US, Egyptian, Israeli and Qatari officials were expected to meet in Cairo to seek a truce in Gaza as more than a million civilians crammed into a southern corner of the Palestinian enclave, waiting in fear for an Israeli assault.

Amid growing international concern over the plight of civilians, Israeli tanks shelled the eastern sector of Rafah city overnight, residents said, although the anticipated ground offensive did not appear to have started.

The Israeli military said its forces killed dozens of Palestinian fighters in clashes in the southern and central Gaza Strip over the last 24 hours, including 30 in Khan Younis, a city close to Rafah on the coastal enclave’s border with Egypt. Gaza health officials said an Israeli strike on a house in Nusseirat refugee camp in central Gaza killed 16 Palestinians overnight.

In Khan Younis, Israeli tanks advanced further from the west and the east as bombing continued, residents said.

Israeli forces ordered displaced people in some shelters to head to Rafah. But the boom of tank shelling east of Rafah caused waves of panic inside the makeshift tent camps housing the displaced.

With the Israel-Hamas war now in its fifth month, attention is focused on the situation in Rafah. Around half of Gaza’s 2.3 million people are now living there in desperate conditions, including many who fled other areas pulverised in Israel’s offensive.

Israel says it intends to wipe out the Hamas fighters operating in Rafah and that it plans to evacuate civilians. Aid officials and foreign governments say there is nowhere for them to go, and Egypt has made clear it will not allow a refugee exodus over its border.

Much of the densely populated enclave is in ruins, with 28,473 Palestinians killed and 68,146 wounded since October 7, according to Gaza health officials who announced 133 new Palestinian deaths in the past 24 hours.

Many other people are believed to be buried under rubble. Supplies of food, water and other essentials are running out and diseases are spreading. “Since Israel said they are invading Rafah soon...we read our last prayers every night. Every night we say farewell to one another and to relatives outside Rafah,” said 30-year-old Aya, who is living in a tent with her mother, grandmother and five siblings.

“Unless the world shows some mercy and stops Israel from raiding Rafah, we think we are not going to survive. The sounds of shelling and explosions get closer and closer,” she said. On Monday, US President Joe Biden and Jordan’s King Abdullah kept up pressure for a ceasefire.