Israeli forces stormed Gaza's largest hospital Wednesday, targeting a Hamas command centre they say is located below thousands of ailing and sheltering civilians.
Israeli and Palestinian officials said military operations were taking place at Gaza City's Al-Shifa hospital, which has been the focal point of days of fighting and nearby aerial bombardments.
The Israel Defense Forces said its troops were carrying out "a precise and targeted operation against Hamas in a specified area" of the facility.
Youssef Abul Reesh, an official from the Hamas-run health ministry who is inside the hospital, told AFP he could see tanks inside the complex and "dozens of soldiers and commandos inside the emergency and reception buildings."
After sharp warnings from the United States that Al-Shifa hospital "must be protected", Israel said the raid was being executed based on intelligence and "an operational necessity".
Thousands of patients, staff and displaced civilians are believed to be inside the hospital complex, according to local officials.
Witnesses have described conditions as horrific, with medical procedures taking place without anaesthetic, families with scant food or water living in corridors, and the stench of decomposing corpses filling the air.
"There are bodies littered in the hospital complex and there is no longer electricity at the morgues," said hospital director Mohammad Abu Salmiya.
Israel has repeatedly claimed that Hamas uses the hospital as cover for a command post and weapons stores, a claim Hamas denies.
That use "jeopardises" the hospital's "protected status under international law", the military said, a claim that many international human rights lawyers refute.
Israel has vowed to destroy Hamas in response to attacks on October 7, which killed an estimated 1,200 people, mostly civilians, and saw 240 hostages being taken to Gaza.
The Palestinian group accused US President Joe Biden of being "wholly responsible" for the Israeli assault on Al-Shifa.
The Palestinian Authority, historically the representative body for the Palestinians but which has no authority in Gaza, warned "against a massacre being carried out inside the hospital."
- 'No harm' -
Anticipating a fierce backlash against the hospital raid, the Israel Defense Forces said it had given authorities in Hamas-run Gaza 12 hours' notice that any military operation inside must cease.
"Unfortunately, it did not," the Israeli military said, again calling on "all Hamas terrorists present in the hospital to surrender".
Israeli army ground teams were said to include medics and Arabic speakers "who have undergone specified training to prepare for this complex and sensitive environment".
The "intent" was that "no harm is caused to the civilians being used by Hamas as human shields", the Israeli military added.
Abul Reesh, from Gaza's health ministry, called on "the international community and the United Nations to intervene immediately and urgently to stop the Israeli storming operation."
He urged both to protect what he said were "20,000 people inside the hospital including medical staff and 650 ailing people and thousands of injured people."
The White House on Tuesday said that US intelligence sources had corroborated Israel's claim that Hamas has buried an operational centre under the hospital.
Hamas and another Palestinian militant group, Islamic Jihad, "operate a command and control node from Al-Shifa in Gaza City", National Security Council spokesman John Kirby told reporters.
"They have stored weapons there and they're prepared to respond to an Israeli military operation against that facility."
- 'I was bleeding' -
The situation in Gaza's other hospitals is also dire, with the UN saying 22 of 36 are not functional due to lack of generator fuel, damage and combat.
"The 14 hospitals remaining open have barely enough supplies to sustain critical and life-saving surgeries and provide inpatient care, including intensive care," said the World Health Organization.
The health ministry in Hamas-run Gaza says Israel's offensive has killed 11,320 people, mostly civilians, including thousands of children.
The humanitarian crisis in the territory also includes the hundreds of thousands of people who have fled southwards at Israel's urging to get away from the most intense fighting.
Even escaping the fighting is dangerous. Wounded Palestinians told AFP how they were hit by a strike on their way south.
"I walked around three to four kilometres (around two miles) while I was bleeding," said Hasan Baker, whose head and left hand were bandaged. "There was no possibility for any ambulance to enter the area."
- Hostage talks -
Israeli leaders have so far insisted there will be no ceasefire in the five-week-old war until hostages are released.
Qatar is mediating talks on a possible deal to free captives.
Abu Obeida, a spokesman for Hamas's military wing, said Monday that Israel asked for the release of 100 hostages while the militants want 200 Palestinian children and 75 women freed from Israeli prisons.
"We informed the mediators we could release the hostages if we obtained five days of truce... and passage of aid to all of our people throughout the Gaza Strip, but the enemy is procrastinating," Abu Obeida said in an audio statement.
Qatari foreign ministry spokesman Majed bin Mohammed Al-Ansari told a news conference in Doha that the "deteriorating" situation in Gaza was hampering efforts to find a deal.
"We believe that there is no other chance for both sides other than for this mediation to take place," he said.
With pressure building on the Israeli government, Prime Minister Benjamin Netanyahu said he was "working relentlessly" to get the hostages out.
Relatives of the hostages set out Tuesday on a five-day protest march from Tel Aviv to the prime minister's office in Jerusalem to call for the captives' release, the Hostages and Missing Families Forum said.
The families group later demanded the government "approve a deal tonight to bring home all hostages from Gaza".
- West Bank violence -
The Israeli army said it had captured Gaza's parliament, the government building, the police headquarters and other government institutions run by Hamas in Gaza City, as its forces deepened their offensive in the Palestinian territory.
The war in Gaza has also spurred violence on other fronts.
In the occupied West Bank, eight Palestinians were killed in clashes with Israeli troops, seven during an army raid on the northern city of Tulkarem and one near the southern city of Hebron, the Palestinian health ministry said on Tuesday.
