Asked in a Senate hearing Tuesday about charges of Israeli-authored genocide in Gaza, US Defence Secretary Lloyd Austin responded, “We don’t have evidence of that.”

“We are committed to help assist Israel in defending its territory and its people by providing security assistance,” he added

Earlier that day, Israeli Prime Minister Benjamin Netanyahu confirmed that a date was set for a ground assault of Rafah, hosting over 1.5 million Palestinians, the vast majority of them refugees. Netanyahu threatened, “There is no force in the world that will stop us.”

An invasion of Rafah would send the death toll in Gaza skyrocketing. According to the Gazan health ministry, the latest daily figures as of Tuesday were 153 killed and 60 injured, taking the totals to 33,360 and 75,993, not including those missing and unaccounted for. Among the dead are 14,500 children and 9,560 women.

The Israeli government knows the Palestinians in Rafah have nowhere to go. Its defence ministry has cynically put out a tender for just 40,000 tents, supposedly to house those expected to flee, which an official confirmed was part of preparations for the Rafah offensive.

UK Foreign Secretary David Cameron and US Secretary of State Anthony Blinken gave a sickening press conference in Washington attempting to cover up the expanding pattern of war crimes.

Cameron spoke of a “plan B” in the event of “conflict” in Rafah, apparently involving “go[ing] hard on getting aid into Gaza” while supporting “Israel in its legitimate right of self-defence to deal with the Hamas threat.” He was sure to add that the UK’s position on continuing to supply Israel with arms—roughly £42 million worth in 2022—remains “unchanged”.

Blinken praised Israel’s “initial actions” towards increasing the flow of aid into the Strip while claiming, “The ball is in Hamas’s court.”

The post-invasion reality facing Rafah is already on display in the rest of the Gaza Strip. Khan Younis, the next major city to the north of Rafah, is a wasteland. An estimated 55 percent of its buildings are destroyed or damaged, according to US-based mapping experts working from satellite imagery.

Air strikes against civilians continue daily. Five were killed in a single bombing Tuesday in the al-Maghazi refugee camp in central Gaza Tuesday, including the head of the municipality council Hatem Al-Ghamri.

Hunger could soon become the biggest killer thanks to Israel’s deliberate strategy of starvation. Half the Gazan population is facing “catastrophic” levels of food insecurity, double the number in December. Another 38 percent are suffering “emergency” levels and 12 percent “crisis” levels of shortage.

According to Gaza’s health ministry, 32 people including 28 children had already died in hospital of malnutrition and dehydration as of April 1. Charity Save the Children confirmed the deaths of 27 children.

Alexandra Saieh, head of Save the Children’s humanitarian policy and advocacy, told Middle East Monitor a few days earlier, “We believe that in reality, the stats of 25 children dying from starvation so far is just the tip of the iceberg. These are the children whose parents actually managed to bring them to health facilities to try to get some help, and who have been recorded.

“One of my colleagues who was at one of the hospitals in Gaza said doctors had to discharge mothers immediately after delivering babies because they don’t have the capacity to support them. And then the children, babies and infants, just go back to the shelters and die because the mother is not able to feed her child.”

At Kamal Adwan Hospital in northern Gaza, Dr. Hussam Abu Safiya told Human Rights Watch on April 4 that 26 children had died after experiencing starvation in his hospital alone. The majority, 16, were under five months old, with the other 10 younger than eight. He told Middle East Monitor that the youngest died at just two days old after being born severely dehydrated due to his mother’s poor health: “[She] had no milk to give him.”

At al-Awda Hospital, also in the north, acting director Mohammed Salha told the Guardian, “Everyone here has lost more than a quarter of their body weight due to malnutrition. There is no food.”

Dr. Margaret Harris of the World Health Organization said this weekend that at least 15 malnourished children arrive at the drastically undersupplied Kamal Adwan Hospital in northern Gaza every day.

Disease is rampant. Anadolu Agency reported Monday that there have now been over one million recorded cases of infectious disease—almost half the Palestinian population—including 8,000 cases of hepatitis C.

Harris explained, “614,000 cases of upper respiratory infections and 330,000 cases of diarrhoea have been recorded among displaced people in shelter centres since October 7.” There have also been 83,500 cases of scabies, 48,000 skin rashes and 7,300 cases of chickenpox. Jaundice is being monitored in 21,300 people.

Harris added, “The cases of measles diagnosed in UNRWA health centres are worrying,” warning that 9,000 patients need evacuation for treatment, including 6,000 with severe psychological trauma and 2,000 suffering from serious chronic diseases like cancer. These are likely huge underestimates.

This burden is falling on a healthcare system that has been deliberately destroyed. Just 10 of Gaza’s 36 hospitals are even partially operating.

A video posted by the Palestinian Red Crescent Society Tuesday showed the wreckage left in the wake of the Israeli rampage. The organisation commented, “The deliberate destruction carried out by Israeli occupation soldiers inside the PRCS al-Amal Hospital in Khan Younis has resulted in extensive devastation, rendering the hospital incapable of providing services to patients and wounded individuals.”

Israel’s claims that its forces are allowing more aid into Gaza, repeated by Blinken and Cameron, have been challenged by the United Nations. According to the spokesman for its humanitarian office, Jens Laerke, trucks screened by Israeli soldiers are “typically only half-full. That is a requirement that they have put in place for screening purposes”.

Moreover, “counting day to day and comparing makes little sense because it does not take into account the delays that happen at the crossing and the further movement to warehouses”. Laerke noted that “Half of the convoys that we were trying to send to the north with food [in March] were denied by the very same Israeli authorities.”

According to UNRWA, crippled by the imperialist blockade on funding, it has been totally unable to bring food into north Gaza since January.

The World Food Programme suspended deliveries in February due to security concerns, but resumed them last month. Senior spokeswoman Abeer Etefa told the Guardian, “After many failed attempts, we managed to send a number of convoys to the north during March—we sent around 47 trucks. Since the beginning of January around 110 trucks managed to reach the north, but that’s nowhere near enough. We need 30 trucks going in every day.

“It’s hit and miss, sometimes there are clearance issues, sometimes there are safety and security problems, and sometimes we are turned away from checkpoints or left there for hours.”

According to Laerke, food convoys are “three times more likely to be denied than any other humanitarian convoys with other kinds of material.”

By assassinating members of the World Central Kitchen charity last week and forcing it to suspend its operations in Gaza, Israel pulled the plug on an organisation feeding 500,000 people a day.

Speaking to the Guardian, Care International and Juzoor doctor Umaiyeh Khammash described northern Gaza as “hell on earth,” explaining, “We have tried many times to get food supplies through; one time we were able to get a truck of food but it was hit and 20 people died.”

On February 29, at least 112 Palestinians were massacred and hundreds injured by Israeli forces while trying to collect flour from an aid convoy. Israel blamed the deaths on a “stampede”.

A CNN investigation published Tuesday, based on “analysis of dozens of videos from the night and testimonies from eyewitnesses casts doubt on Israel’s version of events. The evidence, reviewed by forensic and ballistic experts, indicated that automatic gunfire began before the IDF [Israel Defence Forces] said the convoy had started crossing through the checkpoint and that shots were fired within close range of crowds that had gathered for food.”