Gaza Death Toll Surpasses 20,000 and Israel Expands Ground Offensive Despite Pressure to Scale Back

RAFAH, Gaza Strip — The Palestinian death toll in Gaza surpassed 20,000, health officials said Friday, the latest indication of the staggering cost of the war as Israel expanded its ground offensive and ordered tens of thousands more people to leave their homes.

The deaths, amounting to nearly 1% of the territory’s prewar population, are just one measure of the devastation wrought by the conflict that over 11 weeks has displaced nearly 85% of Gaza’s people and leveled wide swaths of the tiny coastal enclave.

More than half a million people in Gaza — a quarter of the population — are starving, according to a report Thursday from the United Nations and other agencies describing the crisis caused by Israel’s bombardment and siege on the territory in response to Hamas’ Oct. 7 attack.

Despite the emergency, a U.N. Security Council vote on aid deliveries and terms for a cease-fire was delayed again late Thursday, after days of high-level negotiations.

The United States, which has veto power, has pushed back against calls for an immediate cease-fire and giving the U.N. sole responsibility for inspecting aid deliveries. Israel, citing security grounds, insists it needs to be able to screen goods entering Gaza.

The U.S. said it would back a revised resolution that calls for “creating the conditions” for a cease-fire, rather than an immediate end to fighting. Other countries support a stronger text and said diplomats would need to consult their governments before a vote, which is expected later Friday.

Martin Griffiths, the U.N. humanitarian affairs chief, lamented the world’s inaction.

“That such a brutal conflict has been allowed to continue and for this long — despite the widespread condemnation, the physical and mental toll and the massive destruction — is an indelible stain on our collective conscience,” he wrote in a post on X, the social media platform formerly known as Twitter.

Israel, shielded by the United States, has resisted international pressure to scale back its offensive and has said it would press on until Hamas, the militant group that has ruled Gaza for 16 years, has been destroyed.

The military has said that months of fighting lie ahead in southern Gaza, an area packed with the vast majority of the enclave’s 2.3 million people, many of whom were ordered to flee combat in the north in earlier stages of the war.

Since then, evacuation orders have pushed displaced civilians into ever-smaller areas of the south as troops focus on the city of Khan Younis, Gaza’s second-largest. The military said late Thursday that it is sending more ground forces, including combat engineers, to Khan Younis to target Hamas militants above ground and in tunnels.

On Friday, the military ordered tens of thousands of residents to leave their homes in Burej, an urban refugee camp, and surrounding communities, within the territory that Israel originally told people to flee to.

The air and ground campaign also continued in the north, even as Israel says it is in the final stages of clearing out Hamas militants there.

Mustafa Abu Taha, a Palestinian farm worker, said ground battles and airstrikes have continued in his hard-hit Gaza City neighborhood of Shijaiyah, adding that many areas have become inaccessible because of massive destruction from airstrikes.

“They are hitting anything moving,” he said of Israeli forces.

In the city of Rafah, on the border with Egypt, an airstrike on a house killed six people, including an infant, according to Associated Press journalists who saw the bodies at a hospital. Rafah is one of the few places in Gaza not under evacuation orders, but has been targeted in Israeli strikes almost every day.

Gaza’s Health Ministry said Friday that it has documented 20,057 deaths in the fighting. It does not differentiate between combatant and civilian deaths. It previously said that roughly two-thirds of the dead were women or minors. It said 53,320 Palestinians have been wounded.

Israel blames Hamas for the high civilian death toll during its intense air and ground campaign, citing the group’s use of crowded residential areas for military purposes.

Israel declared war after Hamas militants stormed across its border and killed some 1,200 people and kidnapped 240 others. Israel’s military says 139 of its soldiers have been killed in the ground offensive. It says it has killed thousands of Hamas militants, including about 2,000 in the past three weeks, but it has not presented any evidence to back up the claim.

Meanwhile, phone and internet services were gradually being restored late Thursday, after the latest communications blackout of 35 hours.

Repeated cuts in communications have hampered aid deliveries at a time of unprecedented humanitarian needs in Gaza.

The hunger eclipsed even the near-famines of recent years in Afghanistan and Yemen, according to Thursday’s report, which warned that the risk of famine is “increasing each day,” blaming the hunger on insufficient aid entering Gaza.

“It doesn’t get any worse,’’ said Arif Husain, chief economist for the U.N.’s World Food Program. “I have never seen something at the scale that is happening in Gaza. And at this speed.”

The war has also pushed Gaza’s health sector into collapse.

Only nine of its 36 health facilities are still partially functioning, all located in the south, according to the World Health Organization.

The agency reported soaring rates of infectious diseases in Gaza, including a five-fold increase in diarrhea, particularly among young children, compared to pre-war figures. It said there’s been a rise in upper respiratory infections, meningitis, skin rashes, scabies, lice and chickenpox.

“With the health system on its knees, those facing the deadly combination of hunger and disease are left with few options,” it said.

WHO relief workers reported “unbearable” scenes in two hospitals they visited in northern Gaza: Bedridden patients with untreated wounds cry out for water, the few remaining doctors and nurses have no supplies, and bodies are lined up in the courtyard.

Israeli forces have raided a series of health facilities in the north in recent weeks, detaining men for interrogation and expelling others.

On Thursday, troops stormed the Palestinian Red Crescent’s ambulance center in the Jabaliya refugee camp, taking away paramedics and ambulance crews, the group said. On Friday, the Red Crescent said the military released some of the paramedics, including women, but eight remained in detention with their whereabouts not known.

Magdy reported from Cairo.

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