RAFAH, Gaza Strip (AP) — Israel’s ground troops advanced toward Gaza City on Thursday, as the U.S. and Arab countries intensified diplomatic efforts to ease the siege of the Hamas-ruled enclave and bring about at least a brief stop to the fighting to help civilians.

President Joe Biden suggested a humanitarian “pause” on Wednesday, as hundreds of foreign passport holders and wounded Palestinians were allowed out of Gaza for the first time, exiting via Egypt’s Rafah crossing. U.S. Secretary of State Antony Blinken is expected back in the region on Friday.

Arab countries, including those allied with the U.S. and at peace with Israel, have expressed mounting unease with the war. Jordan recalled its ambassador from Israel and told Israel’s envoy to remain out of the country until there’s a halt to the war and the “humanitarian catastrophe” it is causing. More than 3,600 Palestinian children have been killed in 25 days of fighting, as bombings have driven hundreds of thousands of people from their homes and food, water and fuel run low.

Israeli troops pushed into Gaza in larger numbers over the weekend after three weeks of heavy airstrikes that have demolished entire neighborhoods and driven more than half the territory’s 2.3 million people out of their homes. The war, the fifth and by far deadliest in Gaza, began when Hamas launched a bloody Oct. 7 rampage into Israel, which killed hundreds of men, women and children. Some 240 were captured.

The U.S. has pledged unwavering support for Israel as it seeks to end Hamas’ rule over Gaza and crush its military capabilities, even as the two allies seem to have no clear plan for the day after. White House officials said a pause in fighting would allow more aid to get into Gaza and create a possibility for more hostages to be freed.

The opening of Rafah came after weeks of talks among Egypt, Israel, the U.S. and Qatar, which mediates with Hamas. It was first time people left Gaza other than four hostages released by Hamas and another rescued by Israeli forces.

Israeli troops meanwhile appear to be advancing on three main routes, according to the Institute for the Study of War, a U.S. research group. One thrust came from Gaza’s northeast corner. Another, south of Gaza City, cut across the territory, reaching the main north-south highway.

The third, from Gaza’s northwest corner, has moved about 5 kilometers (3 miles) down the Mediterranean coast, reaching the outskirts of the Shati and Jabaliya refugee camps, on the edges of Gaza City. Airstrikes on Tuesday and Wednesday destroyed apartment blocks in Jabaliya, but the number of dead and wounded remained unknown. Israel said the strikes killed militants and demolished Hamas tunnels.

Palestinian militants fired antitank missiles, set off explosive devices and hurled grenades at Israeli troops during an overnight battle, the Israeli military said Thursday. It said soldiers returned fire and called in artillery, as well as strikes from a helicopter and a naval ship. The report could not be independently confirmed.

Hundreds of thousands of Palestinians remain in the path of the fighting in northern Gaza, despite Israel’s repeated calls for them to evacuate the region and head to the territory’s south, which is also being bombarded.

Casualties on both sides are expected to rise as Israeli troops advance toward the dense residential neighborhoods of Gaza City. Israeli officials say Hamas’ military infrastructure, including tunnels, is concentrated in the city and accuse Hamas of hiding among civilians.

Rocket fire from Gaza into Israel, and daily skirmishes between Israel and Lebanon’s Hezbollah militants, has disrupted life for millions of Israelis and forced an estimated 250,000 to evacuate towns near the borders in the north and south. Most rockets are intercepted or fall in open areas.

More than 8,800 Palestinians have been killed in the war, mostly women and minors, and more than 22,000 people have been wounded, the Gaza Health Ministry said Wednesday, without providing a breakdown between civilians and fighters. The figure is without precedent in decades of Israeli-Palestinian violence.

Over 1,400 people have died on the Israeli side, mainly civilians killed during Hamas’ initial attack, also an unprecedented figure. Sixteen Israeli soldiers have been killed in Gaza since the start of the ground operation.

At least 335 foreign passport holders left Gaza through the Rafah crossing into Egypt on Wednesday, said Wael Abu Omar, a spokesman for the Palestinian Crossings Authority. Seventy-six Palestinian patients, along with their companions, were evacuated for treatment in Egypt, he said. The U.S. has said it is trying to evacuate 400 Americans with their families.

Egypt has said it will not accept an influx of Palestinian refugees, fearing Israel will not allow them to return to Gaza after the war.

Those remaining in Gaza face an increasingly dire humanitarian situation, with basic supplies running low and hundreds of thousands packed into hospitals and U.N.-run shelters. Israel has allowed more than 260 trucks carrying food and medicine to enter from Egypt, but aid workers say it’s not nearly enough.

Hospitals in Gaza say their emergency generators are running dangerously low on fuel amid a territory-wide blackout. The World Health Organization said the lack of fuel puts at risk 1,000 patients on kidney dialysis, 130 premature babies in incubators, as well as cancer patients and patients on ventilators.

Israel has refused to allow fuel in, saying it fears Hamas would steal it for military purposes. The military released a recording of what it said was a Hamas commander forcing a hospital to hand over some fuel. The recording could not be independently verified.

Only hours of electricity remained at Gaza City’s largest hospital, Shifa, according to its director, Mohammed Abu Salmia, who pleaded for “whoever has a liter of diesel in his home” to donate it.

The Turkish-Palestinian Hospital, Gaza’s only facility offering specialized treatment for cancer patients, was forced to shut down Wednesday because of lack of fuel, leaving 70 cancer patients in a critical situation, the Health Ministry said.

The Indonesian Hospital in northern Gaza, where many of those wounded in the Jabaliya strikes were being treated, was forced to turn off most lights and its mortuary refrigerators.

“These exceptional measures will allow the Indonesian Hospital to work for a few more days,” Health Ministry spokesman Ashraf al-Qudra said. “However, if we cannot secure electricity or fuel then we will face a disaster.”

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Chehayeb reported from Beirut. Associated Press writers Wafaa Shurafa in Deir al-Balah, Gaza Strip, and Amy Teibel in Jerusalem, contributed to this report.

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