‘Anything could happen’: Gaza Strip left hanging while Israel plots response to Iran’s attack

As Israel weighs up plans to respond to Iran’s drone and missile attack, the fate of nearly 2 million Palestinians in the Gaza Strip sheltering in the border town of Rafah hangs in the balance.

Israel has said for weeks it is going to launch a ground operation into the last corner of the territory that has not seen fierce ground fighting, despite intense opposition from its closest allies.

The military had planned to start dropping leaflets calling for an evacuation on Monday evening, CNN reported, but called the operation off after the Iranian attack. The war cabinet is now focused on weighing up options for retaliation but the government has insisted the operation will still go ahead.

On Monday evening, the minister of defence, Yoav Gallant, held a briefing on plans to prepare for the operation in Rafah. The emphasis, his government said in a statement, was on the evacuation of civilians and delivery of aid.

Large groups of displaced people, worried about the possible arrival of Israeli forces and tired of living in overcrowded shelters, have tried to head north in recent days. But Israeli troops opened fire on one group on Sunday, killing five.

Maha Hussaini, a human rights activist with the organisation EuroMed who lived in Gaza City before the war, had joined columns of people heading north with her family.

“I’d been looking for a shelter to go to from Rafah for the past two or three weeks as Israel is threatening a military attack there,” she said. “When the Israeli army invades a place, the attacks are indiscriminate.”

Related: ‘Sympathy shifted to Israel’: many fear Iran attack has distracted aid effort

On hearing that some Palestinians had been able to cross back into Gaza City, they rushed to pack and leave. “We didn’t even mind the famine, the indiscriminate intense attacks or the bombardment of entire neighbourhoods. We just wanted to return to our homes.”

They joined a column of thousands of others walking, driving or riding on donkey carts up the Al Rasheed coastal road. At present a 37-mile (60km) reinforced barrier and Israeli military checkpoints separate Gaza City from anywhere south of the Gaza River. As Hussaini and her family got close, an attack began.

“When we reached the north of Nuseirat, the last point before Gaza City, intense Israeli bombardments began. There was artillery shelling, naval shelling, and sonic booms from F16s.”

“We just found ourselves in the middle of a fire. Everyone ran back, people were screaming and crying. It was difficult to drive my car back and return to the south, so I drove to another shelter in Deir al-Balah. This is my third displacement since the 17th October.”

The issue of whether Palestinians can return to the north of Gaza has been a sticking point during recent negotiations with Hamas over a potential ceasefire and hostage release deal.

The 300,000 people still living there are enduring a kind of siege within a siege, with more desperate shortages of food and other necessities, because of Israeli controls.

Until last week the only access for aid shipments was in the south, and a new crossing opened in the north cannot be used by the UN, which provides the vast majority of food aid in Gaza.

Bringing food and other supplies from the south is logistically difficult and dangerous; the risks were highlighted when Israeli forces killed seven international humanitarian workers from the World Central Kitchen charity.

Before Iran’s attack, Israel’s key international allies had been increasing pressure on the prime minister, Benjamin Netanyahu, over the death toll from airstrikes, looming famine and broader humanitarian catastrophe in Gaza.

The US administration has for months warned Israel against moving into Rafah without a comprehensive plan to protect civilians, even as Netanyahu says four Hamas battalions are sheltering there and must be targeted.

The two governments have been in talks about a possible operation, said John Kirby, White House national security council coordinator for strategic communications. “We expect that larger conversation with our Israeli counterparts to happen in coming days,” he told CBS news on Sunday.

One of the major questions is where refugees would go to escape fighting. Swathes of Gaza to the north of Rafah have been flattened by massive bombs, including buildings such as schools, which have been used as shelters, and there is a shortage of tents.

Reports on Tuesday indicated a renewed presence of Israeli ground troops in northern Gaza, while the Al Mezan Center for Human Rights published photos of leaflets they said were dropped over parts of central and southern Gaza, urging people not to return to the north.

In Jabaliya at the northern edge of Gaza City, a doctor at one of the few operational hospitals said he feared for himself and patients, after the Israeli military sent a new round of evacuation orders.

“The IDF sent messages last night and this morning to those of us in the north to leave areas like Beit Hanoun and Jabaliya, places that are close to this hospital,” said Mohammed Salha, the acting head of al-Awda hospital in northern Gaza. “Maybe they are thinking of targeting these areas.”

“We are really worried about the Israelis re-entering northern Gaza and another round of bombing – there have been strikes at night,” he said. “It’s extremely crowded in the Jabaliya refugee camp.”

Related: ‘It’s death there’: babies and children hit hardest as famine tightens hold on Gaza

“We are scared that the Israeli forces will return to northern Gaza, to bomb these areas again and to repeat what they did in November and December,” he said. “Anything could happen, we don’t know what could happen in the coming days.”

The World Health Organization had recently been able to reach the hospital to provide three deliveries of fuel and essential medicines, allowing it to operate at full capacity and take in a rush of patients from Gaza City.

But they had not been able to provide all the medical equipment the hospital needs, including for sterilisation and for desalinating water supplies. He feared that a repeated Israeli incursion into northern Gaza would halt future shipments.

“As always, we are worried, we need a store of fuel, medication and medical supplies, and we don’t know how the political situation will affect these things,” he said. “We are constantly afraid that Israeli ground troops will re-enter northern Gaza and that supplies will stop from the WHO, or even put our hospital under siege again.”