Any Israeli military advance into the Rafah area in southern Gaza it can cause massive deaths to one million Palestinians stranded there, with humanitarian aid at risk of collapse, aid workers said today.

Israel threatened to move on from Khan Younis, the southern Gaza Strip’s main city of Rafah, where the population has quintupled as people flee to escape shelling, often under evacuation orders, after Israel launched its offensive against the Palestinian group that rules Gaza .

About 1.5 million people are now piling up in filthy, overcrowded shelters or on the street crammed into a stretch of land between the Egyptian and Israeli border fences and the Mediterranean, and by Israeli forces.

Doctors and aid workers are struggling to provide even basic aid and stop the spread of disease.

“No war can be allowed in a huge refugee camp,” said Jan Egeland, secretary general of the Norwegian Refugee Council (NRC), warning of the risk of a “bloodbath” if Israeli operations expand there.

“Expanded hostilities in Rafah could cause the humanitarian response to collapse,” the NRC added in a statement.

The Reuters agency has taken in recent days footage of funerals of civilians killed by Israeli strikes.

Israel says it is taking steps to avoid harming civilians and accuses Hamas fighters of hiding among them, including in shelters — which Hamas denies.

About 28,000 Palestinians have been confirmed dead, according to Gaza’s health ministry, in a war that broke out on October 7 when Hamas militants killed 1,200 people and took 253 hostages in Israel, according to Israeli accounts.

A doctor who left Gaza last week described Rafah as a “closed prison” with excrement everywhere on the streets, which are so crowded that there is hardly any room for medical vehicles to pass.

“If the same bombs that were used on Khan Younis are used on Rafah, the toll will be at least double or triple because it is so densely populated,” Santos Kumar said.

The charity ActionAid said some people end up eating grass. “Every person in Gaza is hungry now, and the world has only 1.5 to 2 liters of unsafe water every day to meet all their needs,” her statement said.

Aid groups say they cannot move people to safer areas because Israeli troops are stationed in the north, and that the aid allowed into the enclave is not enough for everyone.

“All our shelters are overflowing with people and we can’t take any more,” said Juliette Touma, spokeswoman for the UN agency for Palestine refugees.