Palestinian officials said a baby died and dozens more patients were at risk from an Israeli siege around Gaza's largest hospital on Saturday, while Israel said it had killed a Hamas militant who had stopped another hospital from being evacuated.
Israel says doctors, patients and thousands of evacuees who have taken refuge at hospitals in northern Gaza must leave so it can tackle Hamas gunmen who it says have placed command centres under and around them.
Hamas denies using hospitals in this way. Medical staff say patients could die if they were moved and Palestinian officials say Israeli weapons fire makes it dangerous for others to leave.
"It's totally a war zone, it's a totally scary atmosphere here in the hospital," Ahmed al-Mokhallalati, a senior plastic surgeon at Al Shifa hospital, told Reuters.
"It’s continuous bombardment for more than 24 hours now, nothing stopped, you know, it's all from the tanks, from the street, from the airstrike."
The Israeli military did not immediately respond to a request for comment on the reported situation in Al Shifa hospital, where a Palestinian health ministry spokesman said Israeli shelling had killed a patient in intensive care.
Ashraf Al-Qidra, who represents the health ministry in Hamas-controlled Gaza, said Israeli army snipers commandeering rooftops of buildings near the hospital fired into the medical complex from time to time, limiting the ability of medics and people to move.
"We are besieged inside the Al Shifa Medical Complex, and the (Israeli) occupation has targeted most of the buildings inside," he said.
The hospital suspended operations after fuel ran out, Qidra said, adding: "As a result, one newborn baby died inside the incubator, where there are 45 babies."
Clashes all night
Residents said Israeli troops, who began a war to eliminate Hamas after it staged a bloody cross-border assault on October 7th, had been clashing with Hamas gunmen all night in and around Gaza City where the hospital is located.
"The hospitals need to be evacuated in order to deal with Hamas. We intend on dealing with Hamas who have turned hospitals into fortified positions," the Israeli military said when asked if it planned to enter Gaza hospitals at some point.
Hamas denies using the hospital for its military purposes and has asked the United Nations and the International Committee of the Red Cross to send missions to Shifa to investigate the Israeli allegations.
Israel said earlier it had killed what it called a Hamas "terrorist" who it said had blocked the evacuation of another hospital in the north, which Palestinian officials have said is out of service and surrounded by tanks.
"(Ahmed) Siam held hostage approximately 1,000 Gazan residents at the Rantissi Hospital and prevented them from evacuating southwards for their safety," an Israeli military statement said.
It said Siam was killed along with other militants while hiding in the "al Buraq" school. Palestinian officials told Reuters on Friday at least 25 Palestinians had been killed in an Israeli strike at the school, which was packed with evacuees.
The Palestinian Health Ministry, which is based in the Israeli-occupied West Bank - separated from Gaza by Israel and run by a rival administration to Hamas - said separately that 39 babies were at risk at Shifa hospital.
Minister Mai Alkaila had initially said they had died because they could not get oxygen or medicine to them and electricity was cut off, but the ministry later corrected the information to say that one had died and 39 were at risk.
"Failure to bring fuel into the hospitals will be a death sentence for the rest. The incubators will only be able to work until this evening, after which the fuel will run out," the ministry said.
'Afraid we might lose them'
Contacted again about the ministry's statement, Qidra reiterated that there was no electricity at the hospital and no internet.
"We are working hard to keep them alive, but we are afraid we may lose them in the coming hours," he said, referring to the babies and other vulnerable patients. "There is no electricity in the hospital completely."
On Friday, Gaza officials had said missiles landed in a courtyard of Al Shifa, killing one person and wounding others. Israel's military said later that a misfired projectile launched by Palestinian militants in Gaza had hit Shifa.
Israel said on Saturday that rockets were still being fired from Gaza into southern Israel, where it has said about 1,200 people were killed and more than 200 taken hostage by Hamas militants last month. It reduced the death toll by 200 on Friday.
Palestinian officials said on Friday 11,078 Gaza residents had been killed in air and artillery strikes since October 7th, around 40 per cent of them children.
World Health Organisation Director-General Tedros Adhanom Ghebreyesus said health workers the group was in contact with at Shifa had been forced to leave the hospital in search of safety.
"Many of the thousands sheltering at the hospital are forced to evacuate due to security risks, while many still remain there," Tedros wrote on social media on Friday.
At another hospital, Al-Quds, medical teams worked on patients under torchlight in video footage released by the Palestinian Red Crescent. The hospital is one of four that Palestinian officials said on Friday had been blockaded by Israeli tanks.
Israel said on Saturday it had increased the number of places in which it said it would stop firing for several hours at a time so Gazans could move south and said many had done so.
"We have over the last three days seen a mass evacuation of at least 150,000 people," a military spokesman said. "And we have seen more people evacuating today as the humanitarian pause in Jabalya area has been implemented."
A US official said a week ago that between 350,000 and 400,000 people remained in the north of Gaza.
Meeting in Saudi Arabia, Muslim and Arab countries called for an immediate end to military operations in Gaza, declaring at a joint Islamic-Arab summit that Israel bears responsibility for "crimes" against Palestinians.
