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Five weeks after Israel swore to destroy Hamas in retaliation for a cross-border assault by militants, the fate of Gaza City’s Al Shifa hospital has become a focus of international alarm, including from Israel’s closest ally, the United States.

Palestinians trapped inside Gaza’s biggest hospital were digging a mass grave to bury patients who died under Israeli encirclement, and said no plan was in place to evacuate babies despite Israel announcing an offer to send portable incubators.

Israeli forces have surrounded Al Shifa hospital which they say sits atop an underground headquarters of Hamas militants.

People mourn as they collect the bodies of Palestinians killed in Israeli raids in Khan Yunis, Gaza. Credit: Getty

Hamas, Gaza’s ruling Islamist group, denies fighters are present and says 650 patients and 5000-7000 other civilians are trapped inside the hospital grounds, under constant fire from snipers and drones. It says 40 patients have died in recent days, including three premature babies whose incubators were knocked out.

A Hamas official in Beirut said 25 of Gaza’s 35 hospitals were out of use because of Israel’s assault. UN Secretary-General Antonio Guterres was deeply disturbed by the “dramatic loss of life” in the hospitals, his spokesman said.

The Israeli military says it has seized a series of government buildings in central Gaza City as its offensive against the ruling Hamas militant group advances.

Israel vowed to wipe out Hamas after militants burst across the fence around the enclave and rampaged through Israeli towns killing civilians on October 7.

Around two thirds of Gaza’s 2.3 million people have been made homeless, unable to escape the territory where food, fuel, fresh water and medical supplies are running out.

Elsewhere in the conflict:

• US President Joe Biden said on Tuesday he is engaged in daily discussions to secure the release of hostages held by the Hamas militant group and believes it will happen.
• Tens of thousands of demonstrators gathered in Washington on Tuesday for a “March for Israel” to show solidarity with Israel in its war with Hamas and condemn rising antisemitism.
• Another 200,000 Palestinians fled south in Gaza in the past 10 days, the UN humanitarian office said.
• Medical charity Medecins Sans Frontieres said shots were fired on Tuesday at one of its bases near Al Shifa, where MSF staff and their families, more than 100 people in total, were sheltering.
• Israel’s emergency response service Magen David Adom says at least two people were injured from shrapnel in Tel Aviv on Tuesday as militants from Gaza Strip continued launching rockets at Israel.
• Families of hostages have begun a protest march from Tel Aviv to Jerusalem demanding that the government do more to secure their release.
• Vivian Silver, a Canadian-born Israeli activist who devoted her life to seeking peace with the Palestinians, was confirmed killed in Hamas’ October 7 attacks.
• Israel’s foreign minister said on Tuesday that United Nations Secretary-General Antonio Guterres was not fit to head the global body, saying he had not done enough to condemn militant group Hamas and was too close to Iran.

The human toll

Israel says 1200 people were killed and around 240 were dragged back to Gaza as hostages in the deadliest day of its 75-year history. Medical officials in Hamas-run Gaza say more than 11,000 people are confirmed dead from Israeli strikes, around 40 percent of them children, and countless others trapped under rubble.

The response

US President Joe Biden said: “Hang in there, we’re coming” when asked by reporters what his message to family members of hostages would be.

United Nations Secretary-General Antonio Guterres spokesman said: “In the name of humanity, the secretary-general calls for an immediate humanitarian ceasefire.”

“We are here to show the world that we won’t be exterminated again,” Marco Abbou, a pro-Israel protester at the rally in Washington DC.

Ahmed El Mokhallalati, a surgeon at Al-Shifa hospital, said: “Burying 120 bodies needs a lot of equipment, it can’t be by hand efforts and by single person efforts.”

• US President Joe Biden said: “Hang in there, we’re coming” when asked by reporters what his message to family members of hostages would be.
• Israeli Israeli commander identified as Lieutenant Colonel Gilad said in a video from Gaza released by the army: “In every location, the enemy forces were eliminated, the location was demolished”. He said documents and other items taken from the locations were being studied.
• United Nations Secretary-General Antonio Guterres spokesman said: “In the name of humanity, the secretary-general calls for an immediate humanitarian ceasefire.”
• Marco Abbou, a pro-Israel protester at the rally in Washington DC: “We are here to show the world that we won’t be exterminated again”.
• Ahmed El Mokhallalati, a surgeon at Al-Shifa hospital, said: “”We are sure that all kind of infections will be transmitted… Today we had a little bit of rain … It was really horrible, nobody could even open a window, or just walk around the corridors with a really bad smell,” he said. “Burying 120 bodies needs a lot of equipment, it can’t be by hand efforts and by single person efforts.”

More coverage of the Hamas-Israel conflict

• Hamas had bigger plans on October 7: Intelligence about Hamas’ motivations reveals an intention to strike a blow of historic proportions and provoke an overwhelming Israeli response.
• Escape from chaos: An Australian father faced heartbreaking dilemma – flee Gaza to his children, or stay with his wife?
• Open letters: Mass resignations, boardroom turmoil and angry donors are some of the ways the Israel-Hamas war is filtering down into Australia’s high-powered arts world.
• Gaza’s youth: One of the cruelest ironies of war is that they are never started by children; yet it is children who suffer the most.

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