Gaza City, once home to approximately one million people, has become the epicenter of a dramatic and deadly new phase in the nearly two-year war between Israel and Hamas. As Israel’s military ground offensive intensified this week, the city was plunged into chaos, with residents fleeing south, hospitals overwhelmed, and the death toll mounting daily. The humanitarian crisis that has been simmering for months has now reached a fever pitch, leaving those who remain in Gaza City and its surroundings facing unimaginable hardship.
The escalation began in earnest on September 16, 2025, when the Israel Defense Forces (IDF) launched a ground incursion into Gaza City, aiming to dismantle what they call terrorist infrastructure and eliminate Hamas’s operational capabilities. According to The Associated Press, the IDF stated that their “activity” in Gaza City is expected to “expand in line with the current situational assessment,” with the ultimate goal to “achieve the war’s objectives in Gaza and to enhance the achievements made during combat.” Israeli Defense Minister Israel Katz echoed this determination, declaring, “We will not relent, and we will not go back — until the completion of the mission.”
For Gaza’s civilians, the consequences have been devastating. The Associated Press and EFE report that Israeli calls for a full evacuation have prompted hundreds of thousands to attempt the perilous journey southward, away from the relentless bombardment. Yet, as of September 20, 2025, the Hamas-run government estimated that some 900,000 people remained in Gaza City, while about 270,000 had managed to escape. The United Nations, still compiling its own figures, noted over 290,000 north-to-south movements, but warned these don’t represent unique individuals—many have moved multiple times, seeking safety that remains elusive.
Those who have fled often find themselves living in sprawling tent cities in mid-Gaza, stretching from the Mediterranean to the eastern border. Dr. Michael Falk, a trauma specialist with MedGlobal based at Nasser Hospital in Khan Younis, described the scene to ABC News: “There’s literally no place for 350,000 refugees to go. Mid-Gaza is a tent city from the Mediterranean to the eastern border. You can buy a tent for $400, rent the land, and then somehow feed your family—but that’s all while the war is going on around you.”
The displacement crisis is compounded by dire humanitarian conditions. International organizations, as reported by EFE, have sounded the alarm over water shortages, overcrowding, and mounting waste in these makeshift camps. Famine grips the territory, with hospitals reporting cases like that of three-year-old Habeeba Abu Shaar, who died in Khan Younis “due to malnutrition and lack of treatment,” according to Nasser Hospital on September 21, 2025. The suffering is not limited to those who have fled; many who sought shelter in the south have returned to Gaza City, unable to find adequate living conditions elsewhere—approximately 22,000 residents have made this desperate journey back north, the local government says.
Inside Gaza City itself, the violence has reached staggering levels. On September 20, 2025, Gaza’s Civil Defense issued an “appeal to the world,” warning of “violent bombardment” that had claimed about 60 lives that day alone. By the afternoon, Gazan journalists updated the death toll to 61, with most victims arriving at Al-Shifa Hospital and Al-Ahli Arab Hospital. The attacks have not spared medical professionals. Dr. Mohammed Abu Salmiya, director of Al-Shifa Hospital, lost his three nephews when his family’s home in the Shati refugee camp was bombed while he was at work. In a statement to EFE, he lamented, “The ‘Israeli’ occupation destroyed my home and killed several members of my family without warning, with the intention of committing a massacre.” He added, “The world has decided to watch the genocide of millions of people without caring.”
Such tragedies are not isolated. On September 21, 2025, at least 91 Palestinians were killed in Israeli aerial and ground attacks across the Gaza Strip, according to medical sources cited by PressTV, with 76 of those deaths occurring in Gaza City. The targets included residential homes, schools-turned-shelters, tents housing displaced people, and even a truck carrying civilians attempting to flee. In one particularly harrowing incident, an Israeli strike on a truck in Gaza City’s Nasr area left at least four dead, their bodies scattered amid the wreckage.
Hospitals, overwhelmed and under siege, have become both sanctuaries and targets. Nasser Hospital, designed for 300 patients, is currently caring for more than 1,000, Dr. Falk told ABC News. Medical staff themselves are not immune to the violence; an ambulance driver was shot and killed outside Nasser Hospital just days ago. “There really is no safe space in Gaza,” Dr. Falk said. “Gaza is the worst I’ve ever seen. This feels indiscriminate. There is no reprieve, no calm place to go. It’s constant and everywhere.”
As the ground offensive continues, Israel maintains its focus on military objectives. The IDF claims to have dismantled terrorist infrastructure, found weapons, and eliminated several Hamas militants since September 16, 2025, though specifics remain scarce. The army has also detonated dozens of high-rises in Gaza, alleging they were used by Hamas for military purposes. However, these operations have drawn sharp criticism from international observers and Palestinian officials, who argue that civilian infrastructure and lives are being destroyed indiscriminately.
The psychological toll on Gaza’s residents is profound. Many describe feeling trapped, with no safe exit. A Gazan Health Ministry official told EFE, “My area is dangerous. It’s not easy to leave home. A drone will shoot at you immediately. They want us to leave.” The IDF, for its part, has designated certain southern areas, like Mawasi, as “humanitarian zones,” urging civilians to relocate there. Yet, as the Associated Press notes, these zones are already overwhelmed, with nearly one million people crowding beaches and makeshift shelters, enduring water shortages and unsanitary conditions.
Meanwhile, the political and military stakes continue to rise. Israel’s mobilization of 60,000 reservists and extension of service for another 20,000 soldiers underscores the seriousness of its campaign. Secretary of State Marco Rubio’s visit to Israel on September 15, 2025, highlighted international concerns, as he warned that “time is running out” to negotiate an end to the conflict. Nevertheless, for those on the ground in Gaza, diplomatic overtures offer little immediate relief from the daily grind of survival.
As winter approaches, the outlook grows even more grim. Dr. Falk warned, “If this ground offensive lasts months, it’s going to be horrible. As soon as winter sets in you’ll see more waterborne diseases, more respiratory illnesses, and people are already chronically malnourished. They can’t heal. Post-operative wound infections are horrendous, and mortality is far higher than in the U.S.”
With the ground offensive showing no sign of abating and humanitarian conditions worsening by the day, Gaza stands at a crossroads. The stories emerging from its battered streets and overcrowded hospitals paint a picture of a city—and a people—enduring an ordeal with no clear end in sight.