Updated November 2, 2023 at 3:10 PM ET

RAFAH, the Gaza Strip — U.S. citizens say they're both happy and exhausted to have finally left the embattled Gaza Strip after nearly a month of bombardments and blockades — but they're also fearful for family and loved ones left behind.

President Biden said "74 American folks" were able to leave Gaza Thursday.

Dr. Barbara Zind, a pediatrician from Grand Junction, Colo., went to Gaza on a humanitarian mission, but she spent nearly a month trapped by the war. She described a chaotic process when she navigated the Rafah crossing.

"There was chaos at the first door" where people were told to wait to hear their name called on Wednesday, she said. "And then you go into this other waiting room, and there was just chaos."

Zind said it took about 12 hours for her and other aid workers to leave Gaza and cross into Egypt. She is expectd to fly home Thursday night.

A Massachusetts family also made it out of Gaza on Thursday. Abood Okal, his wife, Wafaa Abuzayda, and their 1-year-old child had been turned away repeatedly as they tried to leave, and they had trouble finding clean drinking water.

"They're very happy" to make it out, Boston attorney Sammy Nabulsi said on the family's behalf. "They're exhausted. They're drained, they're emotionally and physically drained. They're also worried. They still have family behind in Gaza."

Some 400 Americans and their relatives set to exit

Hundreds of Americans and other foreign passport holders are poised to leave the Gaza Strip this week — the first major departure of civilians from the territory since the war between Israel and the militant group Hamas began early this month.

A new list of passport holders approved to depart — all of them foreign citizens or dual national Palestinians — was issued by the border authority overnight. It included around 400 Americans.

The State Department has been in contact with about 400 Americans who have expressed a desire to leave, department spokesperson Matthew Miller said Wednesday. With their family members, the total number is around 1,000, Miller said.

Haneen Okal, a 31-year-old mother of three, is on the list of American passport holders approved to leave Gaza.

"We can't describe our feelings of getting evacuated," she told NPR as she waited at the Rafah border crossing on Thursday. "But we're still sad because what's happening in Gaza. The war is still there."

"I left my two sisters, my two brothers, and my mom and my dad," Okal said. "My mom and my dad do have American citizenship, but they don't want to leave my other family members, so hopefully we can get them all out of there as soon as we can."

"It's a disaster. There is lack of food, electricity, power, no internet in there, bombing is all over. It's not safe at all," she said. "I don't know when this situation will end, but it's really a disaster in there."

At least 300 foreign citizens departed Gaza on Wednesday, according to the Gaza border authority, which is operated by Hamas. In addition, dozens of critically wounded Palestinians were transported by ambulance to hospitals in Egypt for treatment.

Israel's airstrikes are ongoing, and its ground campaign inside Gaza has intensified. Israeli troops have entered from Gaza's north and east, and the Israeli military have reported multiple skirmishes between its soldiers and Hamas fighters.

Biden joins those calling for a cease-fire

In Gaza, access to water, food, fuel and medical care remain urgent humanitarian issues, the United Nations reports.

More than 9,000 Palestinians have been killed since Oct. 7, according to Palestinian health officials. Some 240 hostages remain held by Hamas, who say dozens of them have died in Israeli airstrikes.

Calls for a cease-fire have grown from human rights groups, international leaders and left-leaning members of the Democratic Party. The White House, once steadfast in its support of Israel's opposition to a cease-fire, has shown support in recent days for what officials have called a "humanitarian pause."

On Wednesday, President Biden himself called for one.

"I think we need a pause," he said, speaking to a crowd of supporters after giving a campaign speech. A brief cessation of military operations could "give time to get the prisoners out," he added, which the White House later clarified to refer to hostages held by Hamas.

At least 17 Israeli soldiers have died since Israel's ground troops entered Gaza in what officials have called the "second phase" of the war. In total, 332 Israeli soldiers have died in the conflict so far, most of them on Oct. 7.

The health ministry in Gaza reports that 195 died in the Israeli strike on Jabalia refugee camp earlier this week, with 120 people still missing under the rubble.

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

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