RAFAH, Gaza Strip — Israeli troops advanced toward Gaza City on Thursday, as the Palestinian death toll rose above 9,000. With no end in sight after weeks of heavy fighting, U.S. and Arab mediators intensified efforts to ease Israel’s siege of the Hamas-ruled enclave and called for at least a brief halt to the hostilities in order to aid civilians.

U.S. President Joe Biden suggested a humanitarian “pause” the day before, as an apparent agreement among the U.S., Egypt, Israel and Qatar, which mediates with Hamas, allowed hundreds of Palestinians with foreign passports and dozens of wounded to leave Gaza for the first time. Dozens more left on Thursday.

Israel did not immediately respond to Biden’s remarks, but Prime Minister Benjamin Netanyahu has previously ruled out a cease-fire.

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 3,700 Palestinian children have been killed in 25 days of fighting, and bombings have driven more than half the territory’s 2.3 million people from their homes, while 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. The war, the fifth and by far deadliest in Gaza, began when Hamas launched a bloody Oct. 7 rampage into Israel, killing hundreds of men, women and children. Some 240 were taken captive.

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 what would come next.

White House officials said a pause in fighting would allow for more aid to be sent in and potentially facilitate the release of hostages. U.S. Secretary of State Antony Blinken is expected back in the region on Friday.

The departure of Palestinians through the Rafah crossing into Egypt on Wednesday came after weeks of talks. It was first time people left Gaza other than four hostages released by Hamas and another rescued by Israeli forces. Israel has also allowed more than 260 trucks carrying food and medicine through the crossing, but aid workers say it’s not nearly enough.

At least 335 foreign passport holders left Wednesday and approximately another 100 left Thursday, according to Wael Abu Omar, a spokesman for the Palestinian Crossings Authority. Seventy-six Palestinian patients, along with their companions, were also evacuated, 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.

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

Israeli Troops Approaching Gaza City

Israeli troops appear to be advancing on Gaza City along three main routes: from the northeast, from the northwest along the Mediterranean coast, and from the south after reaching the territory’s main north-south highway. Israeli officials have provided only vague statements about troop movements.

Airstrikes on Tuesday and Wednesday destroyed apartment buildings in the Jabaliya refugee camp near Gaza City, 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. The report could not be independently confirmed.

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.

At least 9,061 Palestinians have been killed in the war, mostly women and minors, and more than 32,000 people have been wounded, the Gaza Health Ministry said Thursday, without providing a breakdown between civilians and fighters. The death toll is without precedent in decades of Israeli-Palestinian violence, and is around four times the figure from the 2014 Gaza war, which lasted over six weeks.

Four Palestinians, including three teenagers, were shot dead in different parts of the occupied West Bank early Thursday, the Palestinian Health Ministry said. More than 130 Palestinians have been killed in the West Bank since the start of the war, mainly in violent protests and gunbattles during Israeli arrest raids.

An Israeli man died after a suspected militant opened fire on his car near a settlement in the West Bank on Thursday, the military and medics said.

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

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 border towns. Most rockets are intercepted or fall in open areas.

Those remaining in Gaza face an increasingly dire situation amid a territory-wide blackout. The World Health Organization said the lack of fuel for hospitals’ generators 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.

“If we cannot secure electricity or fuel then we will face a disaster,” Health Ministry spokesman Ashraf al-Qidra said.