Israeli strikes pounded Gaza City overnight and into Sunday as ground forces battled Hamas militants near the territory's largest hospital, where health officials say thousands of medics, patients and displaced people are trapped with no electricity and dwindling supplies.
In a televised address on Saturday, Prime Minister Benjamin Netanyahu rejected growing international calls for a cease-fire unless it includes the release of all the nearly 240 hostages captured by Hamas in the Oct. 7 rampage that triggered the war, saying Israel was bringing its "full force" to the battle.
Israel has vowed to end Hamas' 16-year rule in Gaza and crush its military capabilities while blaming the militants for the war's heavy toll on the 2.3 million Palestinians trapped in the besieged territory. But it has come under mounting international pressure over the plight of civilians.
In Gaza City, residents reported heavy airstrikes and shelling overnight, including in the area around Shifa Hospital. Israel, without providing evidence, has accused Hamas of concealing a command post inside and under the hospital compound, allegations denied by Hamas and hospital staff.
"We spent the night in panic waiting for their arrival," said Ahmed al-Boursh, a resident taking shelter in the hospital. "They are outside, not far from the gates."
Hospitals out of service
The hospital's last generator ran out of fuel on Saturday, causing the death of a premature baby, another child in an incubator and four other patients, according to the Health Ministry in Hamas-ruled Gaza. It says another 37 babies are at risk of death because there's no electricity.
Health Ministry Undersecretary Munir al-Boursh said Israeli snipers have deployed around Shifa, firing at any movement inside the compound. He said airstrikes had destroyed several homes next to the hospital, killing three people, including a doctor.
"There are wounded in the house, and we can't reach them," he told Al Jazeera television in an interview from the hospital. "We can't stick our heads out of the window." It was not clear if he was related to the other man with the same surname.
Israel's military said there was a safe corridor for civilians to evacuate from Shifa to southern Gaza, but people sheltering in the hospital said they were afraid to go outside. The military said troops would assist in moving babies on Sunday, and that it was in contact with hospital staff.
It was not possible to independently ascertain the situation in and around the hospital.
The Health Ministry says there are still 1,500 patients at Shifa, along with 1,500 medical personnel and between 15,000 and 20,000 people seeking shelter. Thousands have fled Shifa and other hospitals, but physicians said it's impossible for everyone to get out.
The Palestinian Red Crescent rescue service said another Gaza City hospital, Al-Quds, is "no longer operational" because it has run out of fuel. Gaza's sole power plant was forced to shut down a month ago, and Israel has barred any fuel imports, saying Hamas would use them for military purposes.
Nebal Farsakh, a spokesperson for the Red Crecent, said 6,000 people, including displaced families, patients, and medical staff, remained trapped in the hospital.
With Shifa and other hospitals now inaccessible, people sheltering in Gaza City said they were cut off from emergency care. Heba Mashlah, who was sheltering at a U.N. compound along with thousands of families, said a strike late Saturday killed four people and wounded 15.
"The wounded are bleeding, and no one is able to come and help them," she said, adding that the dead were buried inside the compound. The U.N. Development Program confirmed one of its compounds was hit. U.N. agencies have not been able to provide services in the north for weeks.
Netanyahu rejects US postwar vision
Netanyahu has said the responsibility for any harm to civilians lies with Hamas. Israel has long accused the group, which operates in dense residential neighborhoods, of using civilians as human shields.
On Saturday, Netanyahu began to outline Israel's postwar plans for Gaza, which contrast sharply with the vision put forth by the United States.
Netanyahu said Gaza would be demilitarized and that Israel would retain the ability to enter Gaza freely to hunt down militants. He also rejected the idea that the Palestinian Authority, which currently administers parts of the Israeli-occupied West Bank, would at some stage control Gaza. Hamas drove the PA's forces out of Gaza in a week of street battles in 2007.
Secretary of State Antony Blinken has said the U.S. opposes an Israeli reoccupation of Gaza and envisions a unified Palestinian government in both Gaza and the West Bank as a step toward a Palestinian state. Even before the war, Netanyahu's government was staunchly opposed to Palestinian statehood.
The war threatens to trigger a wider conflict, with Israel and Hezbollah militants in Lebanon frequently trading fire along the border. Hezbollah fired anti-tank missiles into Israel on Sunday, and Israel responded with artillery. Israel's power company said workers repairing lines damaged in previous attacks were wounded, and video footage showed two vehicles on fire.
Evacuation windows, but no pauses
The U.S. has also pushed for temporary pauses that would allow for wider distribution of badly needed aid to civilians in the besieged territory, where conditions are increasingly dire.
But Israel has only agreed to brief daily periods during which civilians can flee the area of ground combat in northern Gaza and head south on foot along two main north-south roads. Israel is meanwhile striking what it says are militant targets across southern Gaza as well, often killing women and children.
Dozens of wounded people, including children, were brought to a hospital in Khan Younis after an Israeli airstrike demolished a building in the southern town. Hospital officials said at least 13 people were killed.
The war has displaced over two-thirds of Gaza's population, with most fleeing south. Egypt has allowed hundreds of foreign passport holders and medical patients to exit through its Rafah crossing, as well as the entry of some humanitarian aid.
More than 11,000 Palestinians, two-thirds of them women and minors, have been killed since the war began, according to the Health Ministry in Gaza, which does not differentiate between civilian and militant deaths. About 2,700 people have been reported missing and are thought to be trapped or dead under the rubble.
At least 1,200 people have been killed on the Israeli side, mostly civilians killed in the initial Hamas attack. Forty-six Israeli soldiers have been killed in Gaza since the ground offensive began.
About 250,000 Israelis have been forced to evacuate from communities near Gaza, where Palestinian militants are still firing barrages of rockets, and along the northern border with Lebanon.
