More than half of the enclave's 2.3 million people have sought shelter in Rafah, crowding tents in refugee camps stalked by growing hunger, disease and more recently fear that there will be nowhere to escape if troops enter the city.
Washington said it could not support such an operation without proper planning, world leaders voiced growing alarm, and aid officials warned of a “bloodbath.”
In the face of that pressure, Israeli Prime Minister Benjamin Netanyahu suggested Friday that civilians would be able to flee before the expected ground assault, which he said was necessary in the campaign against Hamas.
“It is clear that a massive operation in Rafah requires the evacuation of the civilian population from the combat zones,” Netanyahu said in a statement on social media. He ordered his military to prepare a plan but offered no further details.
The Israeli military did not immediately respond to a request for further details on the plan from NBC News.
NBC News spoke to several residents who described mounting anxiety in the city, the last major population hub in Gaza that has not been taken over by Israeli troops.
“The last stop was supposed to be Rafah,” Isra Shehada, 33, told an NBC News crew on the bustling streets. “After Rafah, we only have God. Where can we go next ?”
But while Palestinians like Shehada saw Rafah as a last refuge, with at least basic infrastructure and aid present, Israel made clear this week that it views the city on the Egyptian border as a last remaining stronghold for Hamas.
“It is impossible to achieve the war goal of eliminating Hamas and leaving four Hamas battalions in Rafah,” Netanyahu's office said Friday. It said he had ordered the military to draw up “a dual plan for both the evacuation of the population and the dismantling of the battalions.”
His comments follow rare public pushback from the U.S., Israel’s closest ally.
President Joe Biden said Thursday that its response in Gaza “has been over the top.”
John Kirby, the National Security Council spokesperson, said that a ground offensive in Rafah is “not something we would support.” Vedant Patel, a State Department spokesman, said that going ahead with such an offensive “with no planning and little thought in an area where there is sheltering of a million people would be a disaster.”
Palestinian Authority President Mahmoud Abbas denounced Netanyahu's call for an evacuation plan and said a ground assault into Rafah would pose “a real threat and a dangerous prelude to implementing the policy of displacing our people.”
Rafah was home to an estimated 250,000 people before the war, but has since been “stretched beyond its limits,” according to humanitarian officials, as Palestinians heeding Israeli evacuation calls and chasing relative safety fled to the city.
Local health officials say more than 27,900 people have been killed in Gaza since Israel launched its military campaign in the wake of the Oct. 7 Hamas terror attack, which Israeli officials say killed 1,200 people.
'Already a disaster'
Any attempt to evacuate from the overcrowded city would be neither feasible nor safe, said Andrea De Domenico, who heads the U.N. humanitarian agency responsible for the Palestinian territories.
“People are everywhere. This congestion not only makes it difficult for people to move but also hampers any potential evacuation efforts, and humanitarian operations,” she said in a statement from Gaza.
Satellite imagery shows the sprawling growth of makeshift shelters and tents that have transformed the enclave’s southernmost city over the past two months.
The city has been beset by soaring food prices, contaminated water and spreading disease. Incidents of theft have hampered what little aid is coming through, which charities describe as a “drop in the ocean” compared to the need.
“Rafah is already a disaster,” Amira Riyad, 30, said from an overcrowded hut. She said she was sharing a toilet with more than 50 people and struggles to find diapers for her 1-year-old daughter.
In some cases, Gazans have been forced to shelter in the most unlikely of places.
One family resorted to living in a chicken coop, with young children sleeping atop poultry cage shelves with nothing but flimsy mats and some blankets.
Though “the smell of the sewage at night is terrible, and the smell of the chicken is nasty,” Lana Hanoun, 8, said it was still better than the risk of shelling from which the family had fled several times.
But the situation would only be exacerbated by a ground assault.
The United Nations agency for Palestinian refugees, which has been the main humanitarian relief provider on the the ground since the onset of hostilities, warned it may be forced to cease operations.
“No war can be allowed in a gigantic refugee camp,” said Jan Egeland, secretary-general of the Norwegian Refugee Council, warning of a “bloodbath” if Israeli operations expand there.
As Palestinians have been pressed toward Egypt’s doorstep, towering concrete walls stand ominously at the border — a reminder of their perilous situation. Egypt has warned against any action that could force a mass displacement of Palestinians across its border.
Egypt's Rafah border crossing with Gaza is mostly sealed, but has been the main entry point for humanitarian aid. The vast majority of Gazans are unable to cross, however.
The news of a potential Israeli operation was “very frightening,” said Mustafa Banna, who lived farther north in Gaza city before the war.
What worries the 29-year-old graphic designer most is the fate of his seven-month pregnant wife and his 6-year-old daughter Ayla. He said he wished he could cross into Egypt to ensure the health of his wife and children.
“We have no relatives or friends to displace to. Where should I go with my big family?”