What an Israeli invasion of Rafah would mean for civilians: 'Catastrophically serious'

As Israel continues to indicate plans to launch a ground offensive into Rafah, aid organizations warn that an invasion would be a "bloodbath" for civilians and deepen the humanitarian crisis in the Gaza Strip.

Some 1.4 million Palestinians are believed to be in Rafah, the southern city of Gaza bordering Egypt. More than 1 million Palestinians have fled there to seek shelter during the Israel-Hamas war, according to the United Nations.

Israeli Prime Minister Benjamin Netanyahu said last week that a victory against Hamas is "impossible" without the Israel Defense Forces entering Rafah to eliminate the rest of the terrorist group's battalions.

Netanyahu said he has approved the IDF's plan to evacuate the civilian population from the "battle zones," though it's not clear when or how that would occur. The IDF has said they plan to push civilians toward "humanitarian islands" in the center of the Gaza Strip in advance of an offensive in Rafah.

The U.S. has said it opposes a major operation in Rafah, with Secretary of State Antony Blinken saying during his Middle East trip last week that it would be a "mistake" and "something we can't support."

"A major ground operation there would mean more civilian deaths. It would worsen the humanitarian crisis," Blinken said during a press conference in Egypt on Thursday. "There is a better way to deal with the threat, the ongoing threat posed by Hamas."

Blinken has described this week's planned meetings in Washington between the U.S. as a chance to persuade Israeli officials to take "alternative actions" in Rafah, which an administration official said would consist of more targeted, high-value counterterrorism missions to eliminate Hamas.

Humanitarian groups working in Gaza have also continued to speak out against an incursion in Rafah.

"A military operation in Rafah would be an absolute bloodbath with consequences more devastating than we can imagine," Deepmala Mahla, the chief humanitarian officer for CARE, an international humanitarian organization that targets global poverty and hunger, told ABC News.

With about two-thirds of the entire population in the Gaza Strip sheltering in Rafah, an offensive would result in a "terrible loss of life," Mahla said.

"We are basically talking somewhere around 1.5 million people in Rafah -- there is no safe way to evacuate them," she said.

The city's population includes some 600,000 children, according to UNICEF.

"This is a city of children," UNICEF spokesperson James Elder told ABC News. "A military offensive here would be absolutely catastrophic for children. It cannot be allowed to occur."

Even if civilians were able to evacuate out of Rafah, there is "no safe place" for them to go in Gaza, Mahla said.

Bob Kitchen, the vice president for emergencies for the International Rescue Committee, an organization that aids people affected by humanitarian crises, said the risk of loss of life in a Rafah invasion is "very significant."

"We're incredibly fearful of the humanitarian impact and also just the loss of life should a ground offensive happen," he told ABC News.

The IDF has pushed the population south in the Gaza Strip as the frontline has moved, with a "huge concentration" in Rafah against the Egyptian border, "which is firmly closed," he said.

"There's nowhere else for them to run," Kitchen said.

Israel has designated a safe zone in Al Mawasi, on the southern coast of the Gaza Strip, though that has been "bombed indiscriminately," Kitchen said.

"There's no safe place," he said. "If the offensive moved forward, it will be catastrophically serious."

With most humanitarian organizations in Gaza working out of Rafah, Mahla said, an incursion there would also bring aid operations in the territory "to a standstill" for a population facing hunger and disease.

"The life-saving work will not happen," she said. "We will not be able to alleviate suffering and save people."

Mahla said CARE has been delivering necessities like drinking water, hygiene kits and first aid kits under already challenging circumstances, and that it has been difficult to reach northern Gaza with aid amid the war.

Last week, a report from the Integrated Food Security Phase Classification initiative found that the entire population of the Gaza Strip, about 2.23 million people, is facing high levels of food insecurity and, in the most likely scenario, an estimated 1.1 million people -- half of the population -- will be experiencing famine levels of hunger by mid-July.

"The speed at which health and hunger have deteriorated I've not seen before," Kitchen said. "I've not seen a population go from being basically food secure to facing now famine in the space of five months."

Israeli officials have said Hamas steals aid once it enters Gaza and claim looting is also a problem. Israel continues to deny all accusations that it isn't letting enough aid into Gaza and encourages other countries to send in aid, with Israeli officials saying the U.N., its partners and other aid agencies have created logistical challenges, resulting in a bottleneck. The U.N. disputes these claims.

Access to the Gaza Strip became increasingly limited following Hamas' surprise terrorist attack in Israel on Oct. 7, 2023. More than 1,200 people have been killed in Israel since then, according to the Israeli Prime Minister's Office. More than 32,000 Palestinians have been killed and more than 74,000 injured over the same period, according to the Hamas-run Gaza Health Ministry.

Many humanitarian aid organizations, including CARE, the International Rescue Committee and UNICEF, have called for an immediate humanitarian cease-fire in Gaza to spare civilian lives and allow for unimpeded humanitarian access.

"The population is just growing more and more vulnerable," Kitchen said. "A cease-fire is the first thing that's absolutely needed immediately. And then we also need to just see a change of how aid is allowed in."

A U.S.-sponsored resolution calling for an immediate cease-fire in Gaza tied to a release of hostages held by Hamas failed Friday in the United Nations Security Council, with Russia, China and Algeria voting against it.

The U.S. resolution draft emphasized concern that a ground offensive into Rafah "would result in further harm to civilians and their further displacement including potentially into neighboring countries."

The representatives from Russia and China both argued that they saw the resolution as overly supportive of Israel, while Algeria's representative said the draft resolution failed to adequately address the suffering of the Palestinian people. The U.S. ambassador to the U.N., meanwhile claimed that Russia and China could not bring themselves to condemn Hamas for the Oct. 7 attack in Israel.

A day after the resolution failed, U.N. Secretary-General Antonio Guterres called for an immediate humanitarian cease-fire and said it is time to "truly flood Gaza with lifesaving aid" during a press address on the Egyptian side of the border, not far from Rafah.

"Here from this crossing, we see the heartbreak and heartlessness of it all. A long line of blocked relief trucks on one side of the gates. The long shadow of starvation on the other," he said Saturday.

"Any further onslaught will make everything worse. Worse for Palestinian civilians. Worse for hostages. And worse for all people of the region," he added.

ABC News' Shannon K. Crawford and Sami Zayara contributed to this report.