At least 180 Palestinians and three Israelis have been killed across the West Bank since October 7, according to officials on both sides.
Biden believes deal on hostages 'going to happen'
US President Joe Biden said Tuesday he believes that a deal with Hamas to free the hostages the militants are holding in the Gaza Strip will happen, but did not offer specifics.
"I've been talking with people involved every single day. I believe it's going to happen but I don't want to get into detail," Biden told reporters at the White House when asked about an eventual agreement.
When asked if he had a message for the families of those being held by the Palestinian militant group, he replied: "Hang in there. We're coming."
Nine Americans and a person with permanent US residency are among an estimated 240 people taken hostage by Hamas fighters last month when they crossed the border to stage the deadliest attack in Israeli history.
"I cannot look you in the eye and tell you how many of those hostages are still alive," US National Security Advisor Jake Sullivan told a news conference on Monday.
Biden spoke with Israeli Prime Minister Benjamin Netanyahu on Tuesday, and the White House said the two "discussed at length ongoing efforts to secure the release of hostages held by Hamas, including many children and a number of Americans."
The October 7 Hamas attack left around 1,200 dead on the Israeli side, mostly civilians, according to the latest official Israeli figures.
The health ministry in Hamas-run Gaza says Israel's relentless assault in retaliation has killed more than 11,300 people, also mostly civilians, including thousands of children.
On Tuesday, Qatar urged Israel and Hamas to take up its offer to mediate to reach a deal.
The United States has repeatedly asked for a pause in the fighting to facilitate the liberation of those held in Gaza.
The White House said Tuesday that Biden's main advisor on the Middle East, Brett McGurk, would head to the region, notably to Qatar, where Hamas has its political office, to discuss the hostages issue.
Israeli raid at Gaza hospital sparks international concern
The Israeli army operation in Al-Shifa hospital, targeting what it says is a Hamas command centre under Gaza's biggest medical facility, on Wednesday set off a wave of international condemnation.
The army had announced overnight it was carrying out "a precise and targeted operation against Hamas in a specified area" of the hospital where the UN estimates there are at least 2,300 patients, staff and displaced Palestinians.
An official from the Hamas-run health ministry who was in the hospital told AFP he could see tanks inside the compound.
Israel has long accused the Islamist group of using Gaza hospitals as bases, digging tunnels under Al-Shifa and exploiting patients as human shields.
Israel has vowed to destroy Hamas in response to its attacks on October 7, which killed an estimated 1,200 people, mostly civilians, and saw 240 hostages taken to Gaza.
The territory's health ministry says Israel's ensuing aerial bombardment and ground offensive have killed 11,320 people, mostly civilians and including thousands of children.
- Hamas blames Biden -
The Islamists said US President Joe Biden was "wholly responsible for the assault on the Al-Shifa medical complex".
"The adoption by the White House and the Pentagon of the occupation's false claim that the resistance is using the Al-Shifa medical complex for military ends has given the green light to the occupation to commit more massacres against civilians."
The Palestinian authority that runs the occupied West Bank denounced the raid as a "flagrant violation" of international law, demanding world action to protect patients and civilians inside the facility.
- US says patients 'must be protected' -
The White House renewed its concerns for the safety of civilians shortly after the raid began.
The White House "won't speak to the specifics of an ongoing Israeli military operation," a National Security Council spokesperson said.
"We do not support striking a hospital from the air and we don’t want to see a firefight in a hospital where innocent people, helpless people, sick people trying to get medical care they deserve are caught in the crossfire," said the spokesperson said.
"Hospitals and patients must be protected."
Earlier, the White House had said US intelligence sources corroborated Israel's claim that Hamas and another Palestinian militant group, Islamic Jihad, had buried an operational "command and control node" under Al-Shifa.
- Top UN officials says stop the 'carnage' -
The United Nations humanitarian chief demanded immediate action to "rein in the carnage".
"As the carnage in Gaza reaches new levels of horror every day, the world continues to watch in shock as hospitals come under fire, premature babies die..."
"An entire population is deprived of the basic means of survival. This cannot be allowed to continue," said Martin Griffiths.
Griffiths stressed in a separate video statement he understood Israel wanted to find Hamas leaders, but insisted that was no excuse for turning hospitals into a battlefield.
"Hamas must not, should not, use a place like a hospital as a shield for their presence," he said.
- Red Cross and WHO voice 'extreme concern' -
The International Committee of the Red Cross said it was "extremely concerned about the impact on sick and wounded people, medical staff, and civilians".
"All measures to avoid any consequences on them must be taken," the ICRC said, insisting that "patients, medical staff, and civilians must be at all times protected".
World Health Organization chief Tedros Adhanom Ghebreyesus said the agency had lost touch again with staff at the hospital.
"We're extremely worried for their and their patients' safety."
- Jordan calls out UN Security Council 'silence' -
Jordan accused the UN Security Council of enabling the "barbarism" of Israel's raid on the hospital through its silence.
"The catastrophe in Al-Shifa hospital shows the barbarism UNSC's silence is allowing," Foreign Minister Ayman Safadi wrote on X.
"We condemn the silence on this brutality. It is providing cover for war crimes. It is unacceptable, unjustifiable. The Council must act."
- 'Going too far' says Norway -
"That's going too far and cannot be accepted", said Norwegian Foreign Minister Espen Barth Eide in an email to AFP.
"It aggravates an already horrible humanitarian situation in Gaza."
