November 13, 2023
Updated 46 minutes ago
Image source: Getty Images
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Wounded Palestinian women injured in Israeli airstrikes visit Al-Shifa Hospital in Gaza City for treatment on October 10
Hospitals and medical facilities are embroiled in heavy fighting as Israel presses forward with its offensive against Hamas in Gaza City.
The focus of attention has been Al-Shifa, the largest hospital in the Gaza Strip, where thousands are trapped by nearby fighting, but other facilities are also reporting a lack of supplies and electricity due to the fighting.
Israel says it is not directly targeting hospitals but acknowledges there are “clashes” around Al-Shifa and other facilities.
According to the World Health Organization (WHO), 36 health facilities, including 22 hospitals, have been damaged since the war began on October 7, and only a handful of them remain operational.
Here’s what the BBC knows about the situation at the main compounds in the northern Gaza Strip.
Al-Shifa Hospital, Gaza City
The WHO said on Sunday that Al-Shifa in Gaza City – the territory’s largest with 700 beds – was no longer functioning and that the situation there was “grim and dangerous”.
Fighting breaks out between Hamas and Israeli forces in the surrounding streets. According to the United Nations, critical infrastructure was damaged.
Israel says Hamas militants operate in tunnels beneath the hospital – a claim Hamas denies.
Staff inside say it is impossible to leave the building without risking injury or death.
WHO Director-General Tedros Adhanom Ghebreyesus said on
Multiple reports from inside say there is no food or fuel to run the generators. Solar energy is used to operate some critical systems.
There have been communications breakdowns – the charity Doctors Without Borders was unable to contact its members in the Gaza Strip over the weekend. Attempts by the BBC to contact workers were often unsuccessful.
According to the Hamas-run Ministry of Health, at least 2,300 people remain in hospital – up to 650 patients, 200-500 staff and around 1,500 people seeking shelter.
This number also includes newborns who are admitted to an on-site operating room.
Staff say three of 39 infants in their care died over the weekend due to a lack of incubators. Doctors said the surviving babies were at serious risk of death.
Israel Defense Forces (IDF) chief spokesman Rear Admiral Daniel Hagari said on Saturday that Israel would provide assistance in evacuating the babies to a “safer hospital.”
However, this evacuation had not yet taken place as of Monday afternoon.
Hospital staff told the BBC that sophisticated equipment was needed to transport the babies safely and that there was no “safer hospital” in Gaza.
Mark Regev, a senior adviser to Israeli Prime Minister Benjamin Netanyahu, said Hamas does not want to accept solutions to the lack of fuel needed to save the babies and that “they want images that show a crisis.”
“We bought fuel specifically for the babies and the incubators… no one wants these babies to be harmed,” Mr Regev said, also reiterating Israel’s claims that its forces did not deliberately attack hospitals.
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Babies trapped in Al-Shifa Hospital, in a picture of the medical staff
On Saturday, Col. Moshe Tetro of the IDF said there had been clashes nearby, but no shots were fired at the hospital itself and no siege.
Anyone who wants to leave can do so, he said. He insisted that saying otherwise was a lie.
More on the Israel-Gaza war
Marwan Abu Saada, a surgeon in Shifa, told the BBC that bombings had taken place around the hospital and ambulances could not get in.
The IDF also said efforts to deliver 300 liters of fuel to Shifa on Sunday failed because Hamas refused to accept it – which Hamas denied.
Mr Abu Saada told the BBC the same day that 300 liters would “last 30 minutes” – the hospital needs 10,000 liters a day to function normally.
Added to this is the growing risk of disease due to poor hygiene and the decomposition of corpses that cannot be refrigerated.
Mr Abu Saada said attempts to bury the dead had been thwarted by fighting around the complex and that the mortuary’s refrigerator had failed due to a lack of electricity.
There were 100 bodies unburied in the hospital courtyard, he added.
Dr. Marwan Al-Barsh, director general of the Hamas-run Ministry of Health in the Gaza Strip, said that in addition to the courtyard, the hospital’s morgues were also filled with bodies.
He added that hospital officials tried to bury those who died in the hospital, but people were unable to leave the hospital without coming under fire.
Israel says it knows “for certain” that there is a Hamas command center beneath Shifa.
A 3D rendering of what was said to be a network of tunnels beneath the hospital has been shared and is said to be footage of Hamas militants discussing it.
Hamas denies that it is using the hospital and that there is an operations center underneath. Doctors inside insist there is no Hamas presence there. The BBC’s Gaza correspondent Rushdi Abualouf said he had never seen “any military capacity” at the hospital, but acknowledged it was difficult to verify Israeli or Hamas claims.
