Updated October 16, 2023 at 7:58 PM ET

JERUSALEM — Gaza's 2.3 million residents are struggling to find clean, safe water — and some are drinking brackish water from wells, raising new health concerns in a Palestinian territory that's under siege from Israel.

"Gaza is running dry," UNRWA, the U.N. agency for Palestinian refugees, said on Monday, as conditions deteriorate ahead of an expected Israeli ground invasion.

Electricity is dangerously scarce: Israel shut off supply to Gaza's main grid five days ago, and as hospitals cope with thousands of wounded people, fuel for generators is running low.

Israel began a bombardment of Gaza more than a week ago, after the Palestinian militant group Hamas killed at least 1,300 people in a surprise attack on Israel that also included hostage-taking. Since then, Israel has killed 2,778 people in the Gaza Strip, according to the Ministry of Health in Gaza.

Secretary of State Antony Blinken landed back in Israel on Monday after a visit last week, reiterating U.S. pledges of support for Israel — while also calling for aid and supplies to be allowed to enter Gaza. New rocket attacks briefly sent Blinken into a bunker.

Blinken, along with other U.S. officials, have been trying to work with Egypt to help usher in humanitarian aid into Gaza and to allow civilians, including Americans trapped there, to leave Gaza.

President Joe Biden held calls with German Chancellor Olaf Scholz, ahead of Scholz's own planned travels to Egypt and Israel, and Egyptian President Abdel Fattah El-Sisi on Monday, the White House said.

The expanding humanitarian crisis in the Gaza Strip has pushed more international political bodies to discuss next steps.

European Council President Charles Michel called for an emergency meeting of the panel for Tuesday.

"It is of utmost importance that the European Council, in line with the Treaties and our values, sets our common position and establishes a clear unified course of action that reflects the complexity of the unfolding situation," Michel said in a statement.

The Council plans to discuss providing humanitarian assistance as well as the long-term security and migration consequences of this conflict for Europe.

Here's a rundown of where things stand right now:

Hospitals are running out of electricity

Hospitals in Gaza, which have been inundated with roughly 9,000 people wounded in Israeli attacks, only have enough fuel to keep their generators running through Monday night, the U.N. Office for the Coordination of Humanitarian Affairs said late Sunday.

Losing electricity would plunge the hospitals into a new crisis as life support and other systems are shut down — even as more of the injured and dead continue to be brought in.

"The shutdown of backup generators would place the lives of thousands of patients at risk," OCHA said.

Doctors Without Borders says hospitals have also run out of painkillers. It says the wounded, many of them children, are left screaming in pain.

At least 1,000 Palestinians remain missing; many of that number are presumed dead, buried in rubble.

"The specter of death is hanging over Gaza," said OCHA chief Martin Griffiths.

Emergency water and fuel are blocked from Gaza

At Gaza's southern border, trucks loaded with fuel, water and other humanitarian supplies are waiting to cross over from Egypt through the Rafah crossing to bring some relief to the besieged area.

The border closed on Tuesday because of Israel's airstrikes on the Gaza side. Israel says there's no cease-fire deal in place to open the crossing; the U.S. says it's working on it.

"Rafah will be open," Blinken said on Sunday, as he visited Egypt on his way to Israel.

"We're putting in place — with the United Nations, with Egypt, with Israel, with others — the mechanism by which to get the assistance in and to get it to the people who need it," he said.

As of Monday night in Washington, D.C., the Rafah Crossing remained closed.

Even if the crossing does reopen, it's an open question as to how the aid would be distributed. Roads leading to Rafah's crossing have been destroyed, posing a serious challenge to any efforts to distribute fuel and water.

One reason the U.S. wants the border to open is so that some 500 to 600 Americans, including those of Palestinian origin, and other foreign nationals, can leave Gaza. But Egypt says that if the border crossing opens for people to exit, it must also remain open to allow aid to reach Gazans from Egypt's side.

On Monday, Blinken met with Israeli President Isaac Herzog to reiterate U.S. support for Israel's right to defend itself from Hamas' terrorism. He reaffirmed U.S. commitment to provide Israel with the assistance it needs to protect its citizens.

