Fighting rages near Gaza hospital as people trapped inside say they cannot flee

They said fighting continued just outside the facility where incubators lay idle with no electricity and critical supplies were running out.

Prime Minister Benjamin Netanyahu has rejected urgent international calls for a ceasefire unless it includes the release of all the nearly 240 hostages captured by Hamas in the October 7 rampage that triggered the war.

A day after Mr Netanyahu said Israel was bringing its “full force” with the aim of ending Hamas’ 16-year rule in Gaza, residents reported heavy airstrikes and shelling, including around Shifa Hospital.

Israel, without providing evidence, has accused Hamas of concealing a command post inside and under the compound, allegations denied by Hamas and hospital staff.

“They are outside, not far from the gates,” said Ahmed al-Boursh, a resident sheltering at the facility.

The hospital’s last generator ran out of fuel on Saturday, leading to the deaths of three premature babies and four other patients, according to the Health Ministry. It said another 36 babies are at risk of dying without electricity.

Israel’s military said it placed 300 litres of fuel near Shifa overnight and co-ordinated the delivery with hospital officials.

But the delivery location was not clear from the military’s video, and there was no immediate response from the Health Ministry and others including the Red Cross.

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. “We can’t stick our heads out of the window.”

Speaking to CNN, Mr Netanyahu said “100 or so” people had been evacuated from Shifa and that Israel had created safe corridors.

But the Health Ministry has denied claims of evacuees and safe corridors, and 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 Shifa staff.

But Medical Aid for Palestinians, a UK-based charity that has supported the hospital’s neonatal intensive care unit for years, questioned the military’s claim.

“The transfer of critically ill neonates is a complex and technical process,” chief executive Melanie Ward said in a statement.

“With ambulances unable to reach the hospital and no hospital with capacity to receive them, there is no indication of how this can be done safely.”

The only safe option is for Israel to stop its assault and allow fuel to reach the hospital, she said.

The Health Ministry said there are still 1,500 patients at Shifa, with 1,500 medical personnel and between 15,000 and 20,000 people seeking shelter.

The Palestinian Red Crescent rescue service said another Gaza City hospital, the Red Crescent-run 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 Red Crescent spokesman, said 6,000 people, including displaced families, patients, and staff, remained trapped in the hospital.

Alarm was growing. “Decisive international action is needed now to secure an immediate humanitarian ceasefire and prevent further loss of life” amid attacks on health care, the UN regional directors of the World Health Organisation and others said in a statement.

They added that more than half of Gaza’s hospitals are closed and the rest are under “massive strain”.

Muhammed Zaqout, director of hospitals in Gaza, said the Health Ministry has been unable to update the death toll since Friday as medics are unable to reach areas hit by Israeli bombardment.

“The situation is extremely dire,” he said. “Ambulances are unable to reach people under the rubble.”

About 2.3 million Palestinians remain trapped in the besieged territory.

Mr Netanyahu has said the responsibility for any harm to civilians lies with Hamas. Israel has long accused the group, which operates in dense residential neighbourhoods, of using civilians as human shields.

Wael Abu Omar, spokesman for Gaza’s border crossings, said 846 people left Gaza to Egypt through the Rafah crossing on Sunday, of whom 826 were foreigners.

The rest included wounded, patients from Gaza’s hospitals and their caretakers.

He said 76 aid trucks entered Gaza. The UN and partners have said much more needs to enter daily.

Jordanian foreign minister Ayman Safadi said on Sunday that he asked European Union foreign policy chief Josep Borrell to apply the same “legal, moral grounds” for EU support of Ukraine to “define its stand on Israel’s war crimes”.

The US has 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 roads.

Israel continues to strike what it says are militant targets across southern Gaza, often killing women and children.

Dozens of wounded people, including children, were taken to a hospital in Khan Younis after an Israeli airstrike demolished a building in the southern town. Hospital officials said at least 13 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 a small amount of 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.