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It comes as nearly 20,000 Palestinians are being denied the ability to leave Gaza for medical treatment, in what activist Muhammad Shehada called "a slow-motion massacre."
Israeli bombings across Gaza have killed at least 23 Palestinians since dawn on Wednesday, including at least two infants, according to hospital officials and other health authorities.
“Where is the ceasefire? Where are the mediators?” asked Dr. Mohamed Abu Salmiya, director of Gaza City’s Shifa Hospital, which received the bodies of 11 people—mostly from the same family—who were killed after Israeli soldiers fired upon a building in northern Gaza.
Israel said the attack was in retaliation after Hamas militants fired at an Israeli soldier, badly wounding him. The Associated Press reports that among the Palestinians killed were "two parents, their 10-day-old girl Wateen Khabbaz, her 5-month-old cousin, Mira Khabbaz, and the children’s grandmother."
Another attack on a tent in the southern city of Khan Younis killed three more people: Nasser Hospital, which received the bodies, said they included a 12-year-old boy. Another strike killed five more people, including a paramedic named Hussein Hassan Hussein al-Semieri, who was on duty at the time.
A total of 38 Palestinians were wounded in the series of attacks, according to the Gaza Health Ministry.
Since a "ceasefire" agreement went into effect on October 10 last year, the Gaza Government Media Office says Israel has committed at least 1,520 violations, killing at least 556 people—including 288 children, women, and elderly people—and wounding 1,500 others.
In comments to Al Jazeera, the Palestinian human rights advocate Muhammad Shehada said a ceasefire that is violated so consistently “is no ceasefire at all”.
“At most, [the deal] can be just described as some sort of mild diplomatic restraint,” Shehada said. “Whenever the world’s attention is elsewhere, Israel escalates dramatically.”
Since its genocidal war in Gaza began in October 2023, nearly 72,000 Palestinians have been killed and 171,000 injured, according to the Gaza Health Ministry, whose figures the Israel Defense Forces (IDF) recently conceded are accurate after more than two years of denial. Independent estimates suggest the true death toll is much higher.
Wednesday's onslaught came as Israel began to slowly open the Rafah crossing—the main point of entry and exit from the strip—for those in severe need of medical attention to leave.
Gaza's hospitals have been rendered largely inoperable by two years of relentless bombing and a lengthy blockade on medical supplies entering the strip, which has left more than half the population without medical treatment.
The World Health Organization said last week that 18,500 Palestinians are in need of medical treatment abroad, including hundreds in need of immediate treatment.
According to Egyptian officials, 50 patients were expected to enter through the crossing each day. However, on Monday, just five Palestinians were allowed to leave Gaza for treatment, followed by 16 on Tuesday, according to Al Jazeera reporters on the ground.
Around 4,000 of those awaiting treatment are children. According to health officials, one of them, 7-year-old Anwar al-Ashi, died of kidney failure on Wednesday while on a waitlist.
Meanwhile, those attempting to cross have been met with treatment described as "humiliating" by reporters who witnessed it. Israeli troops have subjected patients to strip searches and interrogations—some were blindfolded and had their hands tied.
"The Rafah crossing continues to be a cruel and severely restricted 'passage' of pain and humiliation," said the Palestinian politician and activist Hana Ashrawi. "This continues to be a multifaceted war of aggression, based on the deliberate manipulation of the pain of a captive people."
Salmiya said that at the rate Israel is allowing them to leave, "it will take about five years on average for all patients to be discharged." He referred to Israel's actions as "crisis management, not a solution to the crisis."
On Tuesday, United Nations Secretary-General António Guterres called for "the facilitation of rapid and unimpeded passage of humanitarian relief at scale—including through the Rafah crossing."
He added that Israel's recent suspension of dozens of aid organizations—including Doctors Without Borders, Oxfam, and Save the Children—defies humanitarian principles, undermines fragile progress, and worsens the suffering of civilians."
Shehada, who said he and his family were eagerly awaiting the end of travel restrictions, told Al Jazeera that "Israel hollowed [it] out of any substance or meaning." Instead, he said, "it’s basically a slow-motion massacre."
“We know that patients have died basically waiting for evacuation," a WHO spokesperson said, "and that’s something which is horrible when you know just a few miles or kilometers outside that border help is available."
With only five Palestinians in need of medical evacuation from Gaza permitted to leave through the Rafah crossing after it reopened on Monday, health authorities in the exclave warned that the restrictions Israel is continuing to impose at the crossing could ultimately kill thousands of Palestinians who have been waiting for years for treatment as Israeli attacks have decimated Gaza's health system.