The U.S has already sent a warship to the eastern Mediterranean — a measure it says is aimed at deterrence. It has also sent to Israel "small diameter bombs" and is sending more ammunition and interceptor missiles for Israel's Iron Dome, which intercepts most Hamas rockets that are fired at Israel.

As part of that promised U.S. support, some 2,400 Marines with the 26th Marine Expeditionary Unit now off Kuwait were ordered late Monday to head west into the Red Sea with a possible direction to head into the Eastern Mediterranean, an official told NPR. The Marines could take part in any civilian or embassy evacuation, the official said.

Another 2,000 American troops will be sent on a short deployment, expected to last between 24-48 hours, to the Middle East. Those soldiers will consist of medical troops, explosive ordinance and potentially military police, according to an official that spoke to NPR.

None of these troops are expected to get involved in any combat missions related to the Israel-Hamas fight.

People are trying to flee northern Gaza

Israel has repeatedly told more than 1 million Palestinians to leave their homes in northern Gaza and head south, setting a mass evacuation in motion that lacks essential supports and has no clearly defined destination.

Israel says it will not stop its attacks until it has completely destroyed Hamas. "Every Hamas member is a dead man," Prime Minister Benjamin Netanyahu said last week.

The Israeli military dropped leaflets from the sky, telling people in northern Gaza to leave their homes. Many of the hundreds of thousands who did so traveled by foot, walking for miles. Mothers were seen carrying their babies as they headed south, with no guarantee of safety at the other end of their trek.

Those left behind included people wounded in Israel's bombardment, as well as those who are disabled or elderly, or were simply unable to find transportation to take them out of the north.

The Israeli military says Hamas is "responsible for the humanitarian consequences" of the violence and chaos that followed last weekend's attack and the ensuing evacuation order.

Rockets target Israeli cities

Sirens sounded in Tel Aviv and Jerusalem on Monday, warning of new rounds of rocket attacks. The alarms briefly sent lawmakers and others into shelters at the Knesset, where parliament was beginning its winter session.

Rockets also forced Blinken to move to a bunker for about five minutes.

In Israel, families are holding funerals and grieving — and some are also waiting for DNA confirmation of whether their loved ones are among the bodies found in southern Israel in communities known as kibbutzim that were overrun by the militants. The dead include 30 U.S. citizens.

Other families are waiting to hear whether their missing loved ones were taken hostage. Israel's military said on Monday that 199 hostages are being held in Gaza — far higher than previous estimates.

Militants in the Gaza Strip say some 22 hostages, among them foreigners, have been killed in Israeli airstrikes.

In northern Israel, people who live within about a mile of the border with Lebanon are now under evacuation orders. The Israel Defense Forces say the residents will be moved into "state-funded guesthouses."

The evacuation order covers 28 communities, according to the IDF.

Americans who want to leave Israel are doing so on planes and boats, in a slow and uncertain process. The State Department says flights are leaving from Ben Gurion International Airport on Monday and Tuesday.

And on Sunday, U.S. nationals and their immediate relatives were told to report to the seaport in Haifa for a chance to board a U.S.-organized evacuation ship leaving Israel, bound for Crete. Crowds of people showed up, and officials reportedly told some to come back another time.

Aid agencies portray dire circumstances in Gaza

"People are going through the most difficult times of their history in Gaza," Hisham Mhanna, a spokesperson for the International Committee of the Red Cross, told NPR from southern Gaza.

Mhanna said there are thousands of people who have been left without any shelter, not even a blanket or mattress. Physicians have been working at their limits since the violence escalated, he said.

"Some of the doctors actually received casualties, which turned out to be members of their own families, dead and injured," he said. "Despite all that, they continue to serve and they continue to save people's lives."

A quarter of a million people have moved to shelters in Gaza over the past 24 hours, according to the UNRWA, which says most of those people are seeking refuge in schools where "clean water has actually run out."

Most of its shelters in Gaza have run out of clean water, and others are on daily rations, the UNRWA said. Shops have run out of bottled water, and people's water tanks have emptied. Some families in Gaza are now drinking contaminated water.

The U.N. agency says 14 of its staff members are confirmed to have been killed, adding that the actual number is likely higher.

Aya Batrawy reported from Jerusalem; Bill Chappell and Jaclyn Diaz are based in Washington, D.C.

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

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