Gaza hospitals overwhelmed ahead of expected Israeli ground offensive

Medics in Gaza warned Sunday that thousands could die as hospitals packed with wounded people ran desperately low on fuel and basic supplies. Palestinians in the besieged coastal enclave struggled to find food, water and safety ahead of an expected Israeli ground offensive in the war sparked by Hamas' deadly attack.

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 broad campaign to dismantle the militant group. A week of blistering airstrikes have demolished entire neighborhoods but failed to stem militant rocket fire into Israel.

The Gaza Health Ministry said 2,450 Palestinians have been killed and 9,200 wounded since the fighting erupted, more than in the 2014 Gaza war, which lasted over six weeks. That makes this the deadliest of the five Gaza wars for both sides.

More than 1,400 Israelis were killed, the vast majority of them civilians, in Hamas' Oct. 7 assault. An estimated 150 others, including children, were captured by Hamas and taken into Gaza. It's also the deadliest war for Israel since the 1973 conflict with Egypt and Syria.

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The U.S. State Department said Secretary of State Antony Blinken would return to Israel on Monday after completing a frantic six-country tour through Arab nations aimed at preventing the fighting from igniting a broader regional conflict.

Fighting along Israel's border with Lebanon, which flared since the start of the latest Gaza war, intensified Sunday with Hezbollah militants firing rockets and an anti-tank missile, and Israel responding with airstrikes and shelling. The Israeli military also reported shooting at one of its border posts. The fighting killed at least one person on the Israeli side and wounded several on both sides of the border.

An Israeli drone fired two missiles late Sunday at a hill west of the town of Kfar Kila in south Lebanon, the state-run National News Agency reported. There were no casualties reported in the strikes, which hit near a Lebanese army center.

The Israeli army said in a post on X, formerly known as Twitter, that it had hit Hezbollah targets but did not specify what they were.

Hezbollah said in a statement that it had fired rockets toward an Israeli military position in the northern border town of Shtula in retaliation for Israeli shelling that killed Reuters videographer Issam Abdallah on Friday and two Lebanese civilians on Saturday.

A Hezbollah spokeswoman, Rana Sahili, said the increased fighting represented a "warning" and did not mean Hezbollah has decided to enter the war.

With the situation in Gaza growing increasingly desperate, the U.S. named David Satterfield, the former U.S. ambassador to Turkey with years of experience in Mideast diplomacy, to be special envoy for Middle East humanitarian issues. U.S. national security adviser Jake Sullivan said in a statement Sunday that Satterfield will focus on getting humanitarian assistance to Palestinians in Gaza.

Hospitals in Gaza are expected to run out of generator fuel within two days, endangering the lives of thousands of patients, according to the U.N. Gaza’s sole power plant shut down for lack of fuel after Israel completely sealed off the 40-kilometer (25-mile) long territory following the Hamas attack.

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In Nasser Hospital, in the southern town of Khan Younis, intensive care rooms are packed with wounded patients, most of them children under the age of 3. Hundreds of people with severe blast injuries have come to the hospital, where fuel is expected to run out by Monday, said Dr. Mohammed Qandeel, a consultant at the critical care complex.

There are 35 patients in the ICU who require ventilators and another 60 on dialysis. If fuel runs out, "it means the whole health system will be shut down," he said, as children moaned in pain in the background. "All these patients are in danger of death if the electricity is cut off."

Dr. Hussam Abu Safiya, the head of pediatrics at the Kamal Adwan Hospital in northern Gaza, said the facility did not evacuate despite Israeli orders. There are seven newborns in the ICU hooked up to ventilators, he said. Evacuating "would mean death for them and other patients under our care."

Ahmed Al-Mandhari, the regional director of the World Health Organization, said hospitals were able to move some mobile patients out of the north, but most patients can’t be evacuated, he said.

Shifa hospital in Gaza City, the territory's largest, said it would bury 100 bodies in a mass grave as an emergency measure after its morgue overflowed. Tens of thousands of people seeking safety have gathered in the hospital compound.

Gaza was already in a humanitarian crisis due to a growing shortage of water and medical supplies caused by the Israeli siege.

"An unprecedented humanitarian catastrophe is unfolding under our eyes," said Philippe Lazzarini, the head of the U.N. agency for Palestinian refugees. He said his agency was no longer able to provide humanitarian assistance and that the number of people seeking shelter in schools and other facilities in southern Gaza exceeded capacity.

Sullivan told CNN that Israeli officials told him they had turned the water back on in southern Gaza. Israel’s minister of energy and water, Israel Katz, said in a statement that water had been restored at one "specific point" in Gaza, but did not give further details. Aid workers in Gaza said they had not yet seen evidence the water was back.

Israel has ordered more than 1 million Palestinians — almost half the territory’s population — to move south. The military says it is trying to clear away civilians ahead of a major campaign against Hamas in the north, where it says the militants have extensive networks of tunnels, bunkers and rocket launchers.

Hamas urged people to stay in their homes, and the Israeli military released photos it said showed a Hamas roadblock preventing traffic from moving south.

Nevertheless, more than 600,000 people had evacuated the Gaza City area, said Israel’s chief military spokesman, Rear Adm. Daniel Hagari.

About 500,000 people, nearly one quarter of Gaza’s population, were taking refuge in United Nations schools and other facilities across the territory, where water supplies were dwindling, said Juliette Touma, spokesperson for the U.N.’s refugee agency. "Gaza is running dry," she said.

The agency says an estimated 1 million people have been displaced in Gaza in a single week.

The U.S. has been trying to broker a deal to reopen Egypt’s Rafah crossing with Gaza to allow Americans and other foreigners to leave and humanitarian aid amassed on the Egyptian side to be brought in. The crossing, which was closed because of airstrikes early in the war, has yet to reopen.

Israel has said the siege will only be lifted when the captives are returned.

Hamas rocket attacks on Israel continued Sunday, spurring a broader evacuation from the southern Israeli city of Sderot. The city of about 34,000 people sits about a mile (1.6 kilometers) from Gaza and has been a frequent rocket target. "The kids are traumatized, they can’t sleep at night," Yossi Edri told Channel 13 before boarding a bus.

The military said Sunday an airstrike in southern Gaza had killed a Hamas commander blamed for the killings at Nirim, one of several communities Hamas attacked in southern Israel. Israel said it struck over 100 military targets overnight, including command centers and rocket launchers.

Israel has called up some 360,000 military reserves and massed troops and tanks along the border with Gaza. Israeli officials gave no timetable for a ground invasion.