The US has warned Israel not to fire on hospitals in Gaza and endanger the lives of patients and sheltering civilians, as fighting rages between Israeli troops and Hamas militants close to the enclave’s largest medical facilities.

Jake Sullivan, US national security adviser, told CBS News on Sunday that the US “does not want to see firefights in hospitals where innocent people -— patients receiving medical care — are caught in the crossfire”.

His remarks reflect rising international alarm over the dire conditions in Gaza’s hospitals, particularly al-Shifa, where thousands of people have sought refuge from Israel’s bombardment of the coastal enclave.

Hamas said some of the facilities have been attacked by Israeli forces and have warned of a catastrophic shortage of essential medical supplies and other staples. It said two newborns died in al-Shifa on Saturday after fuel to power the hospital generators ran out.

Another hospital in Gaza City, al-Quds, was forced to close because it no longer had enough fuel and power, the Palestinian Red Crescent announced on Sunday.

Over the past 36 days, the World Health Organization has recorded at least 137 attacks on healthcare units in Gaza, resulting in 521 deaths and 686 injuries, including 16 deaths and 38 injuries of health workers on duty.

More than half of the hospitals in the Gaza Strip are closed. Those still functioning are under massive strain and can only provide very limited emergency services, the UN agency said.

The battles in Gaza City are the latest stage in a ground offensive Israel launched more than two weeks ago to eliminate Hamas and topple the armed group’s 16-year rule in Gaza.

Al-Shifa hospital on Friday
Patients in al-Shifa on Friday. The World Health Organization said on Sunday that it had lost communication with its contacts in the hospital © Khader Al Zanoun/AFP via Getty Images

The war was triggered by Hamas’s devastating rampage through southern Israel on October 7, in which its militants killed more than 1,200 people, mostly civilians, and took about 240 hostages.

Since then, more than 11,000 Gaza residents have been killed in Israel’s bombardment of the strip, according to Palestinian health officials.

Meanwhile, tentative signs were beginning to emerge of a potential deal, brokered in part by Qatar, to release some of the hostages Hamas is holding.

Representative Michael McCaul of Texas, who serves as the chair of the House Foreign Affairs Committee and is in Tel Aviv, told CBS News on Sunday that there were “very sensitive” discussions ongoing with Doha, which hosts Hamas’s political office. He said there was a possibility of exchanging Palestinians in prison in Israel for civilians held captive in Gaza.

“A ceasefire will be very difficult without an agreement to release all hostages,” he added.

The Israel Defense Forces confirmed over the weekend that armed clashes had taken place between its troops and Hamas militants around al-Shifa, Gaza’s largest medical complex, though it said they had not fired at the hospital.

Al-Shifa has long been in the IDF crosshairs. Israel claims the militant group operates out of a dense network of tunnels underneath the hospital, which Hamas denies.

Sullivan appeared to back up the IDF allegations on Sunday, saying Hamas’s use of hospitals and other civilian facilities for command and control and weapons storage was a “violation of the laws of war”.

He accused Hamas of “operating in a way that is outside the bounds of any civilised concept of how you would think about using a hospital, using human shields”.

Sullivan added that the US was in “active consultations” with the IDF over how to protect patients in Gaza’s hospitals while pursuing Hamas.

On Sunday, the regional directors of three UN agencies, including the WHO and the children’s fund, said: “The world cannot stand silent while hospitals, which should be safe havens, are transformed into scenes of death, devastation and despair.”

“Decisive international action is needed now to secure an immediate humanitarian ceasefire and prevent further loss of life, and preserve what’s left of the healthcare system in Gaza,” they added.

Israel has blamed Hamas for civilian casualties. Speaking to CNN on Sunday, prime minister Benjamin Netanyahu said the organisation’s militants were preventing people leaving the war zone, “sometimes at gunpoint”, and had fired on the safe corridor Israel created to allow Palestinians to move to southern Gaza.

“The Israeli army is doing an exemplary job trying to minimise civilian casualties and maximise terrorist casualties,” he said.

Israel has laid siege to the strip of 2.3mn people since the October 7 attack, allowing only limited aid into the enclave, which is enduring food, fuel and water shortages. More than half the population has been displaced.

A Palestinian health official said only al-Shifa’s A&E department had electricity, after the hospital ran out of fuel to power generators. There was also no water, he said, because water tanks had been struck during the fighting.

“Hospitals are being besieged, bombed, and their patients, medical staff and displaced people being killed in full view of the entire world,” the Palestinian health ministry in Gaza said.

Ghassan Abu-Sitta, a British-Palestinian war surgeon working at al-Ahli hospital in Gaza City, said on Sunday that it had run out of blood. “Our wounded are dying after surgery because we cannot transfuse them,” he said in a post on X, formerly Twitter.

The WHO said on Sunday that it had lost communication with its contacts in al-Shifa. The UN agency said the hospital was now “surrounded by tanks”. “There are reports that some people who fled the hospital have been shot at, wounded and even killed,” it said.

However, those reports have been challenged by Israeli authorities.

Colonel Moshe Tetro, head of Israel’s co-ordination and liaison administration to Gaza, called reports of a siege and strikes on al-Shifa “lies”.

“Even now, anyone who wants to leave can do so,” he said in a post on X. The eastern side of the facility remained open, he added.

Israel-Hamas war: 2-minute briefing

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