A building damaged by Israeli strikes collapsed suddenly in Gaza City early Wednesday, killing at least 21 people in their sleep, including 11 children, in a disaster that forced rescuers to dig through the rubble with bare hands.

The sudden collapse of the building, which was known to be unstable due to damage from Israeli strikes earlier in the war, underscored how perilous and desperate living conditions have grown for the majority of the enclave‘s population as a ceasefire deal between Israel and Hamas stalls.