DEIR AL-BALAH, Gaza Strip (AP) — Israeli forces battled Hamas militants across Gaza on Wednesday after expanding their ground offensive to its second-largest city, further shrinking the area where Palestinians can seek safety and halting the distribution of vital aid across most of the territory.

The assault on the south threatens further mass displacement within the besieged coastal enclave, where the U.N. says some 1.87 million people — over 80% of the population — have already fled their homes.

Much of the north, including large parts of Gaza City, has been completely destroyed, and Palestinians fear the rest of Gaza could suffer a similar fate as Israel tries to dismantle Hamas, which has deep roots in the territory it has ruled for 16 years.

Israel says it can no longer accept a Hamas military presence in Gaza after the Oct. 7 attack that triggered the war, and Prime Minister Benjamin Netanyahu has said Israel will maintain open-ended security control over the territory, something opposed by the United States and much of the international community.

HEAVIEST FIGHTING YET

The Israeli military said Tuesday that its troops were “in the heart” of the southern city of Khan Younis after what it described as “the most intense day” of fighting since the start of the ground operation five weeks ago, with heavy battles in the north as well.

For the past three days, aid distribution — mainly just supplies of flour and water — has been possible only in and around the border city of Rafah, at Gaza’s southern edge, because of fighting and road closures by Israeli forces, the U.N.'s humanitarian aid office said.

The aid group Doctors Without Borders said fuel and medical supplies have reached “critically low levels” at the Al-Aqsa Martyrs Hospital in the central town of Deir al-Balah, north of Khan Younis. Up to 200 wounded people have been brought in every day since Dec. 1, when a weeklong truce expired, it said.

“Without electricity, ventilators would cease to function, blood donations would have to stop, the sterilization of surgical instruments would be impossible,” said Marie-Aure Perreaut Revial, the aid group’s emergency coordinator in Gaza. She said the hospital is also running desperately low on surgical supplies and external fixators to hold broken bones together.

Gaza has been without electricity since early October, and Israel has severely limited fuel imports, forcing several hospitals to shut down because they cannot operate emergency generators.

The war has killed more than 16,200 people in Gaza — 70% of them women and children — and wounded more than 42,000, according to the territory’s Health Ministry, which released new figures late Tuesday. The ministry does not differentiate between civilian and combatant deaths, but its overall tally tracks with a figure released by the Israeli military this week.

The ministry says hundreds more have been killed since the cease-fire ended Friday, and many still are trapped under rubble.

The military accuses Hamas of using civilians as human shields when the militants operate in residential areas. But Israel has not given detailed accounts of individual strikes, some of which have leveled entire city blocks.

Military Chief of Staff Herzi Halevi said militants keep weapons in homes and other buildings so fighters in civilian clothes can use them to fire on troops.

“Striking them requires significant use of fire, both to target the enemy but also to, of course, protect our forces,” he said Tuesday.

ANGER AMONG FAMILIES OF HOSTAGES

Israel says it must remove Hamas from power to prevent a repeat of the Oct. 7 attack, when Hamas and other militants killed about 1,200 people, mostly civilians, and took captive some 240 men, women and children after bursting through Israel’s vaunted defenses.

More than 100 hostages were released during last week’s cease-fire, along with 240 Palestinians imprisoned by Israel.

Family members of hostages held a tense meeting with Netanyahu and the war cabinet Tuesday in which some of them shouted at cabinet members, accusing them of having no plan to bring back the rest.

Five of the released hostages shared details of their experience during the meeting. One spoke of Hamas fighters “touching” female hostages, and another said militants shaved off a male hostage’s body hair to humiliate him, according to a group representing the families.

A doctor who treated some of the 110 released hostages told The Associated Press separately that at least 10 women and men were sexually assaulted or abused, without providing further details, adding to widespread allegations of rape and other atrocities committed during Hamas’ Oct. 7 attack.

NO END IN SIGHT

Hamas’ continuing ability to fight in the north, where Israel entered with overwhelming force weeks ago, signals that eradicating the group without causing further mass casualties and displacement — as Israel’s top ally, the U.S., has requested — could prove elusive.

The military says 88 of its soldiers have been killed in the Gaza offensive. A military official said this week that at least 15,000 Palestinians have been killed, including 5,000 militants, but did not explain how the army arrived at those figures.

Even after weeks of bombardment, Hamas’ top leader in Gaza, Yehya Sinwar — whose location is unknown — was able to conduct complex cease-fire negotiations and orchestrate the release of scores of hostages last week. Palestinian militants have also kept up their rocket fire into Israel.

The war has been an unprecedented catastrophe for Palestinians civilians, eclipsing all four previous wars between Israel and Hamas, and their suffering is set to worsen as the offensive grinds on.

After the full-scale evacuation of northern Gaza ordered by Israel early in the war, most of Gaza’s population was squeezed into 230 square kilometers (90 square miles) of central and southern Gaza.

Since moving into the south, the Israeli military has ordered people out of nearly two dozen neighborhoods in and around Khan Younis, further reducing the area where civilians can seek refuge by more than a quarter.

It was not clear how many people heeded the evacuation orders, as many Palestinians say they don’t feel safe anywhere in Gaza and fear that if they leave their homes they will not be allowed to return.

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Magdy reported from Cairo.

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Full AP coverage at https://apnews.com/hub/israel-hamas-war.