EXPLAINER

Thousands of people, including patients, are trapped inside Gaza’s largest hospital amid deadly Israeli siege.

Israeli forces raided Gaza’s al-Shifa Hospital on Wednesday after laying siege of the enclave’s largest medical facility for weeks. Thousands of people are trapped inside, with decomposed dead bodies buried in a mass grave on the hospital premises. Here is what to know:

What is happening at al-Shifa Hospital?

• Dr Ahmad Mokhallalati, a surgeon at al-Shifa who is currently in the hospital, told Al Jazeera that gunshots can be heard from all directions in the medical facility.
• Dr Mokhallalati said 650 patients remain at the hospital, including about 100 in critical condition. There are 2,000 to 3,000 displaced Palestinians seeking shelter in the building. Additionally, there are 700 medical staff, he said.
• Israeli forces have been calling doctors inside al-Shifa. “You being inside the hospital will create a state of fear and hysteria among the patients here. … The hallways are full of people, all floors are full of people,” Dr Munir al Barsh told an Israeli soldier in a call which was shared online.
• The hospital also has 36 premature babies who were recently taken off their incubators because the station supplying them oxygen was destroyed in Israeli shellings three days ago, said Al Jazeera’s Hani Mahmoud reporting from Khan Younis in southern Gaza. Three babies have already died.
• Those evacuated from inside the al-Shifa have been made to sit in the hospital’s outdoor courtyard. They are forced to take their clothes off and are interrogated outdoors amid rain and cold weather, Mahmoud reported.
• “Israeli forces have tried to kill anyone moving inside … No one has done anything. We don’t have any kind of resistance inside the hospital,” journalist Jihad Abu Shanab, who is inside the medical complex, told Al Jazeera.
• “The bombing has been really really aggressive over the last nine hours with continuous shooting all over the area,” said Dr Mokhallalati. He also said that Israeli tanks can be heard approaching the hospital.

Where is al-Shifa hospital?

• Al-Shifa is situated in Gaza City in the north, 500 metres (0.3 miles) from the Mediterranean coast.
• It is a complex of buildings and courtyards a few hundred metres from Gaza City’s small fishing port.
• It is sandwiched between the Shati refugee camp and the city’s Remal neighbourhood, which was destroyed in the initial days of the Israeli bombing that has killed more than 11,000 Palestinians, including nearly 8,000 women and children.

Is there evidence for Israel’s claims?

• So far there is no concrete evidence of Israeli claims that the hospital was being used for military purposes by the Hamas armed group, which carried out an attack on Israel on October 7 and took more than 200 people captive. Israel has claimed that it is targeting Hamas assets.
• Israeli forces are now saying that there is no indication of the presence of captives inside the hospital and the scan continues, reported Al Jazeera’s Sara Khairat from occupied East Jerusalem.
• Khairat added that this contradicts Israel’s earlier statement when they said they knew exactly what they were going in for.
• Israel carries the burden to produce evidence and prove that Hamas is using al-Shifa for military purposes, Ardi Imseis, an international law expert at Queen’s University in Canada told Al Jazeera.
• “The object of the attack is a civilian object. Until such time that the Israelis provide proof that it has been converted into a military object, the civilian nature of the object does not change,” he added.
• Omar Shakir, the Israel and Palestine Director at Human Rights Watch, told Al Jazeera that “the Israeli government has put forward no evidence that would justify stripping hospitals of their special protections under international humanitarian law”.

What has Hamas said?

• Hamas said on Wednesday that the US announcement had effectively given a “green light” for Israel to raid the hospital. The group said it held Israel and the US President Joe Biden fully responsible for the operation.
• Has has denied it has run military operations from any hospitals in the enclave of 2.3 million people.
• A White House spokesperson for the National Security Council, who did not wish to be named, told the Reuters news agency it does not support attacking a hospital from the air and does not want to see a firefight in a hospital.

What has Israel said?

• Israeli army spokesperson Lieutenant Colonel Peter Lerner told CNN the hospital and compound were for Hamas “a central hub of their operations, perhaps even the beating heart and maybe even a centre of gravity”.
• Israel said in its statement on Wednesday that it had given Gaza authorities 12 hours to cease military activities within the hospital. “Unfortunately, it did not,” the military statement said.
• While the Israeli military said on Wednesday that its forces have provided incubators and baby food to al-Shifa, the practicality of this is questionable. People have pointed out that the hospital needs electricity, which Israel cut, not incubators.

What’s next?

• Tamer Qarmout, assistant professor of public policy at the Doha Institute for Graduate Studies, told Al Jazeera that the al-Shifa raid was part of the bigger project for “a forceful displacement of whoever is left in northern Gaza”.
• With food and water supplies already running out, the destruction of the medical centre is a tactic to empty out the north, Qarmout explained.