Israel is facing growing international pressure to hold off on a planned assault on the last refuge for displaced Palestinians in southern Gaza after truce talks in Cairo ended inconclusively.
Officials said Tuesday's talks were constructive and would continue, but the lack of an immediate breakthrough fuelled fears among hundreds of thousands of people crammed into Rafah that Israel would soon storm the city on the border with Egypt.
Adding to their concerns, Israeli Prime Minister Benjamin Netanyahu said Hamas, which runs Gaza, had presented no new offer for a hostage deal in the Cairo talks, and said Israel would not agree to the Palestinian group's current demands.
Tensions also rose along Israel's northern border with Lebanon on Wednesday. Israel said a woman was killed in a rocket attack from Lebanon, and four people were reported killed in Israeli strikes on southern Lebanon.
The Israeli military says it wants to flush out Islamist militants from hideouts in Rafah and free hostages being held there after the Hamas rampage in Israel on October 7, but has given no details of a proposed plan to evacuate civilians.
Richard Peeperkorn, the World Health Organization representative for Gaza and the West Bank, said an assault on Rafah would be "an unfathomable catastrophe... and would even further expand the humanitarian disaster beyond imagination."
French President Emmanuel Macron raised similar concerns in a phone call on Wednesday with Netanyahu, the president's office said, saying further forced displacements of people could also bring regional escalation.
German Foreign Minister Annalena Baerbock said people in Rafah with nowhere to go "cannot simply vanish into thin air".
"They need safe places and safe corridors to avoid being caught in the crossfire even more," she said before talks with Netanyahu.
Israel says it takes steps to minimise civilian casualties and accuses Hamas fighters of hiding among civilians, including in hospitals and shelters - something the militant group denies.
On Wednesday Israel said it had approved the use of Starlink services - the satellite network of billionaire entrepreneur Elon Musk - to help communications at a field hospital in Gaza and in Israel itself for the first time.
Israeli forces shelled eastern areas of Rafah overnight, and pounded several areas of Khan Younis in southern Gaza, residents said.
The health ministry in the Hamas-governed enclave said Israeli forces were continuing to isolate the two main hospitals in Khan Younis, and that sniper fire at the city's Nasser Hospital had killed and wounded many people in recent days.
An Israeli air strike on a house in Al-Nusseirat refugee camp in central Gaza killed six people, health officials said.
At least 28,576 Palestinians have been killed, including 103 in the past 24 hours, and 68,291 wounded in Israeli strikes on Gaza since October 7, according to the health ministry in Gaza.
At least 1200 Israelis were killed and around 250 were taken hostage in the Hamas raid, according to Israeli tallies.
Israel has vowed to fight on until it eradicates Hamas and has made the return of the last hostages a priority. Hamas says Israel must commit to ending the war and withdrawing from Gaza.
"Israel will not capitulate to Hamas' ludicrous demands. A change in Hamas' positions will make it possible to move forward in the negotiations," Netanyahu's office said on Wednesday.
Diplomacy is focused not just on halting the war and securing the hostages' release but also on preventing the conflict from spreading across the region.
The armed Lebanese group Hezbollah, which backs the Palestinians, has frequently fired across the border into northern Israel since the war began in Gaza.
Iran-aligned Houthi forces in Yemen have also sought to show solidarity with the Palestinians, by attacking international shipping in the Red Sea. The United States and Britain have retaliated with strikes on Houthi targets in Yemen.
In the latest such strike, US Central Command (CENTCOM) said its forces attacked a cruise missile that was about to be fired at ships in the Red Sea.
