Israel continues to prepare for a ground offensive in Rafah on the Gaza border with Egypt and a war with Lebanon to Israel’s north.

Defence Minister Yoav Gallant described the southern Gazan city, currently the location for one million displaced and starving Palestinians, as a “significant Hamas stronghold” and threatened that the Israel Defense Forces (IDF) was “thoroughly planning future operations.”

“We can’t just leave Hamas there,” said Foreign Minister Israel Katz at the Munich Security Conference, “The state of Israel will have to deal with Rafah”. Airstrikes are already killing hundreds of men, women and children in the refugee city.

With the majority of Gaza’s population already crowded into less than 20 percent of its territory and every other major urban centre eviscerated, Palestinians have no way of acting on Israel’s “evacuation” order. Israeli plans have been revealed for a series of tent cities in an even smaller corner of the enclave’s south west, pressed against the sea.

Egypt is also making plans to prevent a mass flight of thousands of desperate people across the border into its Sinai desert. While reinforcing the border fence, a gated area with 23ft walls is being constructed and multiple new agencies report sources telling them an eight-mile square camp is planned.

This criminal work is part of a conspiracy against the Palestinian people, with Israel seeking to reassure Egypt that the forced displacement of hundreds of thousands of human beings will, one way or another, be strictly controlled. It was to this end that Katz told reporters in Munich that Israel had no intention of forcibly deporting Palestinians out of Gaza and that the country would “coordinate with Egypt” to ensure its interests—that is, internal security concerns—are not harmed.

The fascist government of Israel has in any event repeatedly made clear that it prefers to see the Palestinians thrown into the Sinai desert and out of the Occupied Territories it intends to annexe permanently. If they cannot be forced to leave then those that do not will be killed in their tens of thousands.

Katz’s suggestions that “evacuated” Palestinians could go to Khan Younis underscores these murderous intentions. The city is home to the Nasser hospital, the largest still operational in Gaza, from which horrific scenes have been broadcast in the last two days. Videos show patients rushed through rubble and dust-strewn corridors on stretchers, with live fire ringing out just metres away.

The hospital has been besieged for days and was raided by Israeli soldiers Thursday morning. Besides patients, hundreds of displaced people are sheltering in the compound.

“We stand helpless,” said Dr. Nahed Abu Taima, director of Nasser Medical Complex, “unable to provide any form of medical assistance to the patients inside the hospital or the victims flooding into the hospital every single minute.”

Staff had been “forced to transfer all the patients and the wounded to the hospital’s old building,” he told Al Jazeera, adding that Israeli forces were rounding up patients and civilians taking shelter in the hospital.

“Electric power was cut off from the entire medical complex. Many patients in ICUs and those on oxygen supply and also those on dialysis are left fighting for their lives since 3am [02:00 GMT].”

Hani Mahmoud, reporting for the broadcaster, explained, “There is no electricity, oxygen, food or heating in the hospital. We are looking at another health facility being pushed out of service by Israeli forces.

“It is a continuation of the psychological warfare emphasizing to Palestinians there is no safe place across the Gaza Strip.”

By Friday evening, five people had been reported killed due to a lack of oxygen supply caused by the power outage.

Doctors Without Borders wrote, “After the bombing yesterday morning, our cadres reported an atmosphere of chaos, with an unknown number of dead and wounded. The fate of one of our colleagues remains unknown since the attack.”

One of Médecins Sans Frontières/Doctors Without Borders team was arrested at a military checkpoint as its staff was forced to flee the hospital. The Palestinian Red Crescent Society (PRCS) reports that 12 of its members from the Amal Hospital in Khan Younis are also detained, after being arrested a week ago.

PRCS staff described a caesarean birth carried out at the Amal on Friday with “insufficient blood units, the absence of an available anaesthesia technician (who was arrested), and the lack of a neonatologist”.

Conditions further north are worse. ActionAid reported Friday that the 300,000 living there are almost completely cut off from humanitarian assistance. “People who were so desperate that they were resorting to grinding up animal feed to use as flour are now finding that even this poor substitute is completely running out,” said advocacy and communications coordinator at ActionAid Palestine Riham Jafari.

She continued, “As grim as the picture is, things will get substantially worse if Israel proceeds with its plans for a full military operation in Rafah, which is the main centre of aid distribution for the entire strip. Aid operations will grind to a complete halt, denying a lifeline to hundreds of thousands of people.

“The consequences are unimaginable. Governments around the world must do everything in their power to prevent a further onslaught in Rafah and push for a permanent and immediate ceasefire.”

Far from reining in its soldiers, the Israeli government is widening its offensive, stepping up its aggression against Hezbollah in Lebanon. On Wednesday, Israeli strikes killed at least 10 civilians in southern Lebanon, including five children, in the deadliest day for non-combatants since exchanges began between the two sides on October 8.

Lebanon has submitted a complaint to the UN Security Council. Its Foreign Ministry condemned “Israel’s deliberate and direct bombing of civilians safe in their homes” as “a violation of international humanitarian law and a war crime.”

On Friday, the IDF carried out major exercises in northern Israel, involving the 146th and 210th Divisions, alongside reservists. The Golani Brigade has also begun the “procedure for increasing readiness on the northern border.” Chief of the Northern Command Major General Ori Gordin held meetings with Israeli Air Force officials.

Speaking at Munich, Katz insisted, “The world must pressure Iran and Hezbollah to withdraw from south Lebanon.”

With casualties set to soar, particularly in Rafah, Israel’s imperialist backers have begun to put more emphasis into cynical calls for care and restraint. French President Emmanuel Macron, speaking alongside the King of Jordan on Friday, warned that a ground invasion of Rafah “could only lead to an unprecedented humanitarian disaster and would be a turning point in this conflict.”

He added his caution to those already uttered by Britain, Australia, Canada and New Zealand. Biden commented the same day, “I’ve had extensive conversations with the prime minister of Israel over the last several days, one hour each. And I made the case, that I feel very strongly about, that there has to be a temporary ceasefire to get the hostages out.

“In the meantime, I anticipate, I’m hoping, that the Israelis will not make any massive land invasion [of Rafah] in the meantime.”

The concern of these blood-soaked criminals is not for the Palestinians, but for the popular response the massacre in Rafah will provoke in the Middle East and the imperialist centres. Theirs is primarily an attempt to shield themselves from too open collusion with the planned slaughter and to make it easier for allied Arab states to do the same.

Israel’s genocide in Gaza is the spearhead of a regional war with the West Bank, Lebanon, Syria, Iraq and Iran all in the crosshairs, behind which the US hopes to mobilise its Arab allies. The imperialist powers would likely prefer Israel not to unduly enflame the opposition movement before they have the necessary military, geopolitical and repressive preparation fully in place. But this is purely a tactical consideration. Not one is considering doing anything to stop Israel from acting as it pleases.

Israeli war cabinet member Benny Gantz gave his government’s reply: “There will not be a ceasefire of even one day until the hostages are returned. The fighting will continue until our goals are achieved. It can continue even in the month of Ramadan. Either the hostages will be returned, or we will extend the fighting to Rafah.”