RAMALLAH – Israel is again preventing journalists from entering Gaza to report firsthand on the escalating crisis there as its military operation, codenamed Operation Cast Lead, enters its fifth day.

Israel imposed an unprecedented news blackout in November and banned foreign journalists from the Gaza Strip for an entire month.

This followed an Israeli cross-border military incursion into the coastal territory which broke the fragile ceasefire between Hamas and Israel, and set off the current cycle of violence.

The media ban was eventually lifted after the Foreign Press Association (FPA) in Israel petitioned the Israeli Supreme Court, and editors from a number of foreign media outlets sent a letter of protest to the Israeli government.

The foreign media is once again petitioning an Israeli court for permission to enter Gaza and cover the conflict.

Media outlets have had to rely on international human rights activists, aid organizations and Palestinian journalists based in Gaza to update them on unfolding events.

Meanwhile the number of civilian casualties continues to rise. The total Palestinian death toll now stands at 390 with 1,800 injured. Two Israeli Arabs and one Jewish Israeli have been killed in rocket attacks from Gaza.

The civilian toll on the Palestinian side is shooting up. On Sunday a family from the Jabaliya refugee camp near Gaza city lost five sisters, aged 4 to 17, when an Israeli air strike hit a mosque next to their home.

The same day seven teenagers from a UN Relief and Welfare Agency (UNRWA) school were killed when a missile hit them as they waited after school for a bus to take them home. The UN has called for an investigation into their deaths.

On Tuesday two sisters, aged 4 and 11, perished in an air strike as they rode in a donkey cart in Beit Hanoun in northern Gaza.

The UN released a report on Monday stating that by a conservative estimate more than 60 Palestinian civilians had been killed.

On Wednesday Mahmoed Daher, spokesman for the World Health Organization (WHO) in Gaza told IPS, "Thirty-four children have been killed and 260 injured, many of them critically."

A Palestinian Health Ministry official, Moaiya Hassanain, went further and estimated that one-third of those killed were non-combatants. Children comprise 56 percent of Gaza’s population of about 1.5 million.

Earlier in the year an Israeli operation into Gaza, codenamed Warm Winter, left 120 people, mostly civilians dead, including 33 children.

According to the Defense of Children International (DCI) Palestine branch, since the beginning of the year 700 Gazans and four Israelis have been killed.

"We attended to 15 seriously injured elderly people and more than 20 children in the last few days," said Sammy Hassan, a spokesman from Gaza’s Shifa hospital.

"At one stage over 140 dead and injured were brought in at one go. Our staff was completely overwhelmed, we simply didn’t have the resources to cope. The wounded and dying were lying in the corridors and on the floors," Hassan told IPS.

"We don’t have sufficient medicine or properly functioning medical equipment to deal with the patients. Electricity is cut for a number of hours and fuel supplies for our emergency generator have run precariously low."

Ann Sophie Bonefeld, spokeswoman for the International Committee of the Red Cross (ICRC) in Jerusalem, said her organization was deeply concerned about the deteriorating humanitarian situation.

"There are shortages of blood, medicine and spare parts for essential medical equipment. Medical staff are overstretched and worried for their own safety," Bonefeld told IPS.

"It is imperative that the crossings into Gaza are opened in the next few days because these are Gaza’s only link to the outside world now that the tunnels from Egypt have been destroyed," she added.

Israel’s siege of Gaza, imposed after Hamas took over in June of last year, permits only a trickle of the barest humanitarian aid into Gaza.

In a separate incident, a boat carrying urgent humanitarian supplies from Cyprus was rammed and fired on by the Israeli navy as it approached Gaza on Tuesday.

On board were former US Democratic congresswoman Cynthia McKinney, a CNN news crew and a number of doctors and journalists. The CNN crew filmed the incident.

The boat, which was in international waters, was seriously damaged and forced to head to Beirut for emergency repairs as water started to flood the vessel.

And as Israel fights a military battle in Gaza, it is simultaneously fighting a diplomatic battle on the international front in an effort to justify the Gaza onslaught.

Karen Abu-Zayd, the UNRWA commissioner in Gaza, has said Israel may have breached a 48-hour lull in fighting when it launched its aerial onslaught over Gaza on Saturday.

"What we understood was that there was a 48-hour lull to be called, and this was called by the Israelis," Abu-Zayd said.

On the morning of Friday last week, the Israelis had said they would wait 48 hours until Sunday morning and then they would reevaluate the situation, according to Abu Zayd.

"There was only one rocket that went out on Friday, so it was obvious that Hamas was trying, again, to observe that truce to get this back under control," she said.

Israel’s UN Mission referred any comment on the reported lull to Prime Minister Ehud Olmert’s office in Jerusalem. Olmert’s office did not answer telephone calls for comment early Tuesday morning.