The talks in the Egyptian capital, involving the United States, Israel, Egypt and Qatar, ended without any sign of a breakthrough on Tuesday and no date was announced for the next meeting.

The lack of agreement dealt a new blow to the more than one million Palestinians crammed into Rafah, next to the border with Egypt, where many are living in tent camps and makeshift shelters after fleeing Israeli bombardments elsewhere in Gaza.

The Israeli military says it wants to flush out Islamist militants from hideouts in Rafah and free hostages being held there after the Hamas rampage in Israel on Oct. 7, but has given no details of a proposed plan to evacuate civilians.

"The news was disappointing, we hoped there could be a deal reached in Cairo. We are now counting down the days before Israel sends in tanks. We hope they don't but who can prevent them?" Said Jaber, a Gaza businessman who is sheltering in Rafah with his family, told Reuters via a chat app.

"We've lost our homes, our jobs. Isn't that enough? We've had enough of this war, and we will need decades to rebuild Gaza and regain our lives. When will the world stop Israel's slaughter of our people?"

Israel says it takes steps to minimise civilian casualties and accuses Hamas fighters of hiding among civilians, including in hospitals and shelters - something the militant group denies.

German Foreign Minister Annalena Baerbock, who was expected to hold talks with Israeli Prime Minister Benjamin Netanyahu on Wednesday, said an Israeli army offensive on Rafah would "completely jeopardise the humanitarian situation."

"Because the people in Rafah cannot simply vanish into thin air. They need safe places and safe corridors to avoid being caught in the crossfire even more. They need more humanitarian aid. And they need a ceasefire," she said in a statement released in Berlin.

OVERNIGHT SHELLING

Israeli forces shelled eastern areas of Rafa overnight, Palestinian witnesses said.

Israeli planes and tanks pounded several areas of Khan Younis in southern Gaza, and there was heavy fighting in some parts of the city, residents said.

The health ministry in the Hamas-governed enclave said Israeli forces were continuing to isolate the two main hospitals in Khan Younis, and that sniper fire at the city's Nasser Hospital had killed and wounded many people in recent days.

Speaking in a video from inside Nasser Hospital, one doctor said the facility had been under siege by Israeli forces for 22 days and that bulldozers protected by tanks had knocked down the hospital's northern gate.

"A state of panic prevailed this morning as we woke up today to the sounds of powerful explosions and bombardments near the northern area of the hospital. It is dreadful, food is in short supply," Dr Haitham Ahmed said in the video, which Reuters could not immediately verify.

Rafah residents said on Tuesday that dozens of displaced people had begun to leave Rafah after Israeli shelling and air strikes in recent days.

Rafah neighbours Egypt, but Cairo has made clear it will not allow a refugee exodus over the border.

At least 28,576 Palestinians have been killed and 68,291 injured in Israeli strikes on Gaza since Oct.7, the health ministry in Gaza said on Wednesday.

In the last 24 hours, 103 Palestinians were killed and 145 injured, the ministry's statement added.

Many other people are believed to be buried under rubble of destroyed buildings across the densely populated Gaza Strip, much of which is in ruins. Supplies of food, water and other essentials are running out and diseases are spreading.

At least 1,200 Israelis were killed and around 250 were taken hostage in the Hamas raid on southern Israel on Oct. 7, according to Israeli tallies.

INCONCLUSIVE TRUCE TALKS

Egypt's president met CIA Director William Burns and Qatar's prime minister at Tuesday's talks aimed at agreeing a Gaza truce, protecting civilians and delivering more aid into the enclave, Egypt's state information service said.

It said in a statement that there was a "keenness to continue consultation and coordination" on the main issues, indicating that no breakthrough was made.

The statement made no mention of Israel. The Israeli delegation left Cairo for home, a Reuters reporter said. Netanyahu's office did not respond to a request for comment.

One source briefed on the talks described them as "good" and said the sides had agreed to continue them, but declined to say where or when.

A Palestinian official said Egypt and Qatar would continue talking to the warring sides separately.

"There is no option but to continue efforts to bring an end to this war, this is the common position by the Qataris and the Egyptians, and the Americans support it," the official said, urging Israel to soften its stance.

Israel has vowed to fight on until it eradicates Hamas and has made the return of the last hostages a priority. Hamas says Israel must commit to ending the war and withdrawing from Gaza.