When Israel launched its military response to the Hamas-led attacks of Oct. 7, it told Palestinians in the north of Gaza to evacuate and head south for safety. When the Israeli military operation moved to central Gaza, again Palestinians were ordered south. Today, more than five months into the conflict, many have gone as far as they can go — effectively trapped in Rafah governorate, the southernmost part of Gaza.
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No matter which direction you now turn in Rafah, the people sheltering there are hemmed in. To the north, they're blocked by sustained fighting in Khan Younis, about 6 miles away. On two other sides, they're cut off by Gaza's borders with Israel and Egypt, and on a third there's the Mediterranean Sea.
The mass displacement that has descended on Rafah is stretching it to the breaking point. Before the war, Rafah was home to an estimated 275,000 people. The population has since ballooned by more than three-and-a-half times to over 1 million people by some estimates, and as high as 1.4 million, according to the United Nations.
In all, roughly half of Gaza's prewar population of 2.3 million people has been pushed into Rafah.
This growth is all the more dramatic when you stop to consider the size of Rafah, which even before the war was already one of the most densely populated parts of Gaza.
At roughly 25 square miles, Rafah covers about the same area as cities like Newark, N.J., or Arlington, Virginia.
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But in terms of population, Rafah is now as big as some California cities like San Diego (1.4 million) or San Jose (1 million). Here's the difference, though. In San Diego, the population is spread over an area that is almost 15 times larger than Rafah. In San Jose, the population lives in a space more than seven times bigger than Rafah.
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So picture the population of a city like San Diego in a space the size of Rafah. It's even more densely packed than New York City. In terms of sheer density, it looks like this:
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As the war continues to rage, the population of Rafah is caught in a spiraling humanitarian crisis. It was never designed to accommodate this many people, so there's nowhere near enough housing to squeeze everyone in. Most families don't even have proper tents. Instead, many are sheltering under tarps, blankets or whatever scraps they can find to build shacks.
Food prices have skyrocketed, with reports of a 55-pound bag of flour costing as much as $100 — up from around $10 before the war.
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The struggle to find food means malnutrition has been taking hold, especially among the governorate's youngest inhabitants. The majority of the population in Rafah is children — an estimated 600,000, according to UNICEF. Screenings by the U.N. show that 5% of children under age 2 in Rafah are acutely malnourished, also known as "wasting." The condition leaves them with weakened immune systems, putting them at higher risk of dying from common childhood diseases.
Even before the war, Gaza struggled with water supply, relying on desalination plants and pipes coming in from Israel. But fuel shortages have hampered desalination work, which means that people in Rafah are often drinking salty, contaminated water.
The general water shortage poses hygiene challenges. In some areas, there are hourslong lines where hundreds of people are sharing a single toilet or shower.
All this means diseases and infections are spreading, with little in the way of medical infrastructure to treat those in need, according to doctors and international aid groups.
At this point in the war, hospitals in Rafah are equipped to do little else than offer first aid, as no treatments are available for chronic illnesses like diabetes, according to the U.N. Office for the Coordination of Humanitarian Affairs.
Despite the lack of resources, some Rafah hospitals are seeing as many as three times as many patients as before the war.
Compounding the crisis is the reality that Rafah has become a focus of Israeli airstrikes. Israel has said these strikes are part of its response to the Oct. 7 attack, when Hamas militants stormed southern Israel and killed approximately 1,200 people, according to Israeli officials. The Israeli offensive has killed more than 31,000 Palestinians across all of Gaza, according to Gaza's Ministry of Health.
Some of the strikes in Rafah have targeted Hamas fighters or facilities, while others were carried out in an effort to free Israeli hostages taken by Hamas, according to the Israeli military. But some of these strikes have hit homes, killing and injuring dozens of civilians, including women and children. Others have hit food distribution sites.
The situation may grow only bleaker. Israel and Hamas haven't reached a cease-fire agreement, and Israeli Prime Minister Benjamin Netanyahu has said the Israeli military will eventually launch a broad offensive in Rafah to root out Hamas and claim "total victory."
"It has to be done," he said.
Methodology
The maps of Gaza evacuation areas are based on news reports and data collected by the Institute for the Study of War and the American Enterprise Institute's Critical Threats Project.
Rafah prewar population numbers are from the Palestinian Central Bureau of Statistics (2023 estimates).
Data for the U.S. urban comparisons come from the U.S. Census Bureau. Population data is based on 2022 American Community Survey five-year estimates. Density is calculated based on a place's land area, per the Census Bureau's 2023 National Places Gazetteer Files.
