Israeli forces entered the Gaza Strip’s largest hospital on Wednesday, targeting a Hamas command center that they said was among thousands of sick civilians seeking shelter.

Israeli and Palestinian officials said military operations were taking place at Al-Shifa hospital in Gaza City, which has been the scene of fighting and airstrikes nearby for days.

The Israel Defense Forces said its troops conducted “a precise and targeted operation against Hamas in a specific area” of the facility.

Youssef Abul Reesh, an official with the Hamas-run health ministry who is at the hospital, told AFP he could see tanks in the complex and “dozens of soldiers and commandos in the emergency and reception buildings.”

After stark warnings from the United States that Al-Shifa Hospital “must be protected,” Israel said the raid would be carried out based on intelligence and “an operational need.”

Local officials say thousands of patients, staff and displaced civilians are believed to be staying at the hospital complex.

Witnesses have described conditions as horrific: medical procedures took place without anesthesia, families lived in the corridors with little food or water and the stench of rotting corpses filled the air.

“Bodies are scattered around the hospital complex and there is no electricity in the morgues,” said hospital director Mohammad Abu Salmiya.

Israel has repeatedly claimed that Hamas is using the hospital as cover for a command post and weapons cache, a claim Hamas denies.

This use “endangers” the hospital’s “protected status under international law,” the military said, a claim many international human rights lawyers refute.

In response to the Oct. 7 attacks that killed an estimated 1,200 people, mostly civilians, and brought 240 hostages to Gaza, Israel has vowed to destroy Hamas.

The Palestinian militant group accused US President Joe Biden of being “fully responsible” for the Israeli attack on Al-Shifa.

The Palestinian Authority, historically the representative of the Palestinians but not an authority in Gaza, warned “of a massacre at the hospital.”

‘NO HARM’

Israeli forces expected a strong backlash to the hospital raid and said they had given authorities in the Hamas-controlled Gaza Strip 12 hours’ notice that any military operation inside would have to stop.

“Unfortunately, this is not the case,” the Israeli military said, again calling on “all Hamas terrorists present in the hospital to surrender.”

The Israeli army’s ground teams reportedly included medics and Arabic speakers “who have undergone special training to prepare for this complex and sensitive environment.”

The “intention” is that “no harm be caused to the civilians used by Hamas as human shields,” the Israeli military added.

Abul Reesh of the Gaza Strip Health Ministry called on “the international community and the United Nations to intervene immediately and urgently to stop the Israeli attack.”

He called on both to protect what he said were “20,000 people in hospital, including medical staff, 650 sick people and thousands of injured people.”

The White House said Tuesday that U.S. intelligence sources had confirmed Israel’s claim that Hamas had buried an operations center beneath the hospital.

Hamas and another Palestinian militant group, Islamic Jihad, “operate an al-Shifa command and control node in Gaza City,” National Security Council spokesman John Kirby told reporters.

“They have weapons stored there and are ready to respond to an Israeli military operation against this facility.”

“I bled”

The situation in the other hospitals in the Gaza Strip is also dramatic. According to the United Nations, 22 of 36 are inoperable due to fuel shortages, damage and fighting.

“The 14 remaining hospitals barely have enough supplies to carry out critical and life-saving operations and provide inpatient care, including intensive care,” the World Health Organization said.

According to the Health Ministry in the Hamas-controlled Gaza Strip, the Israeli offensive killed 11,320 people, mostly civilians, including thousands of children.

The humanitarian crisis in the area is also affecting hundreds of thousands of people who have fled south at Israel’s urging to escape the fiercest fighting.

Even escaping the fighting is dangerous. Wounded Palestinians told AFP how they were hit by an attack as they headed south.

“I ran about three to four kilometers while bleeding,” said Hasan Baker, whose head and left hand were bandaged. “There was no way for an ambulance to enter the area.”

Hostage talks

Israeli leaders have so far insisted there will be no ceasefire in the five-week war until the hostages are released.

Qatar is brokering talks on a possible deal to release prisoners.

Abu Obeida, a spokesman for Hamas’s military wing, said on Monday that Israel had demanded the release of 100 hostages, while the militants demanded the release of 200 Palestinian children and 75 women from Israeli prisons.

“We told mediators that we could release the hostages if we reached a five-day ceasefire … and the flow of aid to all our people throughout the Gaza Strip, but the enemy is hesitant,” Abu Obeida said in an audio statement.

Qatari Foreign Ministry spokesman Majed bin Mohammed Al-Ansari told a news conference in Doha that the “deteriorating” situation in Gaza was complicating efforts to reach an agreement.

“We believe that there is no other chance for both sides than for this mediation to take place,” he said.

As pressure mounted on the Israeli government, Prime Minister Benjamin Netanyahu said he was working “tirelessly” to get the hostages out.

Relatives of the hostages set out on a five-day protest march from Tel Aviv to the prime minister’s office in Jerusalem on Tuesday to demand the prisoners’ release, the Hostages and Missing Families Forum said.

The family group later called on the government to “agree to a deal tonight to bring all hostages home from Gaza.”

VIOLENCE IN THE WEST BANK

The Israeli army said it captured the Gaza Strip parliament, government building, police headquarters and other Hamas-run government institutions in Gaza City as its forces intensified their offensive in the Palestinian territory.

The war in Gaza has also led to violence on other fronts.

In the occupied West Bank, eight Palestinians were killed in clashes with Israeli troops, seven in an army attack on the northern city of Tulkarem and one near the southern city of Hebron, the Palestinian health ministry said on Tuesday.

At least 180 Palestinians and three Israelis have been killed across the West Bank since October 7, according to officials from both sides.