Airstrikes on the Gaza Strip’s southernmost town of Rafah have killed at least 44 people as more than a million civilians sheltering in the area brace for the possibility of a full-scale Israeli ground offensive on the territory’s last place of relative safety.
As Israeli forces have expanded ground operations steadily southwards in their war against Hamas over the past four months, Rafah – situated on the border with Egypt, and home before the war to about 280,000 people – has become the last refuge for more than half of the strip’s population of 2.3 million.
Israel’s prime minister, Benjamin Netanyahu, said on Friday that he had instructed the Israel Defense Forces (IDF) and defence ministry to draw up plans for troops to enter Rafah and evacuate civilians, leading to widespread panic in the overcrowded makeshift tent camps that now cover the area.
With two-thirds of Gaza already under evacuation orders, widespread destruction throughout the coastal strip and continuing fighting, it is unclear to where such a large number of people could safely be moved.
The Egyptian foreign minister, Sameh Shoukry, said on Saturday that an Israeli ground offensive on Rafah would have “disastrous consequences,” and that Israel’s aim was eventually to force the Palestinians from their land.
An Egyptian official told the Guardian that under no circumstances would fleeing Palestinians be allowed to cross the border into the Sinai peninsula, and that any attempt to relocate them to Egyptian soil would collapse the peace deal between Egypt and Israel.
A doctor at a UN-run clinic in Rafah said: “I encountered an elderly woman who was looking for a wheelchair for her disabled husband. She said: ‘If I can’t get this chair for my husband, it will be our end. With the occupation in Gaza, how can I take him to Sinai? I cannot leave him alone in Gaza.’”
Israel has carried out airstrikes in Rafah almost daily, even after telling civilians in recent weeks to seek shelter there from fierce ground combat in Khan Younis, just to the north.
Three airstrikes on homes in the Rafah area killed 44 people overnight into Saturday, according to a health official and Associated Press journalists who saw the bodies arriving at hospitals. The strikes killed members of three families, including 12 children, the youngest three months old.
In Khan Younis, Israeli forces opened fire at Nasser hospital, the area’s largest, killing at least two people and wounding five, according to the medical charity Doctors Without Borders. Ahmed Maghrabi, a physician at the hospital, said in a Facebook post that Israeli tanks had reached the hospital gates on Saturday morning, trapping those inside and making the facility inaccessible to those in need of medical attention.
Israel’s threats of a full-scale attack on Rafah – designed to put pressure on the Hamas leadership, which is believed to be hiding in tunnels in the area – have not yet been realised, and Netanyahu did not provide details or a timeline in his announcement.
He has, however, implied the operation is inevitable, and appears ready to push ahead despite mounting warnings from aid agencies and the international community that a Rafah offensive would be a “bloodbath”.
“It is impossible to achieve the goal of the war of eliminating Hamas by leaving four Hamas battalions in Rafah,” Netanyahu’s office said on Friday.
Outside Israel, criticism of his statement was swift. The head of the UN agency for Palestinian refugees (UNRWA), Philippe Lazzarini, said on Friday that a major Israeli offensive in Rafah “can only lead to an additional layer of endless tragedy”.
Hamas said in a statement on Saturday that any Israeli military action in Rafah would have catastrophic repercussions that “may lead to tens of thousands of martyrs and injured”.
The Palestinian militant group, which assumed control of Gaza in 2007, said it would hold “the American administration, international community and the Israeli occupation” responsible if that happened.
Israel’s plans for Rafah drew unusually fierce criticism from the US, the Jewish state’s most important ally, after days of increasing friction between Netanyahu and the Biden administration.
Joe Biden described Israel’s military response in Gaza as “over the top” and said he was seeking a “sustained pause” in fighting in remarks to reporters earlier this week.
“I’m of the view, as you know, that the conduct of the response in the Gaza Strip has been over the top,” the US president said after his secretary of state, Antony Blinken, left the region without any progress on a ceasefire deal.
Biden said he had been pushing for a deal to normalise relations between Saudi Arabia and Israel, increase humanitarian aid for Palestinian civilians and pause the fighting temporarily to allow the release of hostages taken by Hamas.
US officials have also made clear to their Israeli counterparts that Washington expects significant progress towards a two-state solution to the decades-old conflict at the end of the fighting. Netanyahu, however, is opposed to Palestinian statehood, and his hawkish governing coalition could collapse if he is seen to be making too many concessions.
“I’m pushing very hard now to deal with this hostage ceasefire,” Biden said. “There are a lot of innocent people who are starving, a lot of innocent people who are in trouble and dying, and it’s got to stop.”
Netanyahu this week flatly rejected the terms of a Hamas counter-proposal for a ceasefire and exchange of hostages and prisoners after the success of a week-long truce in late November. He has also rebuffed US pressure, saying there could be no solution to Israel’s security issues except “absolute victory”.
He said at televised press conference that “surrendering to Hamas’s delusional conditions”, which include a call for a 135-day ceasefire in exchange for the release of the remaining 130 or so hostages, “would lead to another massacre, and to a great tragedy on Israel that no one would be willing to accept”.
In a blow to the hopes of the families of the remaining hostages being held by Hamas, Netanyahu also said they would be released only by continued military pressure on the militant group.
Israel’s war in Gaza, now in its fifth month, was sparked by Hamas’s unprecedented offensive of 7 October in which 1,200 people were killed and another 250 abducted as bargaining chips.
The Israeli offensive has killed 28,000 people in Gaza, displaced more than 85% of the population and reduced over half of the strip’s infrastructure to rubble.
According to the UN, about 10% of children under five in Gaza are showing signs of acute malnutrition. Food deliveries that reach the strip are regularly mobbed by desperate and hungry people, residents say.
Violence triggered by the war in Gaza is escalating across the Middle East, as hostilities between Iran and Israel, as well as the US, move increasingly into the open through the actions of Iran-backed militias in Iraq, Lebanon, Syria and Yemen.
During a visit to Lebanon on Saturday, the Iranian foreign minister, Hossein Amir-Abdollahian, said a political solution was the only way to end the Gaza conflict, and that Tehran was in talks with Saudi officials on the issue.
He also warned Israel against taking any steps towards a full-scale war against the powerful Lebanese militant group Hezbollah, saying it would be Netanyahu’s “last day.” Hezbollah and Israel have traded near-daily fire across the disputed Israeli-Lebanese border since 7 October.
A senior Hamas official survived what Palestinian security forces called an Israeli assassination attempt in Beirut on Saturday in which two civilians were killed. Israel did not immediately comment on the allegation, and rarely acknowledges drone and airstrikes conducted beyond Palestinian territory.