Israel issued a new round of evacuation orders for a large swath of the southern Gaza Strip on Tuesday, sending thousands of Palestinians fleeing once again for relative safety.

In recent weeks, Israeli officials have spoken of moving toward narrower, more targeted attacks, but the exodus taking place in the city of Khan Younis made it clear Tuesday that for Gazans, a return to ordinary life is not close.

Gazans who had already been forced to flee again and again were once more on the move, hauling piles of their belongings on cars, trucks and donkey carts. Hospital patients were pushed in wheelchairs alongside others who fled on foot.

“How long can we keep being ordered: Leave and come back, leave and come back?” wondered one Gazan, Suzan Abu Daqqa, 59, after fleeing her home southeast of Khan Younis.

The trigger for the evacuation orders appeared to be a barrage of roughly 20 rockets that the Israeli military said had been fired from Khan Younis by Palestinian militants a day earlier. Israeli forces struck back overnight after “enabling civilians to evacuate from the area,” the military said.

The United Nations estimated that some 250,000 people will have to flee large areas of southern Gaza to comply with the new orders. Scott Anderson, a senior U.N. official, said the calculation was based on prewar population data and anecdotal observations of how many people had returned to the area.