Zaher al-Wahidi, a spokesperson for the Gaza Health Ministry, told Al Jazeera Tuesday that although the crossing has reopened—a step that has been hailed as progress under the "ceasefire" agreement reached in October—the intense screening process Palestinians are subjected to by Israeli authorities at the entry point is "too complex."
About 20,000 patients in Gaza are awaiting medical evacuation, including about 440 people whose cases are critical and need immediate treatment.
Egyptian officials had said before the crossing reopened that 50 people were expected to cross from Gaza into Egypt per day, but al-Wahidi said that if the rate of crossing on Monday continues, "we would need years to evacuate all of these patients, by which time all of them could lose their lives while waiting for an opportunity to leave."
Al Jazeera reported that people hoping to leave Gaza must register their names with Egyptian authorities, who send the names to Israel's Shin Bet for approval. Palestinians then enter a checkpoint run by the Palestinian Authority and European Union representatives before Israeli officers use facial recognition software to identify those who are leaving.
Reporting for the outlet, Nour Odeh said the crossing process has been "humiliating" for Palestinians and exemplifies the "absolute control" Israel demands over the lives of people in Gaza.
"There were strip searches and interrogations, but now there are even more extreme elements. We’re hearing about people being blindfolded, having their hands tied, and being interrogated," said Odeh. "When we talk about security screening, and a person needing urgent medical care, that person is basically being denied medical attention."
Ambulances waited for hours on Monday on the Egyptian side of the border, ready to take patients to 150 hospitals across Egypt that have agreed to treat patients from Gaza, before five people were finally able to cross after sunset.
The process, said al-Wahidi, "will not allow us to evacuate patients and provide medical services to them to give them a chance at life."
About 30,000 Palestinians have also requested to return to Gaza, having fled the exclave after Israel began bombarding civilian infrastructure and imposing a total blockade on humanitarian aid in October 2023—retaliating against Gaza's population of more than 2 million people, about half of whom are children, for a Hamas-led attack on southern Israel.
But only about a dozen people were permitted to reenter Gaza on Monday, falling far short of the daily target of 50.
The Associated Press reported that Palestinians arrived at the border crossing with luggage that they were told they could not bring into Gaza.
“They didn’t let us cross with anything,” Rotana Al-Regeb told the AP after returning to Khan Younis. “They emptied everything before letting us through. We were only allowed to take the clothes on our backs and one bag per person.”
Another woman told Tareq Abu Azzoum of Al Jazeera that she was "blindfolded and interrogated by the Israeli military on her way back to Gaza," and other said "they were intercepted by Israeli-backed militias" who demanded information about armed groups in Gaza.
For people who have waited months or years to return to Gaza, Abu Azzoum said, "the Rafah crossing has been a humiliating process instead of a day marking a beautiful reunion with family."
Palestinian political analyst Muhammad Shehada of the European Council on Foreign Relations said the process "means in practice that Israel has made the Rafah border crossing a one-way ticket. If you decide to go to Gaza, they tell you, 'Okay, you will be caged there permanently. Forget about being able to leave ever again.' If you decide to leave you will have to settle with the concept of being banished and exiled again, permanently, because the queue is so formidably long."
Palestinian analyst @muhammadshehad2 explains the restrictions that Israel has imposed at Rafah Crossing are so harsh that it would take approximately 10 years for all 150,000 Palestinians in Egypt to return to Gaza, and similarly long for the tens of thousands of patients and… https://t.co/FBy1TCAW3L pic.twitter.com/WwBA7rs4xC
— Drop Site (@DropSiteNews) February 2, 2026
On Tuesday, a World Health Organization (WHO) team arrived at a Palestinian Red Crescent hospital in Khan Younis to take about 16 patients with chronic conditions or injuries sustained in Israeli attacks to the Rafah crossing. The Red Crescent had previously been told 45 people would be able to cross on Tuesday.
Al Jazeera reported that health authorities in Gaza are being forced to choose which sick and wounded patients will be permitted to get treatment first.
“We know that patients have died basically waiting for evacuation," WHO spokesperson Christian Lindmeier said, "and that’s something which is horrible when you know just a few miles or kilometers outside that border help is available."
Dr. Mustafa Barghouti, a physician and Palestinian leader, said the statement "indicates dangerous Israeli intentions of annexing 53% of the little Gaza Strip, and to prevent reconstruction of what Israel destroyed in Gaza."
