Middle East Crisis Terrified Gazans Await an Israeli Advance in the City Where They Fled

“What would happen to us if there were tanks, clashes, an invasion and an army?” said Ms. Shimali, 31.

More than half of Gaza’s 2.2 million people are now sheltering in Rafah, many of them after Israel told them to flee south to avoid the war farther north.

Israeli officials have been suggesting that the next step in their effort to destroy Hamas will be in Rafah, and, on Friday, the office of Prime Minister Benjamin Netanyahu announced that “any forceful action in Rafah would require the evacuation of the civilian population from combat zones.”

The Israeli government has not specified which areas these would be and where the civilians now sheltering in them would be expected to go.

Aid groups, the secretary general of the United Nations and officials from the Biden administration have warned that an Israeli attack on Rafah would be catastrophic. The area’s high density would increase the chances of civilian deaths in military strikes, and an advance by Israeli ground troops could further interrupt the delivery of aid.

Already, the overcrowding has taxed the area’s resources, and newly displaced Gazans continue to arrive as fighting rages on in the city of Khan Younis to the north.

“It is very bad; the hygiene level is very low,” said Fathi Abu Snema, 45, who has been sheltering with his family in a United Nations school in Rafah since early in the war. “Here we eat only canned food, which is anything but healthy. Everything else is very expensive.”

He feared that many would die if Israel invaded Rafah, especially since people had nowhere else to go.

“I prefer to die here,” he said. “There is not one safe place to go in Gaza. You could get killed anywhere, even in the street.”

Rafah sits along the border with Egypt, although very few Gazans have been allowed to leave during the war, mostly because Egypt, and many Gazans themselves, fear that if they leave, they will never return to Gaza.

That leaves few options for people like Sana al-Kabariti, a pharmacist and skin-care expert.

She fled to Rafah from Gaza City, where both her home and her clinic have since been destroyed, giving her little to return to, she said.

Even if the war were to stop soon, she expects there would be little interest in her skin-care services, since people would be focused on trying to rebuild their homes and lives, she said.

“I am worried about my future in Gaza,” said Ms. al-Kabariti, 33. “I really need to leave the strip.”

Iyad Abuheweila and Abu Bakr Bashir contributed reporting.

Moody’s had begun reviewing Israel’s status after the Hamas-led Oct. 7 attacks, which started the current war with Hamas fighters in Gaza. S&P and Fitch also began to re-examine Israel’s credit rating in November but have yet to take any action.

In its assessment, Moody’s said elevated risks for investors were quite likely to persist in Israel “into the medium to long term.” Moody’s cited concerns over a possible second war with Hezbollah, a militant group in Lebanon; the lack of clarity over when and how Israel’s war with Hamas in Gaza would end; and the country’s failure to adopt a clear plan for a postwar settlement in Gaza.

“The Israeli government has so far rejected such plans,” the agency wrote in its downgrade assessment. “Moreover, even if a plan is eventually agreed, its durable success will be, for a long time, highly uncertain.”

Yair Lapid, the leader of Israel’s parliamentary opposition, called the Moody’s announcement “further proof that this government is not functioning and is harming the public.” Mr. Lapid, a sharp critic of Mr. Netanyahu, reiterated his call for a new Israeli government to be formed.

Another opposition politician, Avigdor Lieberman, said, “the government of destruction continues to drag us down to economic catastrophe, just as it brought a security catastrophe upon us on Oct. 7.”

Moody’s also highlighted rising public debt and budget deficits, in part because of a sharp increase in wartime military spending, as risks. Israel’s public debt will rise to 67 percent of its gross domestic product in 2023 from 60 percent in 2022.

Shaul Amsterdamski, an economics editor at the Israeli Public Broadcasting Corporation, said the announcement was unlikely to immediately affect the national economy. But he said the Moody’s assessment sent an “extremely negative message to investors, showing that the economic resilience which Israel has enjoyed for decades has been damaged.”

Mr. Amsterdamski also dismissed Mr. Netanyahu's contention that the credit rating would rise again as soon as the war ended, noting that the ratings agency had said the economic outlook for the country was negative, indicating further downgrades could come down the road.

If the government had passed a slimmer budget — cutting spending on ministries widely criticized as extraneous, for example — the agency’s risk assessors might have provided a brighter outlook, Mr. Amsterdamski said.

