Two Palestinians were killed in separate shooting incidents in Gaza on Wednesday, according to local hospital officials, as tensions continue despite a ceasefire announced in mid October.

Medical authorities reported that the shootings occurred in the Al Mughraqa area of central Gaza and in Al Mawasi, west of Rafah in the south. At least three other Palestinians were injured in the incidents and taken to nearby hospitals for treatment.

The violence comes as Israeli forces attempt to restrict movement near the Rafah border crossing with Egypt, a critical route for patients seeking urgent medical care outside the territory. Although the crossing reopened several weeks ago, health officials say only about 260 patients have been able to leave Gaza over the past two and a half weeks.

Palestinian health authorities estimate that approximately 18,500 people require immediate medical evacuation for specialized treatment unavailable inside Gaza, where hospitals have been severely strained by months of conflict.

According to the Gaza-based Health Ministry, more than 600 Palestinians have been killed and over 1,600 injured since the ceasefire took effect in mid October. The figures could not be independently verified, and Israeli authorities have not immediately commented on the latest incidents.

The ongoing instability has raised concerns among humanitarian agencies about access to medical care and the durability of the ceasefire agreement.