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Despite international pressure, Israeli Prime Minister Benjamin Netanyahu has reiterated plans for a military ground offensive in the southern Gazan city, saying it is Hamas’ “last bastion.”

Israel Defense Forces spokesperson Lt. Col. Peter Lerner told CNN earlier this week that the military aims to create a plan that evacuates civilians “out of harm’s way” and differentiates civilians from Hamas militants. However, it has not yet presented its evacuation plan to the government, he told CNN on Tuesday.

The city is the last remaining refuge in Gaza for displaced Palestinians, and panic is soaring as many decide whether to stay or leave ahead of the planned ground offensive. Families struggling with shortages of food, water and medicine are living in tents just meters from the barbed-wire fence separating them from Egypt. Most have trekked to Rafah after being displaced by the war elsewhere in Gaza.

Rajaa Musleh, the Gaza representative for the nonprofit organization MedGlobal, currently based in Rafah, painted a vivid picture of the situation in the besieged town, saying that health workers who are still alive “may still be breathing, but we are dying inside.”

“The situation we are enduring in Rafah is horrific and getting worse every day. We do not have water to drink or food to eat, and our health care facilities can hardly operate,” Musleh said.

A growing number of countries and international organizations have called on Israel to avoid a ground operation in what is now Gaza’s most populated city, with the International Committee of the Red Cross regional director Fabrizio Carboni saying “countless lives are hanging in the balance.” The leaders of Australia, Canada and New Zealand warned on Thursday that such an incursion “would be catastrophic.”

Egypt has already condemned Israel’s move to push Palestinians southward in the enclave, suggesting it is part of a plan to expel Gazans and that it would spell the end of the Palestinian cause. Egypt has now sounded alarms again as Israel prepares for its military operation in Rafah.

Egypt began boosting its security presence at its border with Gaza as a “precautionary” measure ahead of the expected Israeli ground operation, Egyptian security officials told CNN. As part of its security buildup, the officials said, Egypt has deployed more troops and machinery in North Sinai, bordering Gaza.

Checkpoints leading to the Rafah border crossing on the Egyptian side were also fortified with more soldiers and the areas around the main road were being prepared for the deployment of tanks and military machinery, a witness told CNN.

It comes as Netanyahu continues to rail against Egypt for not closing the Philadelphi Corridor – the strip of land between Egypt and Gaza and the besieged enclave’s only non-Israeli-controlled border. In a press briefing on January 13, Netanyahu said that Israel would not consider the war over until it was closed.

Israel has been accused of constructing its own buffer zone, but within Gaza, which would effectively shrink the enclave’s borders. UN High Commissioner for Human Rights Volker Türk said in a February 8 statement that the IDF had been destroying Gaza buildings “that are within a kilometer of the Israel-Gaza fence, clearing the area with the objective of creating a ‘buffer zone.’”

“Israel has not provided cogent reasons for such extensive destruction of civilian infrastructure,” Türk went on to say.

Note: CNN’s Nadeen Ebrahim and Sarah El Sirgany contributed to this report

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