WADI GAZA, Gaza Strip — A ship carrying 200 tons of aid approached the coast of Gaza on Friday in a mission to inaugurate a sea route from Cyprus to help alleviate the humanitarian crisis brought by Israel’s 5-month-old offensive in the enclave.

Israel has been under increasing pressure to allow more aid into Gaza, especially in its isolated north where hunger is at its worst, with many Palestinians reduced to eating animal feed and weeds. The United States has joined other countries in airdropping supplies to northern Gaza and has announced separate plans to construct a pier to get aid in.

Aid groups said the airdrops and sea shipments are far less efficient ways of delivering the massive amounts of aid needed. Instead, the groups have called on Israel to guarantee safe corridors for truck convoys after land deliveries became nearly impossible because of military restrictions, ongoing hostilities and the breakdown of order after the Hamas-run police force largely vanished from the streets.

The ship, operated by the Spanish aid group Open Arms, could be seen off Gaza’s coast throughout the day Friday, though it was not clear when it would land. It left Cyprus on Tuesday.

It is towing a barge laden with food, including rice, flour, lentils, beans, tuna and canned meat. The food was sent by World Central Kitchen, the charity founded by celebrity chef José Andrés, which operates kitchens providing free meals in Gaza.

It plans to distribute the food in the north, the largely devastated target of Israel’s initial offensive in Gaza, where up to 300,000 Palestinians are believed to have remained, mostly cut off by Israeli forces since October.

The shipment is intended to pave the way for larger cargos. A second vessel will head to Gaza once the supplies on the first ship are distributed, Cyprus’ Foreign Minister Constantinos Kombos said. Its timing depends in part on whether the Open Arms delivery goes smoothly, he said.

The Israel-Hamas war was triggered by Hamas’ Oct. 7 attack on Israel that killed 1,200 people and left another 250 taken into Gaza as hostages. Israel’s offensive in Gaza has killed over 31,000 Palestinians and driven most of Gaza’s 2.3 million people from their homes. A quarter of Gaza’s population is starving, according to the United Nations.

The Palestinian Health Ministry in Gaza accused Israeli forces late Thursday of attacking Palestinians waiting for an aid convoy at a distribution point in northern Gaza, killing at least 20 people and wounding 155. At Shifa Hospital, doctors said the casualties were mostly hit by live fire, with some showing signs of being crushed.

The Israeli military denied its forces fired at civilians or the convoy. In a statement, it said Palestinian gunmen opened fire among the crowd and that some were run over by the trucks. Aerial footage released by the military appeared to show only one man pushing and shoving people.

Bloodshed surrounding an aid convoy on Feb. 29 killed 118 Palestinians in northern Gaza, when the Israeli military said its forces fired at people in the crowd who were advancing toward them and that tanks fired warning shots to disperse them. Witnesses and hospital officials said many of the casualties were from bullet wounds.

Military officials initially blamed many of the deaths on a stampede; a later military command review said only that the stampede caused “significant harm” without addressing the cause of the deaths.

After that, plans for the sea route took shape and the United States and other countries joined Jordan in dropping aid into the north by plane.

But people in northern Gaza say the airdrops can’t meet the vast need. Many can’t access the aid because people are fighting over it, said Suwar Baroud, 24, who was displaced by the fighting and is now in Gaza City. Some people hoard it and sell it in the market, she said.

A recent airdrop that malfunctioned plummeted from the sky and killed five people.

Another landed in a sewage and garbage dump, said Riham Abu al-Bid. Men ran in but were unable to retrieve anything, she said.

“I wish these airdrops never happened and that our dignity and freedom would be taken into consideration, so we can get our sustenance in a dignified way and not in a manner that is so humiliating,” she said.

An average of around 115 supply trucks a day has entered Gaza over the entire course of the war, according to figures released by the Israeli prime minister’s office — far below the average of 500 a day before Oct. 7 — though on some days the number spikes to above 200.

This week, Israel began allowing trucks to enter directly into the north, a step aid groups have long called for. The military has also been arranging private commercial convoys and says more than 300 trucks — mainly private — have entered the north since the beginning of February.

The Gaza Health Ministry said Friday that at least 31,490 Palestinians have been killed in the war. The ministry doesn’t differentiate between civilians and combatants in its count, but says women and children make up two-thirds of the dead.

International mediators have been working to broker a cease-fire, though hopes were thwarted for one before the Muslim holy month of Ramadan, which started this week.

Hamas put forward a new cease-fire proposal calling for a three-stage process, according to a report by Al-Jazeera TV confirmed to the Associated Press by a Palestinian official.

The first six-week stage would bring a partial Israeli pullback in Gaza and the release of all female hostages held by the militants in exchange for the release of dozens of Palestinian prisoners held by Israel. In the second, a permanent cease-fire would be declared and Hamas would release all Israeli soldiers being held. In the third stage, reconstruction of Gaza would begin and the Israeli blockade of Gaza would be lifted.

Israeli Prime Minister Benjamin Netanyahu called the proposal “unrealistic,” but said Israel would send negotiators to Qatar for more talks.

Netanyahu’s office also said Friday that Israel has approved military plans to attack Rafah, the southernmost town in Gaza where some 1.4 million displaced Palestinians are sheltering.

It said the operation will involve the evacuation of the civilian population but did not give details or a timetable for the plans. The military said Wednesday it planned to direct them to “humanitarian islands” in central Gaza.

At Al-Aqsa Mosque in Jerusalem, the third-holiest site in Islam, the first Friday prayers of Ramadan were held without a major outbreak of protest or violence.

The mosque has been a frequent flashpoint for Israeli-Palestinian violence in the past. Israel limited West Bank Palestinians’ access to Friday’s prayers to men over 55, women over 50 and children under 10.

The compound has long been a deeply contested religious space, as it stands on the Temple Mount, which Jews consider their most sacred site.