RAFAH, Gaza Strip — Many Palestinians who have been forced to leave their homes in Rafah are feeling tired and stressed as they pack up their tents and other belongings and leave the area with their families.
The main hospital has closed, leaving little medical care for people who are suffering from malnutrition, illnesses, and injuries.
With the supply of fuel and other necessities cut off, aid workers are struggling to assist a population that has been desperate after enduring seven months of war.
As the possibility of a full-scale invasion approaches, the overcrowded southernmost city of Gaza has descended into panic and disorder following Israel's seizure of the nearby border crossing with Egypt.
Families who have been displaced multiple times by the war are unsure where to go next: should they head to the partially destroyed city of Khan Younis, go even further north, or enter an area in Gaza that Israel has designated as a “humanitarian zone” which is already crowded with people and lacks sufficient water and supplies?
Over the past three days, large numbers of people on foot or in vehicles have crowded the roads out of Rafah in a confused evacuation, trying to leave with their belongings piled high in cars, trucks, and donkey carts, all while Israeli bombing continues and smoke fills the air.
“The war has affected us even in schools. There is no safe place at all,” said Nuzhat Jarjer, as she and her family prepared to leave a U.N. school that had been turned into a shelter in Rafah but was rapidly emptying as many who had lived there for months were leaving.
Rafah had a population of 250,000 before the war, which had grown to around 1.4 million as people from all over Gaza sought refuge there. Almost every available space was covered with tent camps, and families were crowded into schools or relatives' homes. Like the rest of Gaza’s population, they have relied heavily on aid groups for food and other essentials.
On Monday, Israel ordered the evacuation of the eastern parts of the city, where around 100,000 people live. It then deployed tanks to take control of the nearby Rafah crossing with Egypt, shutting it down.
It is still unclear whether Israel will launch a full-scale invasion of Rafah as international efforts continue for a cease-fire. Israel has stated that an assault on Rafah is essential to their objective of eliminating Hamas following the militant group’s attack on southern Israel on Oct. 7, which resulted in 1,200 deaths and 250 people being held hostage in Gaza.
The United States, which opposes an invasion of Rafah, has indicated that Israel has not presented a credible plan for evacuating and protecting civilians. According to Gaza health officials, the war has claimed over 34,800 Palestinian lives and has forced around 80% of Gaza’s population of 2.3 million Palestinians to leave their homes.
Currently, there is widespread uncertainty. Fearing a larger attack, Palestinians have fled from areas other than the eastern districts where they were instructed to leave. It is estimated that tens of thousands have departed, as per a U.N. official who spoke anonymously due to ongoing efforts by agencies to establish precise figures.
Tent camps in certain parts of Rafah have disappeared, only to reappear further north along the main roads. New camps have emerged in streets, cemeteries, and on the beach in the central Gaza town of Deir al-Balah, which is 15 kilometers north, as people have arrived, as reported by Ghada Alhaddad, who is working with the aid organization Oxfam, speaking at a briefing with other humanitarian workers.
Others went to Khan Younis, a place that was mostly destroyed in a long Israeli ground attack.
The head of operations for the Norwegian Refugee Council in Palestine, Suze van Meegen, said that the area where she works in Rafah seems deserted.
The Israeli military instructed evacuees to go to a designated “humanitarian zone” in Muwasi, a rural area near the coast. This zone is already crowded with around 450,000 people, and new facilities appear to be lacking, despite the military’s promises of providing tents, medical centers, and food.
Many areas are covered in sewage and waste due to the lack of sanitation facilities, according to aid workers. There is a shortage of clean water and high temperatures, sometimes reaching 100 degrees Fahrenheit, are causing dehydration.
The quality of water is extremely poor. James Smith, a British doctor volunteering at the European General Hospital in Khan Younis, described the water as having high levels of fecal content. There is a widespread occurrence of acute jaundice, likely caused by hepatitis, but testing capabilities are lacking.
New arrivals are struggling to find tents due to a severe shortage among aid organizations.
Iyad al-Masry, before moving his family from Rafah to the designated zone, had to sell aid-received food to purchase a tent for nearly $400.
After setting up a tent in Muwasi, Iyad al-Masri mentioned that he is having difficulty finding affordable drinking water.
Al-Masri expressed a desire for food while he waits for aid.
Nick Maynard, a surgeon with Medical Aid for Palestinians, revealed that two teenage girls with survivable injuries died from complications related to malnutrition.
Maynard described a vicious cycle of malnutrition, infection, and wound complications that leads to further malnutrition.
Alexandra Saieh from Save The Children highlighted the high number of children in Rafah who have lost one or more limbs, stating that these individuals cannot easily relocate.
Rafah’s main Youssef al-Najjar Hospital was evacuated, with staff and patients leaving due to fears of potential raids by Israeli troops.
Israel has accused Hamas of using hospitals for military purposes, a claim denied by Hamas and Gaza health officials.
Israeli tank shells struck near the Kuwaiti Hospital, wounding several children and causing damage.
The closure of Rafah crossing and the nearby Kerem Shalom crossing has resulted in a halt to the entry of food, supplies, and fuel for aid trucks and generators. Aid groups are warning that without fuel, humanitarian operations and hospitals in Gaza will soon be forced to close.
Israel stated on Wednesday that it reopened Kerem Shalom, which was closed following the deaths of four Israeli soldiers due to Hamas mortars nearby. However, aid groups reported that no trucks were entering the Gaza side. Trucks allowed through from Israel need to be unloaded and the cargo reloaded onto trucks in Gaza. However, workers in Gaza cannot access the facility to do so because it is too dangerous, according to the U.N.
Palestinian workers attempting to reach the border crossing on Wednesday were fired upon, resulting in several being wounded, the Israeli military reported. It did not specify who opened fire but stated that an investigation was underway. Hamas also shelled the area of Kerem Shalom on Wednesday, claiming it was targeting nearby troops.
The U.N.'s World Food Program has been disconnected from its Gaza food warehouse near the Rafah crossing, according to Carl Skau, its deputy executive director. The organization has acquired another warehouse in Deir al-Balah, but it remains empty until the crossings are reopened, he mentioned.
Van Meegen, from the Norwegian Refugee Council, expressed concern about the lack of supplies, asking, “how do we even start to prioritize the minimal humanitarian aid we have here when nearly every person is being compelled to depend on it?”