Al-Ahli Hospital
Dr. WHO’s Tedros said on November 10 that hospitals in the Gaza Strip were “working far beyond their capacity.”
Dr. Ghassan Abu Sittah, a doctor who works in Al-Ahli in northern Gaza, told the BBC that the hospital was now accepting all the wounded from Gaza City but did not have the resources to cope.
He said ambulances arrived every 10 minutes with injured people and that hospital staff had no access to a blood bank, which he said was surrounded by Israeli tanks.
“We don’t have an X-ray technician and we lack medicines, so for large wounds we have to perform extremely painful procedures to keep them clean without analgesia and anesthesia,” he said.
He added that operating rooms would be reserved for life-saving operations “because we don’t have enough resources to treat everyone.”
Last month, Al-Ahli was the scene of a deadly explosion that has been at the center of conflicting claims between Israel and Hamas over who was responsible.
Al-Quds Hospital
According to the Palestinian Red Crescent, the Gaza Strip’s second largest hospital after Al-Shifa is no longer operational.
The Palestinian Red Crescent said Saturday that its teams were trapped inside with 500 patients and about 14,000 displaced people, mostly women and children.
On Sunday it said the hospital was “out of service… no longer operational…” due to exhaustion of available fuel and power outage.
It added that the hospital “has been left to fend for itself under ongoing Israeli bombardment, posing great risks to medical staff, patients and displaced civilians.”
It also said an “evacuation convoy” traveling from Khan Younis in the southern Gaza Strip to Al-Quds Hospital had to turn back after “relentless bombardment.” It added that people trapped in the hospital had no food, water or electricity.
Doctors Without Borders said on Saturday it had lost contact with a surgeon who works with his family in Al-Quds and is seeking protection there.
A Red Crescent spokesman told Portal that the hospital had been cut off for almost a week, with “no access, no way out” and the surrounding area was under constant attack.
Al-Rantisi and Al-Nasr, north of Gaza City
The small Rantisi Special Children’s Hospital and the nearby Al-Nasr Hospital in northern Gaza City were evacuated on Friday except for a handful of patients and staff. Rantisi had Gaza’s only children’s cancer ward.
The IDF released to the BBC details of telephone conversations between an official in Rantisi and a senior IDF official in which they discussed arrangements to provide ambulances for the evacuation of patients.
The hospital official asked about hundreds of displaced civilians camped at the two hospitals. The Israeli official told them to go through the main entrance at 11:20 a.m. and explained in detail which streets they should take to leave Gaza City.
And he twice told the hospital official to make sure the civilians were wearing something white to show they were not combatants.
“They will all walk out with their hands up,” the hospital official said. “Perfect,” said the Israeli.
In a video confirmed by the BBC, people were seen waving white flags and appearing to come under fire as they tried to leave Al-Nasr on Friday. It was unclear where the shots came from and who fired them.
Dr. Bakr Gaoud, the head of Rantisi, was quoted by the New York Times as saying that Israeli forces arrived late last week and provided maps showing a safe way out.
“We dragged our patients from their beds,” he said, adding that the patients were sent in the worst condition to Al-Shifa, which was already overwhelmed and no longer functioning.
Everyone else, he said, made their way to the south of the Gaza Strip away from the main fighting.
On Monday evening, IDF spokesman Daniel Hagari showed journalists what he said was evidence of Hamas infrastructure in Rantisi – videos of explosives, suicide vests and even a motorcycle used in the Oct. 7 attacks hidden in a basement .
He showed a video of a deep shaft with a ladder on the side that he said was the entrance to a tunnel located next to a school and a hospital, adding that it was “nothing more than a terror tunnel.”
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Refugees seek refuge at Rantisi Hospital ahead of Friday’s evacuation
Al-Sweidi (Swedish) Clinic, Shati Camp
The UN Office for Humanitarian Affairs said in its Sunday evening update that the Swedish clinic was “hit and destroyed” by an airstrike on Saturday.
Around 500 people were housed there, it was said, and the number of victims was “unclear”.
On Monday morning, BBC Gaza correspondent Rushdi Abu Alouf spoke to Maryam al-Arabeed, a 65-year-old woman who said Israeli soldiers entered the facility on Sunday evening and took everyone out. She said she then watched as “an Israeli bulldozer completely destroyed the building.”
“They took out the young men, including my three sons, and separated the women and children,” she told the BBC.
She added that she did not know where her sons or relatives were.
The IDF said it was investigating the report.
“In contrast to Hamas’s deliberate attacks on Israeli men, women and children, the IDF follows international law and takes practical precautions to reduce harm to civilians,” the Israeli military added.