Gaza's desperate civilians search for food, water and safety, as warnings of Israeli offensive mount

Gaza’s 2.3 million civilians faced a deepening struggle for food, water and safety Sunday and braced for a looming invasion a week after Hamas militants launched a deadly assault on Israel. While hundreds of thousands of Gaza residents sought to heed Israel’s order to evacuate roughly the northern half of the territory, others huddled at hospitals in the north.

Israeli forces, supported by a growing deployment of U.S. warships in the region, positioned themselves along Gaza’s border and drilled for what Israel said would be a campaign by air, land and sea to dismantle the militant group.

In Israel, pathologists and others at a military base worked through the Jewish Sabbath to identify the more than 1,300 Israelis and others killed in Hamas's Oct. 7 assault. The Gaza Health Ministry said Saturday that over 2,200 people have been killed in the territory, including 724 children and 458 women.

Israel dropped leaflets over Gaza City in the north and renewed warnings on social media, ordering more than 1 million Gaza residents to move south. The military says it is trying to clear away civilians ahead of a concentrated campaign against Hamas militants in the north, including in what it said were underground hideouts in Gaza City. Hamas urged people to stay in their homes.

The U.N. and aid groups say such a rapid exodus along with Israel’s siege of the 40-kilometer-long (25-mile-long) territory would cause untold human suffering.

The World Health Organization said the evacuation “could be tantamount to a death sentence” for the more than 2,000 patients in northern hospitals, including newborns in incubators and people in intensive care. Gaza's hospitals are expected to run out of fuel for emergency generations within two days, according to the U.N., which said that that would endanger the lives of thousands of patients.

Gaza was already in a humanitarian crisis due to a growing shortage of water and medical supplies caused by the Israeli blockade, which has also forced electrical plants to shut down without fuel. With some bakeries closing, residents complained of being unable to buy bread for their children.

In Gaza City, Haifa Khamis al-Shurafa crowded into a car with six family members, fleeing to the south in the darkness.

“We don’t deserve this,” Shurafa said, before leaving her home city. “We didn’t kill anyone.”

Israel's evacuation directive covers an area with 1.1 million residents, about half of Gaza's population. The Israeli military said “hundreds of thousands” of Palestinians had heeded the warning and headed south. It gave Palestinians a six-hour window that ended Saturday afternoon to travel safely within Gaza along two main routes.

Hundreds of relatives of the estimated 150 people captured by Hamas in Israel and taken to Gaza gathered outside the Israeli Defense Ministry in Tel Aviv, demanding their release.

“This is my cry out to the world: Please help bring my family, my wife and three kids,” said Avihai Brodtz of Kfar Azza. Many expressed anger toward the government, saying they still have no information about their loved ones.

In a nationally broadcast address Saturday night, Israel’s chief military spokesman, Rear Adm. Daniel Hagari, accused Hamas of trying to use civilians as human shields.

“We are going to attack Gaza City very broadly soon,” he said, without giving a timetable for the attack.

Israel has called up some 360,000 military reserves and massed troops and tanks along the border with Gaza.

Ahead of the expected ground offensive, Israelis living near the Gaza border, including residents of the town of Sderot, continued to be evacuated. Militants in Gaza have been firing heaving rocket barrages reaching deep into Israel, as Israeli warplanes pound Gaza.

U.S. Defense Secretary Lloyd Austin said late Saturday that the U.S. was moving a second carrier strike group, the USS Dwight D. Eisenhower, to the eastern Mediterranean, in a show of force meant to deter any allies of Iranian-backed Hamas from seeking to widen the war.

Palestinian militants have fired more than 5,500 rockets into Israel since the fighting erupted, the Israeli military said.

Hamas remained defiant. In a televised speech Saturday, Ismail Haniyeh, a top official, said that “all the massacres” will not break the Palestinian people.

Fighting continued in the run-up to the expected offensive, with Hamas launching rockets into Israel and Israel carrying out strikes in Gaza.

An Israeli airstrike near the Jabaliya refugee camp in northern Gaza killed at least 27 people and wounded another 80, Gaza health authorities said.

Most of the victims were women and children, the authorities said. Doctors from Kamal Edwan Hospital shared chaotic footage of charred and disfigured bodies.

It was not clear how many Palestinians remained in northern Gaza by Saturday afternoon, said Juliette Touma, a spokesperson for the U.N. agency for Palestinian refugees. An estimated 1 million people have been displaced in Gaza in one week, she said.

At Gaza City’s main hospital, al-Shifa, a crowd of men, women and children that medical officials estimated at 35,000 crammed into the hospital's lobby and bloodied hallways and under the trees on the hospital grounds, hoping the facility would be spared in the coming attack.

“People think this is the only safe space after their homes were destroyed and they were forced to flee,” said Dr. Medhat Abbas, a Health Ministry official.

Basic necessities were running out because of the total siege.

Water has stopped coming out of taps across the territory. Amal Abu Yahia, a 25-year-old pregnant mother in the Jabaliya refugee camp, said she waited anxiously for the few minutes when contaminated water trickles from the pipes in her basement. She rations it, prioritizing her 5-year-old son and 3-year-old daughter. She said she is drinking so little herself, she only urinates every other day.

Near the coast, the only tap water is contaminated with Mediterranean Sea water because of the lack of sanitation facilities. Mohammed Ibrahim, 28, said his neighbors in Gaza City have taken to drinking the salt water.

The Israeli military’s evacuation order demands the territory’s entire population cram into the southern half of Gaza as Israel continues strikes, including in the south. The Hamas communications office said Israel has destroyed over 7,000 housing units so far.

Rami Swailem said he and at least five families in his building decided to stay put in his apartment near Gaza City. “We are rooted in our lands,” he said. “We prefer to die in dignity and face our destiny.”

Others were looking desperately for ways to evacuate. “We need a number for drivers from Gaza to the south, it is necessary #help,” read a post on social media.

The U.N. refugee agency for Palestinians expressed concern for those who could not leave, “particularly pregnant women, children, older persons and persons with disabilities.” The agency also called for Israel to not target civilians, hospitals, schools, clinics and U.N. locations.

Al-Shifa hospital was receiving hundreds of wounded every hour and had used up 95% of its medical supplies, hospital director Mohammad Abu Selim said. Water is scarce and the fuel powering its generators is dwindling.

“The situation inside the hospital is miserable in every sense of the word,” he said. “The operating rooms don’t stop.”

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DeBre and Krauss reported from Jerusalem. Associated Press writers Julia Frankel in Jerusalem, Samya Kullab in Baghdad, Samy Magdy in Cairo, Kareem Chehayeb in Beirut, Ashraf Sweilam in El-Arish, Egypt, and Matthew Lee in Riyadh contributed to this report.