Israeli forces seized the main border crossing between Egypt and southern Gaza on Tuesday, shutting down a vital aid route into the Palestinian enclave that is already on the brink of famine.
The Palestinian militant group Hamas accused Israel of trying to undermine efforts to secure a ceasefire in the seven-month-long war that has laid waste to Gaza and left hundreds of thousands of its people homeless and hungry.
Israeli army footage showed tanks rolling through the Rafah crossing complex and the Israeli flag raised on the Gaza side.
Israeli Prime Minister Benjamin Netanyahu said seizing the crossing was a "very significant step" towards its stated aim of destroying Hamas's military capabilities.
Residents reported heavy tank shelling on Tuesday evening in some areas of eastern Rafah.
"They have gone crazy, tanks are firing shells and smoke bombs cover the skies and with smoke over Al-Salam and Jneinah neighborhoods," said Emad Joudat, 55, a Gaza city resident displaced in Rafah.
"I am now seriously thinking of heading north, maybe to the central Gaza area. If they move further into Rafah it will be the mother of massacres," he told Reuters via a chat app.
U.N. and other international aid agencies said the closing of the two crossings into southern Gaza - Rafah and Israeli-controlled Kerem Shalom - had virtually cut the enclave off from outside aid and very few stores were available inside.
Red Crescent sources in Egypt said shipments had completely halted.
As well as a key entry point for aid, the crossing was the only exit point for those needing to leave Gaza for medical treatment that is no longer available in the enclave.
Lama Abu Holi, 8, has been in Al-Aqsa hospital for a month, waiting for a chance to leave for treatment for her injured legs.
"Today my name was at the border, and I should travel to get my legs treated," she said, holding a toy in her hospital bed. "They hurt. I am supposed to have an operation. Because the border crossing is shut today, I could not travel."
OFFENSIVE
The seizure of the Rafah crossing came despite weeks of calls from the U.S., other nations and international bodies for Israel to hold off from a big offensive in the Rafah area - said by Israel to be the Hamas fighters' last stronghold but also the refuge of more than one million displaced Palestinian civilians.
Many of them are struggling to find a safe place to go in the tiny territory that has been bombarded almost non-stop since Hamas fighters stormed over the border into Israel on Oct. 7.
Families have been crammed into tented camps and makeshift shelters, suffering from shortages of food, water, medicine and other essentials.
Israel's military said it was conducting a limited operation in Rafah to kill fighters and dismantle infrastructure used by Hamas, which runs Gaza. It has told civilians to go to what it calls an "expanded humanitarian zone" some 20 km away.
In Geneva, U.N. humanitarian office spokesperson Jens Laerke said "panic and despair" were gripping the people in Rafah.
He said that under international law people must have adequate time to prepare for an evacuation, and have a safe route to a safe area with access to aid. This was not the case in the Rafah evacuation, he said.
"It's littered with unexploded ordnance, massive bombs lying in the street. It's not safe," he said.
A total of 34,789 Palestinians, most of them civilians, have been now killed in the conflict, the Gaza Health Ministry said.
The war began when Hamas militants attacked Israel on Oct. 7, killing about 1,200 people and abducting about 250 others, of whom 133 are believed to remain in captivity in Gaza, according to Israeli tallies.
US RESPONSE
Israel told the United States its operation in Rafah was limited and designed to prevent weapons and funds from being smuggled into Gaza, White House national security adviser John Kirby said on Tuesday.
Talks on a hostage deal and ceasefire were resuming in Cairo on Tuesday with CIA Director William Burns attending and the two sides should be able to close the remaining gaps, Kirby added.
MEDICS FLEE
Fearful medics and patients are fleeing a hospital in Rafah and transfers of the sick and injured via a border crossing with Egypt are at a standstill due to Israel's military operation, doctors and residents said on Tuesday.
The Abu Yousef al-Najjar Hospital is located in an area of southern Gaza the Israeli army has designated a combat zone in a conflict that has seen repeated Israeli attacks on hospitals, with only a third still operational. Israel justifies such attacks by saying that Hamas uses them for military purposes - a claim both hospital staff and Hamas deny.
Doctor Marwan al-Hams told Reuters Israel had put Abu Youssef al-Najjar Hospital at the centre of the battle field. "Its threats to it resulted in people and patients leaving the hospital," he said, adding that some medical crews had also left.
The dialysis department for patients with kidney disease remained open for now, he added.
World Health Organization spokesperson Margaret Harris warned that its closure would immediately endanger the lives of some 200 dialysis patients since it is the only one in Gaza.
"If they are shut down that means all those people will die simply from kidney failure because that's what keeping them alive," she said. Other medical services in Rafah have already been disrupted with some services suspended.
The Rafah crossing to Egypt has been seized by Israel and shut, preventing both medical evacuations of the sick and wounded and imports of medicines, medical aid groups say. The Gaza health ministry said 140 patients were scheduled to leave the besieged enclave on Tuesday for treatment.
Mohammad Abu Skhil, a doctor working in Gaza's Kuwaiti hospital, said the halt to patient transfers would fill up hospital beds and burden the medical system further.
'HUMAN CATASTROPHE'
U.N. Secretary-General Antonio Guterres appealed to Israel and Hamas to spare no effort to get a truce deal and urged Israel to reopen the border crossings immediately, saying Gaza risks running out of fuel on Tuesday evening.
"Make no mistake a full-scale assault on Rafah would be a human catastrophe," Guterres said.
Hamas said late on Monday it had told Qatari and Egyptian mediators it had agreed to a ceasefire proposal but Netanyahu said the proposal falls "far short" of Israel's demands.
However, the various players appeared willing to talk again on Tuesday. An official briefed on the talks said the Israeli delegation had arrived in the Egyptian capital Cairo.
A Palestinian official close to mediation efforts told Reuters a Hamas delegation may arrive in Cairo on Tuesday or Wednesday to discuss a ceasefire.
Any truce would be the first pause in fighting since a week-long ceasefire in November during which Hamas freed around half of the hostages and Israel released 240 Palestinians it was holding in its jails.
Since then, all efforts to reach a new truce have foundered over Hamas' refusal to free more hostages without a promise of a permanent end to the conflict, and Israel's insistence that it would discuss only a temporary pause
