Thousands housed in Gaza City’s hospitals are fleeing as war approaches

DEIR AL-BALAH, Gaza Strip (AP) — Thousands of Palestinians sheltering from the Israel-Hamas war at Gaza City’s main hospital fled south Friday after several reported attacks in and around the area overnight. They joined a growing exodus of people fleeing intense urban battles in the north – including near other hospitals – as Gaza officials said the territory’s death toll exceeded 11,000.

The search for safety across besieged the Gaza Strip has grown desperate as Israel intensified its assault on the area’s largest city.

The Israeli army says Hamas’ military infrastructure is based in the middle of Gaza City’s hospitals and neighborhoods, and that it has set up its main command center in and under the largest hospital, Shifa – claims the militant group and Shifa staff deny.

Israel has promised to destroy Hamas in its own way deadly October 7 surprise attackwhich killed at least 1,200.

More than 100,000 Palestinians have fled south in the past two days, according to Israel, but still face bombardment and harsh conditions. Reported strikes at or near at least four hospitals in northern Gaza overnight underscored the danger to tens of thousands of others who had crowded into the facilities believing they would be safe.


Early Friday, at least three strikes over several hours hit the yard and the obstetrics department of Shifa Hospital, according to Ashraf al-Qidra, spokesman for the health ministry in Hamas-run Gaza.

A video of the yard captured the sound of incoming fire waking people in makeshift shelters, followed by calls for an ambulance. In the blood-spattered courtyard, a man writhed, screaming on the ground, his leg apparently severed.

Al-Qidra blamed Israel for the attack, a claim that could not be independently confirmed. The Israeli army said an attack on Shifa was the result of a misfire by militants targeting its troops nearby.

For weeks, tens of thousands of displaced Palestinians – numbering up to 60,000 this week, according to the health ministry – have been sheltering in the Shifa compound.

The overnight strikes triggered a mass exodus of the displaced. Around 10 a.m., a large number packed their belongings and began walking south, five people who were among those who left told The Associated Press.

Al-Qidra told the Qatar-based satellite news network Al-Jazeera that more than 30,000 displaced people, doctors and patients remain in the hospital.

Mainly those who could not walk or did not know where to go stayed behind, said Wafaa abu Hajajj, a journalist who arrived in the south after leaving the hospital on Friday.

“The strikes were hoping to scare people and it worked. … It became too much,” said 32-year-old Haneen Abu Awda, who had been in Shifa being treated for wounds from an earlier attack on his house.

At the same time, Shifa has been overwhelmed by thousands of wounded, even though it is operating with minimal power and medical supplies.

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In video released Friday by Gaza’s health ministry, bodies of limp children are seen on stretchers across bloodstained hospital floors, some dead, some barely breathing. Other patients were scattered around the floor, unable to be treated due to a lack of supplies. A man is seen gasping for breath.

The director of Shifa, Mohammed Abu Selmia, said Israel demanded the facility be evacuated, but he said there was nowhere for such a large number of patients to go.

“Where should we evacuate them?” he said, speaking to Al Jazeera television.

The Ministry of Health said one person had been killed at Shifa and several were injured. Another attack near Nasr Medical Center killed two people, according to the ministry. Abu Selmia said at least 25 people were killed when an attack hit a school in Gaza City where people were sheltering inside.

The attack on Nasr forced the closure of its children’s hospital, the only remaining specialized pediatric care in northern Gaza, said World Health Organization spokeswoman Margaret Harris. She said it was not known what happened to the patients there, including children who were receiving dialysis and life support — “things that you can’t possibly evacuate them safely with.”

Military spokesman Lt. Col. Richard Hecht said Israel is “aware of the sensitivity of the hospitals” and that forces were slowly closing in on them. Israel “does not fire at hospitals,” he said, but if militants are seen firing from them, “we will do what we have to do” and kill them.

Israel has produced video that it says is proof that Hamas uses not only hospitals, but also schools and mosques, as cover for military activities.

UN Secretary-General Antonio Guterres has said on several occasions that Hamas uses civilians as “human shields”, while stressing that this does not give Israel a free hand to target buildings where militants are hiding among civilians. He has pointed to international humanitarian law, which says the protection of civilians and hospitals, schools and homes is paramount.


Tens of thousands of new evacuees from the north, some from Shifa, poured down the Salah al-Din road – the central spine that runs along the Gaza Strip – and reached the central city of Deir al-Balah on Friday. Without fuel for vehicles, crowds walked for hours as explosions echoed a short distance away. Among them were wounded and elderly people.

They arrived hungry, exhausted and with a stew of emotions: relief, rage and despair.

Reem Asant, 50, described seeing bodies in the street as he and others made their way out of Gaza City in an attempt to avoid shelling.

“We are talking about children killed in a hospital,” shouted one man, Abu Yousef. “Hundreds of women are killed every day. Houses collapse over the heads of civilians. … Where are the human rights? Where is the United Nations? Where is the USA? Where is the International Criminal Court? Where is the whole world?”

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The Israeli military announced an extended six-hour window on Friday for civilians to escape northern Gaza along Salah al-Din, the route used since last weekend. It also announced the opening of another route along the coastal road following an agreement announced by The White House a day earlier.

More than two-thirds of Gaza’s population of 2.3 million have fled their homes since the war began. Israel estimates that more than 850,000 of the 1.1 million people in northern Gaza have left, according to military spokesman Jonathan Conricus.


More than 11,070 Palestinians, two-thirds of them women and minors, have been killed since the war began, according to Gaza’s health ministry, which does not distinguish between civilian and militant deaths. A further 2,650 people have been reported missing.

US Secretary of State Antony Blinken said this on Friday “far too many” Palestinians have died and suffered. While recent Israeli steps to try to minimize civilian casualties are positive, he said they are not enough.

Assistant Secretary of State Barbara Leaf told US lawmakers this week that it was “very possible” the death toll was even higher than the Gaza health ministry’s tally.

At least 1,200 people have been killed in Israel, mostly in the initial Hamas attack, and 41 Israeli soldiers have been killed in Gaza since the ground offensive began, Israeli officials said. The State Department had previously estimated the number of civilian deaths at 1,400 and on Friday gave no reason for the revision.

An Israeli official told The Associated Press that the number had been changed after a painstaking week-long process to identify bodies, many of which were mutilated or burned during the Hamas crackdown. The final death toll could still change, according to the official, who spoke on condition of anonymity pending a formal announcement.

Nearly 240 people abducted by Hamas from Israel remain trapped.

Palestinian militants have continued to fire rockets into Israel, and an attack on Tel Aviv wounded at least two people on Friday, said Yossi Elkabetz, a paramedic with Israel’s emergency services. Hamas claimed credit.

About 250,000 Israelis have been forced to evacuate from communities near Gaza and along the northern border with Lebanon, where Israeli forces and Hezbollah militants have traded fire repeatedly.


Debre reported from Jerusalem, and Jeffery from Cairo. Associated Press writers Bassem Mroue and Sarah El Deeb in Beirut; David Rising in Bangkok, Thailand; Lee Keath in Cairo; and Julia Frankel and Josef Federman in Jerusalem, contributed to this report.


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