Israeli tanks and troops pressed towards Gaza City but met fierce resistance from Hamas fighters using mortars and hit-and-run attacks from tunnels as the Palestinian death toll mounted and foreign passport-holders were being allowed out.

The total death toll in Gaza rose to 9,061 people and 32,000 others injured, the official spokesperson for the health ministry in Gaza said. The dead include 3,760 children and 2,326 women, the spokesperson said.

The four-week conflict is closing in on the Gaza Strip's main population center in the north, where Hamas is based. Israel has been telling the residents to leave as it vows to annihilate Hamas once and for all. 

"We are at the gates of Gaza City," Israeli military commander Brigadier General Itzik Cohen said. 

'They never stopped bombing'

Hamas fighters were emerging from tunnels to fire at tanks, then disappearing back into the network, residents said and videos from both groups showed, in guerrilla-style operations against a far more powerful army.

"They never stopped bombing Gaza City all night, the house never stopped shaking," said one man living there, asking not to be identified by name. "But in the morning we discover the Israeli forces are still outside the city, in the outskirts and that means the resistance is heavier than they expected." 

The latest outbreak in the decades-old conflict began when Hamas fighters broke through the border on October 7. Israel says they killed 1,400 people, mostly civilians, and took more than 200 hostages in the deadliest day of its 75-year history.

Though Western nations have traditionally supported Israel's right to self-defense, harrowing images of bodies in the rubble and hellish conditions inside Gaza have triggered appeals for restraint and street protests around the world.

Israel's right-wing Prime Minister Benjamin Netanyahu knows, however, that his career and legacy depend on crushing Hamas.

Residents reported mortar fire throughout the night in areas around Gaza City and said Israeli tanks and bulldozers were sometimes driving over rubble and knocking down structures rather than using regular roads as planes bombed from overhead. 

Hamas published a video of a drone dropping a grenade.

Brigadier General Iddo Mizrahi, chief of Israel's military engineers, told Army Radio troops were in a first stage of opening access routes in Gaza. "This is certainly terrain that is more heavily sown than in the past with minefields and booby-traps," he said. "Hamas has learned and prepared itself well."

Foreign nationals and wounded Gazans use Rafah border

After being restricted by a total blockade of the Gaza Strip for more than three weeks, foreign passport holders and some severely wounded people were being allowed out. 

Wael Abu Mohsen, spokesman for the Palestinian side of the Rafah crossing, said in a statement that "100 travelers of foreign nationalities" had crossed into Egypt, escaping the bombarded Palestinian territory.

A total of 400 foreign passport holders as well as 60 wounded patients were due to cross by the day's end, Abu Mohsen said.

Another 60 critically injured Palestinians would be crossing too, Mehsen added. One diplomatic source said some 7,500 foreign passport holders would leave Gaza over a couple of weeks.

More than 20,000 wounded people are still trapped in Gaza, according to Doctors Without Borders (MSF), despite a tiny handful of evacuations of "severely injured" people to Egypt.

Egyptian officials said 46 people crossed Rafah for treatment in Egypt alongside 30 people accompanying them. They had initially given a figure of 76 sick and wounded. 

"There are still over 20,000 injured people in Gaza with limited access to healthcare due to the siege," MSF said.

'It is a massacre'

Israel's latest strikes have included the heavily-populated area of Jabalia that was set up as a refugee camp in 1948.

Gaza's Hamas-run media office said at least 195 Palestinians were killed in the two hits on Tuesday and Wednesday, with 120 missing and at least 777 people hurt.

"It is a massacre," said one person on the scene as people desperately hunted for trapped victims.

Israel, which accuses Hamas of hiding behind civilians, said it killed two Hamas military leaders in Jabalia.

The Israeli military said another soldier had died in the Gaza fighting, bringing to 17 the number killed since ground operations were expanded on Friday.

Troops had "confronted several terrorist cells in the northern Gaza Strip during which dozens of terrorists were killed," the military said in a statement.

With Arab nations increasingly vocal in their outrage at Israel's actions, the UN High Commissioner for Human Rights also expressed concern that Israel's "disproportionate attacks… could amount to war crimes."

The United Arab Emirates said it planned to treat 1,000 Palestinian children from Gaza, without saying how they would leave the Israeli-besieged enclave for the Gulf state.

Saudi Arabia said it is launching a fundraising campaign for Palestinians. 

Calls for 'humanitarian pause'

With international calls for a "humanitarian pause" in hostilities going unheeded, conditions are atrocious in Gaza, with food, fuel, drinking water and medicine all running short.

U.S. President Joe Biden said there should be a humanitarian "pause" in the war to get the hostages out. The White House has previously called for humanitarian pauses to allow aid to be delivered into Gaza or to carry out evacuations, but has so far refused to discuss a ceasefire, believing it would exclusively play into the hands of Hamas.

A total of 227 aid trucks have so far entered under a US-brokered deal, according to the UN humanitarian agency OCHA, an amount aid groups say falls far short of meeting the desperate need.

"We open our eyes on dead people and we close our eyes on dead people," said Fathi Abu al-Hassan, a U.S. passport holder waiting to cross into Egypt.

Gaza's struggling hospitals

Hospitals, including Gaza's only cancer hospital, are struggling due to fuel shortages. Israel has refused to let humanitarian convoys bring in fuel, citing concern that Hamas fighters would divert it for military use.

Ashraf Al-Qudra, a spokesperson for the Gaza health ministry, said the main power generator at the Indonesian Hospital was no longer functioning.

The hospital was switching to a back-up generator but would no longer be able to power mortuary refrigerators and oxygen generators. "If we don't get fuel in the next few days, we will inevitably reach a disaster," he said. 

U.S. Secretary of State Antony Blinken is due to depart for his third visit to Israel in less than a month. 

He plans to meet Netanyahu to voice solidarity with its close ally but also to reassert the need to minimize Palestinian civilian casualties, his spokesperson said.

Blinken will also stop in Jordan, one of a handful of Arab states to have normalized relations with Israel. However, Jordan has withdrawn its ambassador from Tel Aviv in protest at the assault on Gaza.