The top-ranking officer in the Israel Defense Forces suggested that Israel may plan to permanently take over more than half of Gaza, which it currently occupies as part of a temporary arrangement under the latest "ceasefire" agreement.
That agreement, signed in early October, required Israel to withdraw its forces behind a so-called "yellow line" as part of the first phase, which left it occupying over half of the territory on its side. Gaza's nearly 2 million inhabitants, meanwhile, are crammed into a territory of about 60 square miles—the vast majority of them displaced and living in makeshift structures.
The deal Israel agreed to in principle says this is only a temporary arrangement. Later phases would require Israel to eventually pull back entirely, returning control to an "International Stabilization Force" and eventually to Palestinians, with only a security buffer zone between the territories under Israel's direct control.
But on Sunday, as he spoke to troops in Gaza, IDF Chief of Staff Lt. Gen. Eyal Zamir described the yellow line not as a temporary fixture of the ceasefire agreement, but as “a new border line" between Israel and Gaza.
Zamir stated that Israel has "operational control over extensive parts of the Gaza Strip and we will remain on those defense lines,” adding that "the yellow line is a new border line—serving as a forward defensive line for our communities and a line of operational activity."
The IDF chief did not elaborate further on what he meant, but many interpreted the comments as a direct affront to the core of the ceasefire agreement.
"The Israeli chief of staff said today that the yellow line in Gaza is the new border between Israel and Gaza," said Dr. Mustafa Barghouti, who serves as general secretary of the Palestinian National Initiative, a political party in the West Bank. He said it "indicates dangerous Israeli intentions of annexing 53% of the little Gaza Strip, and to prevent reconstruction of what Israel destroyed in Gaza."
Zamir's statement notably comes shortly after a report from the Euro-Mediterranean Human Rights Monitor last week provided new details on a US-led proposal to resettle tens of thousands of Palestinians at a time into densely packed "‘cities’ of prefabricated container homes" on the Israeli-controlled side of the yellow line that they would not be allowed to leave without consent from Israel. The group likened the plan to "the historical model of ghettos."
The statement also notably came on the same day that Prime Minister Benjamin Netanyahu told German Chancellor Friedrich Merz at a joint press conference that Israel's annexation of the West Bank "remains a subject to be discussed." This year has seen a historic surge of violence by Israeli settlers in the illegally occupied territory, which ramped up following the ceasefire.
Israel has already been accused by Gaza authorities of violating the ceasefire several hundred times by routinely launching strikes in Gaza. On Saturday, the UN reported that at least 360 Palestinians have been killed since the truce went into effect on October 10, and that 70 of them have been children.
The IDF often claims that those killed have been Palestinians who crossed the yellow line. As Haaretz reported last week: "In many cases, the line Israel drew on the maps is not marked on the ground. The IDF's response policy is clear: Anyone who approaches the forbidden area is shot immediately, even when they are children."
On Sunday, Al Jazeera and the Times of Israel reported, citing local medics, that Israeli forces had shot a 3-year-old girl, later identified as Ahed al-Bayok, in southern Gaza’s coastal area of Mawasi, near Khan Younis. The shooting took place on the Hamas-controlled side of the yellow line.
Within the same hour on Sunday, the IDF posted a statement on social media: "IDF troops operating in southern Gaza identified a terrorist who crossed the yellow line and approached the troops, posing an immediate threat to them. Following the identification, the troops eliminated the terrorist." It remains unconfirmed whether that statement referred to al-Bayok, though the IDF has used similar language to describe the shootings of an 8- and 11-year-old child.
Until recently, Israel has also refused to allow for the opening of the Rafah Crossing, the most significant entry point for desperately needed humanitarian aid, which has been required to enter the strip "without interference" as part of the ceasefire agreement.
Israel agreed to open the crossing last week, but only to facilitate the exit of Palestinians from Gaza. In response, eight Arab governments expressed their “complete rejection of any attempts to displace the Palestinian people from their land."
Zamir's comments come as the ceasefire limps into its second phase, where US President Donald Trump and Israeli Prime Minister Benjamin Netanyahu will push for the full demilitarization of Hamas, which Israel has said would be a precondition for its complete withdrawal from Gaza.
“Now we are at the critical moment," said Qatari Premier and Foreign Minister Sheikh Mohammed bin Abdulrahman Al Thani, at a conference in Doha on Saturday. "A ceasefire cannot be completed unless there is a full withdrawal of the Israeli forces [and] there is stability back in Gaza."