Humanitarian workers, doctors describe 'horrific' situation in Rafah as Israel intensifies strikes

As the latest Israeli military incursion into Rafah continues amid the war with Hamas, humanitarian workers and doctors are warning that the emergency situation in the southern Gaza border city is worsening and having a "horrific" impact on civilians.

The Israel Defense Forces (IDF) dropped leaflets in Rafah on Monday and sent text messages in Arabic calling for about 100,000 people to evacuate the eastern part of the city and to head north to the Al-Mawasi humanitarian corridor ahead of a long-promised major ground invasion into Rafah.

No trucks with food, water, fuel, medicine or other supplies entered Gaza between Monday and Wednesday, according to the latest information from the United Nations Office for the Coordination of Humanitarian Affairs. Additionally, just two hospitals are functional in Rafah, as are two in nearby Khan Younis, to the north, the office said.

Additionally, during a media briefing Wednesday by the nonprofit relief coordination organization Crisis Action, aid workers and medical staff – including some who are currently in or have recently evacuated from Rafah – said there's a lack of food and water and very little health care available for the more than one million people sheltering in Rafah.

Dr. Mohamed Hamooda, a nutritionist and head kitchen chef in Rafah for the nongovernmental organization (NGO) Rebuilding Alliance, had been providing hot meals to thousands of displaced people there since February. However, he was recently forced to evacuate amid orders from the IDF and went to Khan Younis.

"This site, we don't have electricity, clean water," Hamooda said of the move to Khan Younis. "We don't have clean food for my children and my team. Some of [the displaced people], I don't know where [they] will go."

Recently, World Food Programme Executive Director Cindy McCain said that "full-blown famine" is occurring in northern Gaza. Additionally, if Israel's promised ground invasion in Rafah happens, a projected 1.1 million people across Gaza are projected to experience "catastrophic" levels of food insecurity, according to a report from the U.N.-backed Integrated Food Security Phase Classification (IPC) initiative.

Israeli forces took control of the Rafah crossing between Gaza and Egypt early Tuesday and closed it, cutting off one of the most vital entry points for aid into Gaza. Humanitarian workers said there are hundreds of trucks at the border waiting to enter to provide assistance to people inside Gaza who are without sufficient food or water.

However, Israel's Coordination of Government Activities in the Territories (COGAT) said in a post on the social platform X on Thursday that the Kerem Shalom crossing in the south and Erez crossing in the north are open, with border guards "inspecting trucks of aid for the Gaza strip."

"Our staff are here, ready and available to facilitate aid into Gaza," the post also said, adding that "All trucks sent to the crossings are immediately inspected and transferred to Gaza."

Even if true, some humanitarian workers say it's not enough.

"For formula, you need clean water, and clean water is not available right now," said Alexandra Saieh, head of humanitarian advocacy and policy for the nonprofit Save the Children International, during the Crisis Action media briefing Wednesday. "So, the situation for infants is horrific. We were told by doctors at the hospital, basically when they discharge [a] mother and [a] child, they go back to the shelter and, many times, the infant will die because they're not getting the sufficient nutrients and mothers are not getting the sufficient nutrients to breastfeed. So, the situation for infants is catastrophic."

Dr. John Kahler, a pediatrician and co-founder of the NGO MedGlobal, was set to enter Rafah Monday for his third medical mission there since January, but he says his convoy had to turn back to Cairo due to safety concerns over the promised imminent Israeli attacks.

Kahler told ABC News that it's "absolutely undeniable" that the closed border has only worsened the aid crisis in Rafah, and in Gaza as a whole. He said a huge segment of the population is suffering from malnourishment and starvation, and while aid can supply people with the calories they need, it's no guarantee of survival.

"I can bring a bag of flour so people can get the amount of calories they need but they're not getting the nutrients they need," he said. "Nutrition transcends calories and people often confuse the two. The real ethical problem is all this food exists within a stone's throw," the latter referring to the waiting aid trucks sitting outside of Rafah.

During the briefing, Jeremy Konyndyk, president of the humanitarian organization Refugees International, added that part of the reason northern Gaza is experiencing famine but southern Gaza hasn't yet reached that point is because most of the aid operations have been based out of Rafah. However, he warned that aid workers currently in Rafah have very little fuel remaining.

"The whole aid operation runs on fuel, so if the fuel is cut off, the aid collapses and it collapses quickly," he said. "That means water can't be pumped, lights can't be kept on in hospitals, vehicles cannot distribute aid. So what we're seeing with this total closure in the last few days ... really risks the near-term collapse of the aid operation."

Konyndyk further warned that if there's a major offensive in Rafah, it will "fully collapse" the aid operation not only there, but likely throughout Gaza.

"It would also force the NGOs to relocate and the humanitarian groups that would relocate out of Rafah to God knows where – there is really nowhere else for them to viably go," Konyndyk said. "The offices, the residences, the warehouses, the logistical hubs, that's all based in the south. And so, if that it goes away because of an offensive, the impact is not just on the people in Rafah. The impact is throughout Gaza, because it collapses, what remains of the, even as it is woefully insufficient, aid operation."

Humanitarian workers also emphasized that the health care system overall has collapsed in Gaza. Helena Ranchal, a nurse for more than 20 years and director of international operations for the humanitarian organization Médecins du Monde, or Doctors of the World, said she's never seen as severe a situation in conflict zones as she has seen in Gaza.

"The severity of the people in the hospital," she said during the briefing. "Many, many of them, they are children. We are seeing war injuries in children. And it's not just the fact that the health staff are more than tired. It's that we don't have all the materials, or we don't have all the drugs, we don't have all the capacity to move from one place to another."

Ranchal said staff are often also treating people under non-hygienic conditions and frequently have had to triage patients by evaluating the extent of their injuries and treating only those who have the greatest likelihood of survival.

These dire reports come amid negotiations over a possible cease-fire in Gaza. On Monday, Hamas said it had accepted an Egyptian-Qatari proposal regarding a cease-fire agreement. Senior Israeli officials said that plan is different than a proposal that had been discussed over the weekend, while Prime Minister Benjamin Netanyahu continued with plans for an attack on Rafah.

Ghada Alhaddad, a media and communications officer with the global poverty relief NGO Oxfam, who is currently in Rafah, said for the last week, Gazans have been living in a "cycle of hope and hopelessness."

"When we heard about the progress and development in the cease-fire talks, everybody was optimistic in the street," Alhaddad said during Wednesday's Crisis Action media briefing. "We thought that that we would have some peacetime, eventually. However, all of a sudden, we have received fresh evacuation orders for people who live in eastern parts of Rafah. … And you know, all hopes of a cease-fire was dashed and was destroyed."

Since Oct. 7, when Hamas terrorists invaded Israel, and Israel retaliated with ongoing military operations in Gaza, at least 34,735 people in Gaza have been killed and 78,108 have been injured, according to the Hamas-run Gaza Ministry of Health. At least 1,700 Israelis have been killed and 8,700 others injured, according to the Israeli Ministry of Foreign Affairs.

"I mean, I'm afraid that more destruction and more lives will be lost if an invasion happens to this city and in this place," Alhaddad said.