Those who fled to the border city, almost half of Gaza's 2.3 million people, face a terrifying choice: stay in overcrowded Rafah - once home to 280,000 people - and wait for the attack, or risk moving north through an area of continued fighting.
Large parts are occupied by tented encampments, which have encroached even on some of Rafah's cemeteries. Aid officials have described the city as a "pressure cooker of despair", warning that a full-scale Israeli offensive on a place so overcrowded could cause large-scale loss of civilian life, and could be a war crime.
While Rafah has been hit by Israeli strikes throughout the war, the bombing and Israeli troops have been edging ever closer to the city, whose southern boundary is delineated by the mainly closed border with Egypt.
Fears of an imminent Israeli assault have been increased by strikes closer to Rafah, including by Israeli gunboats that shelled the western road into the city yesterday.
Describing the mood this week, Raed al-Nims, the media director of the Palestinian Red Crescent Society in Gaza, said: "Everyone is afraid of the expanding of the ground operation in Rafah." The sense of desperation has been underlined by the fact that some of the few who have tried to leave the city for areas such as Nuseirat, central Gaza, in recent days have lost contact with family members.
Most families who spoke to the Guardian this week indicated they would wait for an Israeli military evacuation order in the hope it would designate a safe exit route in the event of a full-scale assault.
With increasing food shortages, disease and insanitary conditions, the threatened offensive has plunged many into despair. Some said their children were too frightened to sleep because of the encroaching fighting.
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