Israeli strikes pounded Gaza City overnight and into Sunday as ground forces brought the battle near the territory's largest hospital, where health officials say thousands of medics, patients and displaced people are trapped with no electricity and dwindling supplies.
In a televised address on Saturday, Prime Minister Benjamin Netanyahu rejected growing international calls for a cease-fire unless it includes the release of all the nearly 240 hostages captured by Hamas during the Oct. 7 incursion.
In Gaza City, residents reported heavy airstrikes and shelling overnight, including in the area around Al-Shifa Hospital. Israel, without providing evidence, has accused Hamas of concealing a command post inside and under the hospital compound, allegations denied by Hamas and hospital staff.
"We spent the night in panic waiting for their arrival," said Ahmed al-Boursh, a resident taking shelter in the hospital. "They are outside, not far from the gates."
The hospital's last generator ran out of fuel Saturday, causing the death of a premature baby, another child in an incubator and four other patients, according to the Gazan Health Ministry. It says another 37 babies are at risk of death because there's no electricity.
Health Ministry Undersecretary Munir al-Boursh said Israeli snipers have deployed around Al-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 in an interview from the hospital. "We can't stick our heads out of the window." It was not clear if he was related to the other man with the same surname.
Israel's military said there was a safe corridor for civilians to evacuate from Al-Shifa to southern Gaza, but people sheltering in the hospital said they were afraid to go outside. The military said troops would assist in moving babies Sunday, and that it was in contact with hospital staff.
It was not possible to independently ascertain the situation in and around the hospital.
The Health Ministry says there are still 1,500 patients at the hospital, along with 1,500 medical personnel and between 15,000 and 20,000 people seeking shelter. Thousands have fled Shifa and other hospitals, but physicians said it's impossible for everyone to get out.
The Palestinian Red Crescent rescue service said another Gaza City hospital, 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 spokesperson for the Red Crescent, said 6,000 people, including displaced families, patients, and medical staff, remained trapped in the hospital.
With Al-Shifa and other hospitals now inaccessible, people sheltering in Gaza City said they were cut off from emergency care.
Heba Mashlah, who was sheltering at a U.N. compound along with thousands of families, said a strike late Saturday killed four people and wounded 15.
"The wounded are bleeding, and no one is able to come and help them," she said, adding that the dead were buried inside the compound. The U.N. Development Program confirmed one of its compounds was hit. U.N. agencies have not been able to provide services in the north for weeks.
Netanyahu has said the responsibility for any harm to civilians lies with Hamas. Israel has long accused the group of using civilians as human shields.
On Saturday, Netanyahu began to outline Israel's postwar plans for Gaza, which contrast sharply with the vision put forth by the United States.
Netanyahu said Gaza would be demilitarized and that Israel would retain the ability to enter Gaza freely. He also rejected the idea that the Palestinian Authority, which currently administers parts of the Israeli-occupied West Bank, would at some stage control Gaza. Hamas drove the PA's forces out of Gaza in a week of street battles in 2007.
Secretary of State Antony Blinken has said the U.S. opposes an Israeli reoccupation of Gaza and envisions a unified Palestinian government in both Gaza and the West Bank as a step toward a Palestinian state. Even before the war, Netanyahu's government was staunchly opposed to Palestinian statehood.
The war threatens to trigger a wider conflict, with Israel and the Hezbollah in Lebanon frequently trading fire along the border. The Israeli military said it was responding with artillery to anti-tank missiles fired from Lebanon on Sunday. Israel's power company said workers repairing lines damaged in previous attacks were wounded.
The U.S. has also 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 north-south roads. Israel is meanwhile striking targets across southern Gaza as well, often killing women and children.
Dozens of wounded people, including children, were brought to a hospital in Khan Younis after an Israeli airstrike demolished a building in the southern town. Hospital officials said at least 13 people were killed. It was not immediately clear what was targeted.
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 some 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. Forty-six Israeli soldiers have been killed in Gaza since the ground offensive began.
