half the minimum levels the UN says are needed to keep more than two million people alive.

Israeli authorities, the US and humanitarian organisations have all said that deliveries should return to prewar levels of about 500 truckloads of aid a day. On Friday, only 250 trucks entered the enclave, UN figures showed, and that was the highest in April.

In March there had been increasing international pressure on Israel to get more food and other supplies into Gaza, including from a visibly frustrated Biden.

But when an Israeli missile strike on an Iranian diplomatic compound in Damascus earlier this month spurred a dangerous cycle of escalation with Iran, the diplomatic focus abruptly switched to protecting Israel and trying to avoid the conflict spreading.

A series of Israeli measures promised to smooth the flow of aid have stalled, including direct access to northern Gaza and a new system for the military to coordinate with humanitarian groups to ensure their safety, after seven World Central Kitchen workers were killed in airstrikes.

Some trucks have been allowed into northern Gaza through new crossings, but these have not been opened to the UN, which provides the vast majority of food aid there.

There has also been spiralling violence in the occupied West Bank, where an Israeli military raid on a refugee camp near the northern town of Tulkarem on Friday night killed a child and three militants.

Residents closed shops, restaurants and government offices on Saturday in a general strike to protest the attack on the Nur Shams refugee camp, AP reported.

More than 460 Palestinians,including militants and civilians, have been killed by Israeli fire in the West Bank since 7 October, Palestinian health officials say. Some were killed by the Israeli military but others in attacks by settlers.