The southern city of Rafah is the new front line in the Israel-Gaza war.
"Rafah is really in chaos right now. People are on the move," said Arlan Fuller, director of emergency preparedness and response for Project HOPE.
The American nonprofit runs clinics across the world, including several in the Gaza Strip. But for now, its clinics in Rafah are closed.
Its team evacuated to other parts of Gaza, and people in Rafah are trying to do the same ahead of a potential full-scale assault on the city by Israeli forces. Complicating matters is the closure of the Rafah border crossing with Egypt, which is leading to a lack of fuel.
"I think with the border closed, our ability to get supplies in as well as get fuel in and be able to have access for that for power — it is concerning," Fuller said.
Israel at War
Israel orders population of Gaza's crowded Rafah evacuated
It's a concern facing all aid agencies trying to operate in Gaza.
"We think the stocks will run out by Saturday if no more fuel comes in. There is already every rationing of what is available. We are down to the last drop," said Sam Rose, director of planning for UNRWA, the UN agency that handles humanitarian relief for Palestinians.
Aid groups now fear what the future holds for those who remain in Rafah.
"There are enormous concerns over the people who are trapped in Rafah and what's going to happen to them next," Fuller said.
One other dire note: Project HOPE said its medical teams have been seeing an increasing number of children in Gaza suffering from acute malnutrition. With Israeli forces closing the Rafah border crossing, getting needed aid is a big challenge.