“The deficit had to increase so as to fund the war, but it could have been less,” he said. “Before going to borrow money, the government should have tried to show investors that it was getting its house in order.”

Bezalel Smotrich, the finance minister of Israel and a right-wing politician, said in an interview on Israeli television that the Moody’s decision had more to do with political considerations than the strength of the country’s economy.

“Five or six economists sit down in New York and give us grades over whether we went for a cease-fire or didn’t, whether we’re prepared to establish a Palestinian state in Gaza or not, and they decide to lower our rating because, in their opinion, we aren’t doing things correctly from a political standpoint,” he said on Channel 12. “That’s absolutely ridiculous.”

Joe Rennison contributed reporting.

On Saturday, Israeli airstrikes struck a vehicle and homes where displaced people were sheltering. Palestinian media and The Associated Press reported at least 29 people were killed, including children, but the Gazan health authorities did not immediately confirm that death toll.

Gazan health officials said on Saturday that more than 28,000 people had been killed in bombing and other Israeli military actions, most of them women, children and other noncombatants. The Israeli military said one of the airstrikes in Rafah on Saturday killed three Hamas operatives: Ahmed Eliakubi, who Israeli officials said served as a senior commander in the Rafah district; Iman Rantisi, described as a senior military operative for Hamas; and a third person, also described as a military operative, who was not named.

The ongoing Israeli strikes have terrified displaced people in Rafah, who are mostly living in makeshift tents and have nowhere else to flee.

On Saturday, Germany, Jordan and Saudi Arabia joined an international chorus condemning Israel’s stated intention of expanding its ground invasion into the province. Aid groups, the Secretary General of the United Nations and officials from the Biden administration have warned that an Israeli attack on Rafah would be catastrophic.

Nabil Abu Rudeina, the spokesman for the Palestinian Authority in the Israel-occupied West Bank, on Saturday, called on the United States to pressure Israel to stop what he called “the genocidal massacres” of Palestinian civilians. Israel denies it has committed genocide or purposely targeted civilians.

The United States, which sends billions in military aid to Israel every year, has been strongly supportive of the Netanyahu government since it launched the war in Gaza on Oct. 7, after the Hamas-led attacks in southern Israel that Israel says killed some 1,200 people.

The heavy toll on civilians in Gaza has ignited outrage around the world and has eroded support for Israel in the United States, especially in the Democratic Party.

On Thursday, President Biden, who has been a stalwart supporter of Israel’s goal of destroying Hamas, sharply escalated his criticism of the Israeli military’s approach to the war, calling military operations in Gaza “over the top” and saying that the suffering of innocent people has “got to stop.”

Gaya Gupta contributed reporting from New York.

The Red Crescent shared an image of the charred and nearly unrecognizable ambulance on social media.

Neither the Red Crescent nor Hind’s family members who were in the area around the time the ambulance arrived on Jan. 29 reported any fighting between Israeli forces and armed Palestinians there, though this could not be independently verified.

The Israeli military did not immediately reply to a request for comment on the Red Crescent’s allegations. The military said last week that it was not aware of the incident.

A spokeswoman for the Red Crescent said that the girl's family had discovered the bodies of their relatives and the ambulance crew. It was not immediately clear how Hind died.

The Red Cross had issued a series of desperate posts since the rescuers went missing, trying to draw attention to the harrowing situation.

The search was hampered by the ongoing presence of Israeli forces in the area, making it too dangerous to send more rescuers to the scene, according to the Red Crescent.

Israel’s aerial bombardment and ground invasion of Gaza has left more than 27,000 people in Gaza dead in the past four months, according to health authorities in the territory. More than 12,000 of the dead are children, according to Gazan authorities.

The U.N. agency for children, Unicef, said on Friday that more than 600,000 children and their families have been displaced to the southern Gaza city of Rafah.

Israel’s war in Gaza began after Hamas staged a cross-border attack on Israel which Israeli authorities said killed about 1,200 people.

The two ambulance team members, Yousef Zeino and Ahmed al-Madhoun, were sent after a Red Crescent dispatcher spent three hours on the phone trying to console Hind as she was trapped in the car.

The Red Crescent said it had coordinated the movements of the ambulance with the Israeli military. Similar coordination is done by other aid organizations operating in Gaza, including U.N. agencies.

Some aid groups have reported convoys coming under fire.

