Updated November 1, 2023 at 4:07 PM ET

RAFAH, the Gaza Strip — U.S. citizens were among the hundreds of foreign nationals who flooded through the gates at Gaza's border crossing with Egypt on Wednesday, marking the first time that people trapped inside Gaza since fighting broke out between Israel and Hamas have been allowed to leave.

"The situation remains extremely fluid, but this has been an important breakthrough," State Department spokesperson Matthew Miller said on Wednesday.

Miller did not disclose the number of Americans among those who left Gaza. He said around 400 Americans are in touch with the State Department about their desire to leave and counting their family members the total is about 1,000 people.

"We expect exits of U.S. citizens and foreign nationals to continue over the next several days," Miller said, adding that U.S. citizens will be assigned specific departure dates and will be sent emails with "specific instructions about how to exit."

As the first groups of people left Gaza, ambulances from Egypt also entered the Rafah crossing that connects Gaza to Egypt, to evacuate critically injured people from the besieged territory, where Israeli airstrikes have killed thousands since Oct. 7, when the militant group Hamas launched a brutal attack on Israeli towns.

The Gaza border crossing authority, which is run by the Hamas government in Gaza, announced early Wednesday that the Rafah border would be open for injured people and some foreign passport holders to exit the territory.

The authority published a list of people that it said were approved to exit. The list included the names and passport information of nearly 500 foreigners, most of them citizens of eight countries or who are associated with NGOs. It is possible the list of 489 foreign nationals is not comprehensive and more people will be added.

People departing Gaza Wednesday told NPR that the opportunity to escape the constant bombardment and ever-growing humanitarian crisis was bittersweet.

"It's not the greatest feeling, to be honest. It's not," said Jamila Muhaisen, a 24-year-old Bulgarian citizen. "I have family here. I have friends here. It's not OK to just leave a burning city."

Hundreds of Americans are still in Gaza

Some 500 foreign passport holders were allowed to leave on Wednesday, according to the U.N.

More than half of the people on the approved exit list were Jordanian citizens. Others were from Austria, Australia and Japan. Many foreign nationals whose names weren't on the list came to the border anyway on Wednesday out of hopes that they, too, would be allowed out.

But Gaza border officials turned them away at the gate.

"I'm going to keep on coming," said Wafaa Abu Zaida, a Palestinian-American who was not allowed to exit Wednesday. "I don't want to hear, 'We gave you a chance and you didn't make it.'"

Dozens of Americans in Gaza recently sued the U.S. government, accusing it of unequal treatment and urging it to arrange an evacuation. They note that after fighting broke out, the State Department chartered cruise ships to carry Americans out of Israel. The U.S. also arranged numerous charter flights for U.S. citizens who wanted to leave Israel.

Aid groups get a chance to rotate staff in Gaza

Nearly 60 names on the approved list were associated with aid groups, including United Nations agencies and the International Committee of the Red Cross. Seven of those listed were Americans.

U.N. agencies and aid groups have plans to rotate their staff in Gaza where possible. On Friday, a team of 10 ICRC staff, including surgeons and a weapons expert, entered Gaza via the Rafah crossing.

"We also were able to do some rotation of U.N. staff," Stéphane Dujarric, spokesman for the UN Secretary-General António Guterres, said on Wednesday, calling the border opening an important step in dealing with the humanitarian crisis.

The Gaza Border Authority said 81 "seriously injured" people would be taken to hospitals in Egypt for medical care. All of the patients are Palestinians, according to the Egyptian health ministry.

"The World Health Organization welcomes Egypt's decision to accept 81 injured and sick people from the Gaza Strip for treatment," the WHO said in a statement, adding that its staff had helped Egypt establish a plan to evacuate and care for the critically wounded.

Egypt later said that only about 70 patients would be transferred, as the remaining patients had already died. The patients will be transported to hospitals in Egypt's Sinai peninsula, the Egyptian health ministry said.

A much-watched border gate finally opens

Live television footage of the crossing showed ambulances from Egypt entering the border crossing terminal separating Egypt from Gaza.

On the Palestinian side of the border, crowds of people, including children, had gathered at the terminal, many of them carrying suitcases and some with donkey-pulled carts loaded with luggage.

In the early afternoon, border officials opened the gate at the Gaza side of the border, allowing at least 100 people into the border terminal to have their passports and other documents checked.

The Gaza side of the Rafah crossing is operated by local Hamas authorities, who are coordinating with Egypt and facilitating the exit of foreigners and wounded. Hamas, besides having a military wing that is fighting Israel in the war, also runs administrative services in Gaza — including at this international boundary crossing.

With all of Israel's borders with Gaza closed since the Oct. 7 Hamas attacks that killed 1,400 people in Israel, the only operational crossing in and out of Gaza is Rafah, along the territory's southern border with Egypt. Even that border has largely been closed; only aid trucks have been allowed through until now.

Israeli airstrikes have killed nearly 8,800 and injured 22,000 others, Palestinian officials say, and doctors at Gaza's hospitals say they are overwhelmed. Hundreds of American citizens have been stranded in Gaza since the war began, along with thousands of other foreign passport holders.

More humanitarian aid is expected to reach Gaza

On Tuesday, 59 trucks bearing aid entered Gaza — the largest number of trucks in one day since aid began crossing on Oct. 21. Israel continues to block the delivery of fuel. Dozens of additional trucks were expected to enter Gaza Wednesday.

The activity at the border took place as internet and phone service in Gaza went out again temporarily. The Palestinian telecommunications company Paltel attributed the outage to "international routes that were previously reconnected being disconnected again." Service has since resumed.

The announcements followed a 34-hour communications blackout in Gaza over the weekend that coincided with the start of Israel's "expanded" ground operations.

On Tuesday, Israeli airstrikes caused significant damage to a large refugee camp in Jabalia, just north of Gaza City. The Israeli military said it was targeting the area, which it says is a Hamas "stronghold," including underground tunnels and a command center.

A precise number of casualties and injuries isn't yet known; initial reports from the health ministry in Gaza said a large number of people were wounded or killed.

Copyright 2023 NPR. To see more, visit https://www.npr.org.

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