The U.S. said on Wednesday that talks on a ceasefire and release of hostages in Gaza could still reach an agreement between Hamas and Israel as the enclave’s humanitarian crisis prompted South Africa to ask the World Court for new emergency measures.

Negotiators from Hamas militants, Qatar and Egypt - but not Israel - are trying to secure a 40-day ceasefire in time for the Muslim fasting month of Ramadan, which begins early next week.

Despite speculation negotiations being an impasse, the U.S. said on Wednesday that a truce accord was still possible.

“We continue to believe that obstacles are not insurmountable and a deal can be reached … so we’re going to continue to push for one,” U.S. State Department spokesperson Matthew Miller said in Washington.

But South Africa, which in January brought a case at the World Court in The Hague accusing Israel of genocide in Gaza, on Wednesday asked the court to order new emergency measures including a stop to hostilities because Palestinian civilians were facing starvation.

“The threat of all-out famine has now materialised. The court needs to act now to stop the imminent tragedy,” the South African president said.

The Gaza health ministry said two Palestinians, aged 15 and 72, died of dehydration and malnutrition in Al Shifa and Kamal Adwan hospitals on Wednesday, raising the toll of such deaths in just over a week to 20. Reuters could not verify the deaths.

Fears were also mounting that the Gaza conflict could spread in the Middle East, especially after a series of attacks on vessels in the Red Sea and Gulf of Aden by Iran-aligned Houthi forces acting in solidarity with the Palestinians.

In the latest strike, at least three sailors were killed in a Houthi attack on a Greek-owned freighter, U.S. military officials said, the first deaths reported since the Yemeni group began the strikes against shipping in one of the world’s busiest sea lanes.

The U.S. State Department said it would continue to hold the Houthis accountable for such attacks.

‘We are showing flexibility’

Hamas pledged to continue the Cairo talks, but officials in the Palestinian militant group said a ceasefire must be in place before hostages are freed, Israeli forces must leave Gaza and all Gazans must be able to return to homes they have fled.

“We are showing the required flexibility in order to reach a comprehensive cessation of aggression against our people, but the occupation is still evading the entitlements of this agreement,” Hamas said in a statement.

A source had earlier said Israel was staying away from the Cairo talks because Hamas refused to provide a list of hostages who are still alive. Hamas says this is impossible without a ceasefire as hostages are scattered across the war zone.

Senior Hamas official Bassem Naim said the Islamist group had presented its own draft deal and was awaiting a response from Israel, and that “the ball now is in the Americans’ court”.

U.S. President Joe Biden on Tuesday said ally Israel was cooperating and urged Hamas to accept the “rational offer” Israel had made.

Israeli forces, which began their offensive in Gaza after the deadly Hamas raid on Israel on Oct. 7, have continued bombarding the Palestinian enclave since the talks began in Cairo on Sunday, and the dire humanitarian situation in the densely populated coastal strip has deteriorated further.

“Every day costs us dozens of martyrs. We want a ceasefire now,” Shaban Abdel-Raouf, a Palestinian electrician and father of five from Gaza City, who is now in southern Khan Younis, told Reuters via a chat app.

Health officials in Gaza said the number of people confirmed killed in Israel’s offensive had now passed 30,700. It reported 86 deaths in the past 24 hours and witnesses said the Israeli bombardments continued in Khan Younis, the southern city of Rafah, and areas in central Gaza.

Need for ‘Dramatically More’ Aid

The U.S. and Britain on Wednesday reiterated calls for increased aid to Gaza. Washington has pressed Israel to open another border cross in north Gaza to get more aid there.

About 250 aid trucks entered Gaza on Tuesday, the U.S. and Israel said. Miller added: “We need to see dramatically more go in.”

But Israeli government spokesperson Eylon Levy insisted Israel was not imposing any restrictions on aid and was facilitating increased shipments of food, medicine, and other supplies, blaming problems on poor U.N. distribution in Gaza.

“We’re working with the private sector, working with airdrops as well,” Levy said. “Send the aid, we’ll get it in.”

The Biden administration faced growing calls from fellow Democrats to increase pressure on Israel to ease the humanitarian crisis, with some saying they may try to stop military assistance if conditions for civilians do not improve.

The deal presented to Hamas for Gaza would free some of the hostages it still holds following the Oct. 7 attack, in which Israel said 1,200 people were killed and 253 abducted. Palestinian prisoners held in Israel would also be released.