In response, Ophir Falk, a foreign policy adviser to Israeli Prime Minister Benjamin Netanyahu, said Israel acts in compliance with the laws of armed conflict and the army takes extensive measures to avert civilian casualties, including alerting people to military operations via phone calls and text messages.

More than 1.4 million Palestinians – half of Gaza’s population – have been sheltering in Rafah, most after fleeing Israel’s offensives elsewhere. The latest evacuations are forcing some to return north, where areas are devastated from previous attacks. Aid agencies estimate that 110,000 had left before Sunday’s order that adds 40,000.

“Do we wait until we all die on top of each other? So we’ve decided to leave,” Rafah resident Hanan al-Satari said as people rushed to load mattresses, water tanks and other belongings onto vehicles.

“The Israeli army does not have a safe area in Gaza. They target everything,” said Abu Yusuf al-Deiri, displaced earlier from Gaza City.

Many people have been displaced multiple times. There are few places left to go. Some Palestinians are being sent to what Israel has called humanitarian safe zones along the Muwasi coastal strip, which is already packed with about 450,000 people in squalid conditions.

Georgios Petropoulos, with the UN humanitarian agency in Rafah, said that aid workers had no supplies to help people set up in new locations.

“We simply have no tents, we have no blankets, no bedding,” he said.

The World Food Program had said it would run out of food to distribute in southern Gaza by Sunday, Petropoulos said – a further challenge as parts of Gaza face what the WFP chief has called “full-blown famine”. Aid groups have said that fuel will be depleted soon, forcing hospitals to shut down critical operations.

Heavy fighting was also under way in northern Gaza, where Hagari said that the air force was carrying out airstrikes. Palestinians in Jabaliya, Beit Lahiya and surrounding areas were told to leave for shelters in the west of Gaza City, warned that Israel would strike with “great force”.

Northern Gaza was the first target of Israel’s ground offensive launched after Hamas and other militants attacked southern Israel on October 7, killing about 1200 people, mostly civilians, and taking another 250 hostage. They still hold about 100 captives and the remains of more than 30.

Israel’s bombardment and ground offensives have killed more than 34,800 Palestinians, mostly women and children, according to Gaza’s Health Ministry, which doesn’t distinguish between civilians and combatants in its figures. Israel blames Hamas for civilian casualties, accusing it of embedding in densely populated residential areas.

At least 19 people, including eight women and eight children, were killed overnight in central Gaza in strikes that hit Zawaida, Maghazi and Deir al-Balah, according to Al Aqsa Martyrs Hospital and an AP journalist who counted the bodies.

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“Children, what is the fault of the children who died?” one relative said. A woman stroked the face of one of the children lying on the ground.