Dozens of corpses lay on the courtyard outside Gaza’s largest hospital, covering the ground next to a blue refrigerated truck that had long ceased to be able to keep the bodies cool. Most of the bodies were shrouded in colourful blankets originally meant for the living, after the hospital ran out of white bodybags. A severely burnt arm protruded from one of the blankets. Elsewhere, according to video footage seen by the Guardian, the charred body of a child was visible among the soft folds of the material.
“We are under siege,” said Munir al-Boursh, a doctor who is also a Palestinian health ministry undersecretary, speaking from inside Dar al-Shifa hospital. The facility had intended to dig a mass grave until Israeli tanks and snipers encircled the the complex on Friday, making movement around it impossible.
“There are 110 dead bodies in front of the hospital, some in the refrigerator which isn’t functioning, and some just in the open space in front of the emergency unit. This could become a source of disease,” he said.
Six hundred patients as well as 200 to 500 health workers, and about 1,500 displaced people are seeking shelter at the hospital, according to information shared with the World Health Organization. Six bombardments struck the hospital complex in recent days, including the intensive care unit, doctors have said.
Boursh said: “No one can get out or come inside, it’s too risky. Israeli forces said there was a safety corridor through the eastern gate so people could exit and some people did try to get out that way. But there was shooting right in front of them, and they were so scared that they turned back.”
Israel says Hamas operates from bunkers underneath al-Shifa. Hamas and hospital staff have denied this. UN officials and rights experts have stressed that Palestinian armed groups should never use hospitals to hide, nor should Israel use claims they are doing so as a pretext to attack hospitals.
The Hamas-run Palestinian health ministry said at least 11,180 people had died in the Israeli assault on Gaza, which began on 7 October after Hamas militants stormed Israeli towns and kibbutzim around the territory, killing an estimated 1,200 people and taking 240 hostage. Supplies of fuel, electricity and water to Gaza have since been cut.
Medical staff said they were terrified that deaths among the patients holed up inside could rise, with the hospital on its third day without fuel or power. As a result, dozens in the intensive care unit were at risk of death, as well as at least 45 patients on dialysis machines. Thirty-six premature babies were moved out of the neonatal unit and into an operating theatre after bombardment of the wing of the hospital that previously housed them.
Boursh said: “There’s no oxygen supplies and no light for surgeries. We turned off six operating theatres as they are dark, and we’re doing operations in recovery areas as those are the only places that have light. We’re dependent on solar energy not fuel.
“We have no generators as those need fuel to run. There is no food, no water, no electricity and no fuel in Shifa and we are here dealing with casualties.
“We can’t manage this huge number of cases. If people come, we can’t do anything for them.”
The Palestinian health ministry in the West Bank town of Ramallah said that at least nine patients and six children had died at al-Shifa, formerly the cornerstone of Gaza’s health system, as a result of the fuel shortages and department closures after the hospital was encircled by Israeli forces.
“Patients are dying at a higher rate than before,” Nidal Abuhadrous, the head of neurosurgery at al-Shifa, said in a text message sent to the organisation Medical Aid for Palestinians. “The situation in al-Shifa is extremely difficult and dangerous. There is continuous shooting and bombing around.”
“The hospital is not functioning as a hospital any more,” he said. “We, the medical staff, are asking for a safe corridor to leave the hospital with the patients, guaranteed by the International Committee of the Red Cross.”
Boursh said the hospital was ready to accept an offer of 300 litres of diesel fuel from Israeli forces stationed outside, but that the facility’s director would only receive it from the ICRC, fearing the danger of moving around.
The amount of fuel offered was barely enough to power the generators inside al-Shifa for half an hour, he said. “We consume at least 500 litres per hour to run our generators, we need around 10,000 litres each day. Three hundred litres is nothing.”
Dr Medhat Abass from the Palestinian health ministry in Gaza said he was unable to reach his colleagues inside al-Shifa and several other hospitals across the besieged territory, and that instead he had begun listening to local radio hoping to hear some of the doctors giving interviews so he would know they were alive.
“This is war time, and it is miserable,” he said. His office added that the al-Shifa medical complex was “in the circle of death, after Israeli military vehicles advanced to its eastern-southern gate where the maternity hospital is located”.
The Palestinian Red Crescent Society (PRCS) said it had been deluged with “hundreds of calls ... from Palestinians besieged in Gaza City, with helpless cries for ambulances to attend to the wounded and killed, and to help evacuate families who are stuck in their houses that are subject to continuous shelling, lacking safety, water or food”.
Many calls described large numbers of people buried alive under rubble and large numbers of injuries, it said. .
A PRCS convoy intended to help evacuate the besieged al-Quds hospital in Gaza City, which closed on Sunday for lack of fuel, turned back after gunfire and shelling in the area around the facility.
The convoy was unable to reach al-Quds, operated by the PRCS, “due to relentless bombardment and dangerous situation where the hospital is located”, the group said.
Médecins Sans Frontières said it was had been able to reach its staff inside al-Shifa hospital after several hours of communications blackout, with one describing the worsening situation and fears that evacuating even the most desperate cases would be impossible under fire.
“We don’t have electricity. There’s no water in the hospital. There’s no food. People will die in a few hours without functioning ventilators,” they said.
Boursh said he feared that no other place in Gaza would be able to accommodate the 600 patients inside the hospital, despite their desire for a safe evacuation, as al-Shifa had long been the largest and best-equipped facility in Gaza.
“We only accept an evacuation if some of these patients can go to Egypt and get good treatment, rather than being thrown into the streets, and go where exactly?” he said.
“In their homes, no one can take care of them. We have patients who have had abdominal surgery, chest surgery, without treatment they will get infected and die, and I will not allow our patients to die.”
