Israel’s campaign against Hamas in Gaza appeared to be reaching a key moment, with close-quarter battles raging around the most important hospital in the heart of its biggest city.
Residents said Israeli forces had been fighting Hamas gunmen all night and throughout the day in the neighbourhood in Gaza City where the al-Shifa hospital is located, considered a key strategic area.
The Israeli government and military officials believe that seizing effective control of the hospital and the neighbourhood around it will prompt Hamas defences to collapse. But they fear that mounting international outrage as the civilian toll in Gaza mounts may force them to halt their efforts before achieving their goals.
“The IDF is in the midst of ongoing intense fighting against Hamas in the vicinity of the area [of the hospital],” a spokesperson for the Israeli Defence Forces (IDF) said.
With more than 11,000 Palestinians now killed during the Israeli air and ground offensive, and many more wounded, even staunch allies have expressed their concern about the death toll.
The French president, Emmanuel Macron, urged Israel on Friday to “stop this bombing” in Gaza and said: “There is no other solution than first a humanitarian pause, going to a ceasefire, which will allow [us] to protect … all civilians having nothing to do with terrorists.”
In a new sign of Washington’s growing concern, Anthony Blinken, the US secretary of state, said on Friday that “far too many Palestinians have been killed” in Gaza.
Saudi Arabia and other Muslim countries called on Saturday for an immediate end to military operations in Gaza, rejecting Israel’s justification of its actions against Palestinians as self-defence.
The extraordinary joint Islamic-Arab summit in Riyadh urged the International Criminal Court to investigate “war crimes and crimes against humanity that Israel is committing” in the Palestinian territories, according to a final communiqué.
Benjamin Netanyahu, Israel’s prime minister, said the responsibility for any harm to civilians lies with Hamas, repeating allegations that the militant group uses civilians in Gaza as human shields. He said that while Israel has urged civilians to leave combat zones, “Hamas is doing everything it can to prevent them from leaving”.
The director of al-Shifa hospital, Mohammed Abu Selmia, said the facility lost power on Saturday.
“Medical devices stopped. Patients, especially those in intensive care, started to die,” he said by phone, with gunfire and explosions in the background. He said Israeli troops were “shooting at anyone outside or inside the hospital” and preventing movement between buildings.
An Israeli officer, Colonel Moshe Tetro, confirmed to Reuters that there were clashes outside the hospital but denied that al-Shifa was under siege or direct attack. He said he was in touch with the director and had offered safe passage for those willing to leave through the hospital’s east side.
Asked about reports of troops firing into the hospital’s courtyard, the Israeli military would only say that troops were fighting Hamas in the vicinity and taking all feasible measures to prevent harm to civilians. It said soldiers had encountered hundreds of Hamas fighters in underground facilities, schools, mosques and clinics during fighting in Gaza.
Amos Yadlin, a former head of Israeli military intelligence, told broadcaster Channel 12 that as Israel aimed to crush Hamas, taking control of hospitals would be key but require “a lot of tactical creativity,” without hurting patients, other civilians and Israeli hostages.
Observers said Netanyahu was likely to hold off the growing pressure for a ceasefire to allow the IDF to further degrade Hamas by killing senior leaders and destroying tunnels and other military infrastructure. Israeli officials believe this will force Hamas to release more of the 240 hostages they and other factions in Gaza have been holding since launching attacks into Israel which killed 1,200, mostly civilians, last month.
Protests were to take place across Israel on Saturday evening, calling on the government to bring about the immediate release of Israelis taken hostage by Hamas.
Boaz Zalmanovich, son of 85-year-old Arye Zalmanovich who was kidnapped from his home in Kibbutz Nir Oz, said the government and IDF broke “the contract between us”.
“We demand that they fulfil their moral duty and return all the hostages home. The image of victory is not the assassination of [Yayha] Sinwar [the leader of Hamas in Gaza]. The only picture of victory is the return home of the hostages.”
So far Israel has only implemented daily “tactical operational pauses” that spokespeople have explicitly said do not constitute ceasefires, and has portrayed al-Shifa hospital as Hamas’s main command post, saying the group was using civilians as human shields there and had set up elaborate bunkers underneath – claims Hamas and al-Shifa staff deny.
The IDF declined to respond to questions of whether it had altered the rules of engagement as Israeli forces reached the gates of al-Shifa hospital.
“The IDF is in the midst of ongoing intense fighting against Hamas in the vicinity of the area in question, and unlike Hamas, adheres to the law by taking all feasible measures to mitigate harm to civilians,” it said.
Israeli bombardments on Gaza have wounded at least 25,000, according to Palestinian officials. Barbara Leaf, the highest-ranking US state department official on the Middle East, told Congress last week the true death toll was probably “higher than is being cited”.
As Israeli forces encircled al-Shifa, hospital staff described bombardments striking parts of the facility and attacks on those trying to flee. Bodies were strewn among the wounded laying in the courtyard, with medics unable to reach them for fear of being shot.
“Shooting and bombardment everywhere. You hear it every second here, around Shifa hospital. No one can get out of Shifa hospital, no one can come to Shifa hospital. The situation is very, very dangerous, and the people who tried this morning to evacuate from the hospital were shot at in the streets. Some of them were killed, some of them were injured,” said Dr Marwan Abu Sada, the head of surgery at the hospital, in a voice note passed to the Observer by Medical Aid for Palestinians, an NGO.
Médecins Sans Frontières also reported that those attempting to flee the hospital were being shot. “At the time of writing, our staff are witnessing people being shot at as they attempt to flee the al-Shifa hospital,” the charity said.
Israeli officials have previously told Palestinians to flee the northern Gaza strip, and evacuate medical facilities including al-Shifa hospital.
Since these temporary pauses were first announced a week ago, more than 150,000 civilians have fled the north, according to UN monitors.
Tens of thousands more remain in northern Gaza, many sheltering at hospitals and overcrowded UN facilities.