The two rescuers confirmed arriving at the scene of the vehicle in Gaza City, in the Tal al-Hawa neighborhood, at about 6 p.m. on Jan 29. Then the Red Crescent lost contact with them and had not heard from them since.

The Israeli military’s tanks and forces remained in the vicinity, preventing the Red Crescent from sending other rescuers to the scene, the aid group said.

After the tanks withdrew, Hind’s family went to the area and saw that she was dead in the vehicle and the Red Crescent ambulance had been hit, with the two rescuers dead inside, said Nebal Farsakh, a spokeswoman for the Red Crescent. She added that the family notified the Red Crescent and sent them photos.

Tor Wennesland, the U.N. special coordinator for the Middle East peace process, said on a post on social media that when an ambulance appears to have been attacked on its way to help the child, it raises serious questions that need to be answered.

“She was found 12 days after her crushing appeal for help, and I cannot imagine the horrors she experienced,” Mr. Wennesland said.

The International Committee of the Red Cross said in a statement it was “heartbroken” by the reports that Hind and the Red Crescent rescuers were killed, and strongly condemned attacks on health care workers.

“Civilians must be protected — no child should ever be terrified for their life, surrounded by the bodies of their family members,” the Red Cross said. “That these were potentially Hind’s last moments is unbearable.”

Rawan Sheikh Ahmad contributed reporting.

“We want food and water to keep our children alive,” Ms. Abu Awwad said in a voice message this week. “The adults can survive, but the children are dying of hunger.”

The World Food Program warned last month that the entire population of Gaza — about 2.2 million people — was suffering crisis levels of food insecurity or worse. In late December, the agency said that nine out of 10 people were eating less than one meal a day, and the situation has worsened as aid groups struggle to deliver the little aid that is entering Gaza.

“If you want to avert the famine, you need to make sure that people have something to eat every day,” the W.F.P.’s director for the Palestinian territories, Matthew Hollingworth, said in an interview on Thursday after visiting Gaza.

And agencies face hurdles to distributing the aid that does enter Gaza, including roads rendered impassable by bombardment and Israeli military operations. Still, the W.F.P. said that it had delivered boxes of 10-day rations, wheat flour and hot meals to an estimated 1.3 million people last month. In northern Gaza, where the agency says needs are greatest, nearly 300,000 people are “almost entirely cut off from assistance,” it said.

Ameera Harouda contributed reporting from Doha, Qatar.

Now war has come to them again. After Hamas’s Oct. 7 attacks prompted Israel to launch a retaliatory military offensive, Ms. Malkash and her children fled their home in southern Gaza for a makeshift refugee camp set up in a school. Then, as Israeli forces intensified their attacks in the south, she and her children sought refuge at a shelter in central Gaza. (Mr. Fayyad, her husband, died of cancer soon after the family arrived in Gaza in 2012.)

“There is no life here, no future,” Ms. Malkash said by phone recently. She left school after seventh grade and has never worked. Even before the war, she said, she lived on charity in Gaza, which has long been blockaded by Israel and Egypt and where even longtime residents struggled to find work.

Since the war began, many people who held foreign passports have left Gaza after their countries secured permission from the Israeli government. But that did not include Syrians, leaving Ms. Malkash and her children trapped — like more than two million others in Gaza.

Ms. Malkash and her children, who were living in Al Qarara, east of Khan Younis in southern Gaza, first took shelter at the nearby Al Hinawi school, run by the United Nations, along with more than 5,000 others.

Her eldest son, Solaiman, 16, began suffering from severe stomach pains, but the nearest hospital turned him away because it was receiving “too many casualties,” she recalled. “They gave him some medicine and dispatched him.”

Solaiman recovered, but Ms. Malkash said she feared for the health of her children. U.N. officials report soaring cases of diarrhea, respiratory infections, meningitis and other illnesses in Gaza.

Ms. Malkash, whose Syrian passport has expired, said she would apply for a Palestinian passport after the war so she can leave Gaza for good. But she doesn’t know where to go. Syria was not an option, she said.

“Things in Gaza have always been harsh, but things in Syria have been extremely bad too,” Ms. Malkash said. She recently spoke to her sister-in-law there, who said she hadn’t had a decent meal in three years.

As the war rages, Ms. Malkash dreams of simple pleasures in a new home. “I want a place where I can feel alive and enjoy peace,” she said.