DEIR AL-BALAH, Gaza Strip — An Israeli strike on a hospital in southern Gaza killed four journalists Monday, including a freelancer who worked for The Associated Press, according to health officials.

Mariam Dagga, 33, a visual journalist, freelanced for the AP during the war, as well as other news outlets. The AP said in a statement that it was shocked and saddened to learn of Dagga’s death, along with those of other journalists.

In all, 19 people were killed in the strike on Nasser Hospital, according to Zaher al-Waheidi, head of the Gaza Health Ministry’s records department. The Health Ministry is run by Hamas.

The Israel-Hamas war has been one of the bloodiest conflicts for media workers, with at least 192 journalists killed in Gaza in the 22-month conflict, according to the Committee to Protect Journalists. Comparatively, 18 journalists have been killed so far in Russia’s war in Ukraine, according to the CPJ.

Dagga, who has a 12-year-old son who was evacuated from Gaza earlier in the war, frequently based herself at Nasser, most recently reporting on the hospital’s doctors struggling to save children from starvation. Independent Arabia, the Arabic language version of the British Independent, said Dagga had also worked with the organization.

“We are doing everything we can to keep our journalists in Gaza safe as they continue to provide crucial eyewitness reporting in difficult and dangerous conditions,” the AP said.

Al Jazeera confirmed that its journalist Mohammed Salam was also among those who were killed in the Nasser strike. Reuters reported that its contractor cameraman Hussam al-Masri was killed and its contractor photographer Hatem Khaled wounded. It was not immediately clear who the fourth journalist killed was.

The Israeli military said its troops carried out a strike in the area of Nasser Hospital in Khan Younis and that it would conduct an investigation into the incident. The military said it “regrets any harm to uninvolved individuals and does not target journalists as such.”

Thibaut Bruttin, the director general of Reporters Without Borders, said press freedom advocates had never seen such a severe step backward for reporters’ safety. He noted that journalists have been killed both in indiscriminate strikes and in targeted attacks that Israel’s military has acknowledged carrying out.

“They are doing everything they can to silence independent voices that are trying to report on Gaza,” Bruttin said.

In some cases, such as with Al Jazeera correspondent Anas al-Sharif, who was targeted and killed by Israel earlier this month, Israel has accused journalists in Gaza of being part of militant groups. Israel’s military asserted that al-Sharif had led a Hamas cell - an allegation that Al Jazeera and al-Sharif previously dismissed as baseless.

Aside from rare guided tours, Israel has barred international media from covering the war. News organizations instead rely largely on Palestinian journalists in Gaza — as well as residents — to show the world what is happening there. Israel often questions the affiliations and biases of Palestinian journalists but doesn’t permit others in.

Many of the journalists working in Gaza are facing the same struggles to find food, for themselves and their families, as the people they are covering.

In one of Dagga’s last social media posts on Sunday, she published a selfie of herself leaning against a wall.

Lidman reported from Jerusalem. Associated Press writers Samy Magdy contributed from Cairo and Sam Metz from Jerusalem.