Deadly fighting raged on in Gaza on Monday after Israel warned that, unless Hamas frees all hostages, it will push on with its offensive during the Muslim holy month of Ramadan, including in the far-southern Rafah area.

Global concern has mounted over the fate of 1.4 million Palestinians who fighting has forced into Rafah near the Egyptian border, where they endure bombardment and dire food shortages in crowded makeshift shelters and tents.

Over the last day, strikes and battles in Gaza killed more than 100 Palestinians, mostly women and children, pushing the death toll past 29,000, said the health ministry in the Hamas-run territory, with fighting heaviest in Khan Yunis, just north of Rafah.

War cabinet member Benny Gantz warned that the Israeli army is ready to push deeper into Rafah during Ramadan which, based on the lunar calendar, starts around March 10.

“If by Ramadan the hostages are not home, the fighting will continue everywhere to include the Rafah area,” said Gantz Sunday.

He added: “Hamas has a choice. They can surrender, release the hostages, and the civilians of Gaza can celebrate the feast of Ramadan.”

Gantz said Israel would allow the evacuation of civilians from Rafah — but has not specified where Palestinians could go, with vast swathes of the territory flattened after more than four months of devastating war.

Egypt has argued that allowing Gazans to flee over the border would facilitate an effort to empty Gaza of its Palestinian population, an objective Israel denies.

– ‘My children are starving’ –

The war started when Hamas launched its unprecedented attack of October 7 that left about 1,160 people dead in southern Israel, mostly civilians, according to an AFP tally of official Israeli figures.

Hamas militants also took about 250 hostages — 130 of whom remain in Gaza, including 30 presumed dead, according to Israel.

Israel’s retaliatory campaign has killed at least 29,092 people, mostly women and children, according to the latest count by the territory’s health ministry.

The spiralling humanitarian crisis has forced some Palestinians to grind animal feed into flour.

“My children are starving, they wake up crying from hunger,” a northern Gaza woman told AFP. “Where do I get food for them?”

United Nations agencies warned Monday that food and safe water have become “incredibly scarce” in Gaza, finding that one in six children in northern Gaza under the age of two are acutely malnourished.

The UN has previously cited “significant restrictions” on aid deliveries in the north.

At least 90 percent of children under five are affected by one or more infectious diseases, the UN agencies said.

Nearly every household was limiting meals and portions, and 95 percent of pregnant and breastfeeding women faced severe food poverty, accessing food with only low nutritional value.

The Gaza Strip is “poised to witness an explosion in preventable child deaths”, the UN warned.

Weeks of truce talks involving US, Egyptian and Qatari mediators have failed to bring a deal to pause the fighting, and Israel has rejected Hamas’s demands, which include a total withdrawal of its forces.

– Besieged hospital –

Heavy fighting has raged in and around the besieged Nasser Hospital in Khan Yunis.

On Monday the WHO chief Tedros Adhanom Ghebreyesus said that after two days of being denied, the UN agency had finally been allowed inside the hospital to assess patients.

Fourteen critical patients were moved to other hospitals, he said, warning there are still more than 180 patients and 15 medical staff inside the hospital, which is “experiencing an acute shortage of food, basic medical supplies and oxygen”.

There is no tap water and no electricity except for a backup generator maintaining some lifesaving machines, Tedros added.

Israel’s army said Saturday it had detained about 100 suspects at the hospital, and also that it found medicines there that had been sent for hostages but were never delivered to them.

The Gaza health ministry said seven patients, including a child, had died in the hospital since Friday due to power cuts, and “70 staff including intensive care doctors” had been arrested.

Prime Minister Benjamin Netanyahu has repeatedly insisted the army will continue until it achieves “total victory”, despite facing domestic and international pressure.

After struggling for a united response, all EU member states except Hungary on Monday agreed on a statement calling for “an immediate humanitarian pause that would lead to a sustainable ceasefire”.

– ‘Genocide’ claim –

In an escalating diplomatic row, the Brazilian foreign ministry said it had recalled its ambassador from Tel Aviv for “consultations”, after Israel summoned the Brazilian envoy and declared President Luiz Inacio Lula da Silva “persona non grata” over his remarks on the war in Gaza.

The row started Sunday, when Lula said the conflict “isn’t a war, it’s a genocide” and compared it to “when Hitler decided to kill the Jews.”

Netanyahu labelled the comments “shameful”.

A group of UN rights experts also called Monday for an independent investigation into alleged Israeli abuses against Palestinian women and girls, including killings, rapes and sexual assault.

Israel said the claims were “despicable and unfounded”.

In a sign of the war’s economic impact, Israel’s GDP slumped by 19.4 percent in the last three months of 2023 from the previous quarter, the central statistics office said Monday.

The central bank has estimated Israeli spending on the war will reach more than $50 billion.

The Israeli military also voiced fresh fears about three of the hostages — a mother and her two boys, one of whom was just nine months old when he was kidnapped.

Army spokesman Daniel Hagari said they were “concerned for the welfare” of Shiri Bibas, who was seen on a street camera in Khan Yunis surrounded by seven armed men.

Hamas said in November that all three had been killed in an Israeli bombardment, but Israeli authorities have not confirmed the claim.