By Kareem Khadder, Celine Alkhaldi and Ibrahim Dahman, CNN
(CNN) — The Israeli military launched an operation on Monday against Gaza’s largest hospital facility, Al-Shifa, where thousands of people are sheltering.
The Israel Defense Forces (IDF) claimed that “senior Hamas terrorists” were using the facility to “conduct and promote terrorist activity.” Later Monday, Israel said that “terrorist forces” were firing at IDF troops. CNN cannot independently verify these allegations.
The IDF ordered residents and displaced persons near the sprawling medical complex in northern Gaza to withdraw to what it called a “humanitarian zone” further south. However, those warnings came after the hospital had already come under siege, according to one witness.
The Ministry of Health in Gaza said about 30,000 people were inside Al-Shifa seeking refuge and that those attempting to leave were being targeted by snipers and fire from helicopters. Hamas accused Israel of striking targets “without regard” to the patients or medical staff inside – a claim echoed by people at the complex.
“Military vehicles are firing at the hospital buildings’ windows, and at anyone who is caught moving between the hallways,” Hamada Abdelhadi, a displaced Palestinian man seeking shelter at Al-Shifa, told CNN.
Targeting hospitals in wartime is prohibited under international law, but those standards change if enemy combatants are using the facility to attack an enemy.
The IDF said it would “act in accordance with international law” and had instructed troops on the importance of “operating cautiously, as well as on the measures to be taken to avoid harm to the patients, civilians, medical staff, and medical equipment.”
Eyewitness accounts described chaotic scenes both in and around the complex. CNN footage filmed about a kilometer (about .62 miles) away from Al-Shifa shows the impact on the wider area, with injured people amid the debris, and bodies being pulled from the rubble.
Videos aired by Al Jazeera showed massive plumes of smoke from airstrikes in the vicinity of the hospital, with nearby streets covered in the dust and debris from bombed out buildings. In one video, people could be seen frantically going through the rubble to dig out the seeming lifeless body of one young victim. Another showed families running in terror after a deafening missile strike.
One witness who lives in nearby Gaza City told CNN he had seen “a big invasion of tanks” headed toward Al-Shifa.
Abdelhadi, the man sheltering at Al-Shifa, said the operation began “suddenly” at 2:38 a.m. local time.
“People who were on the hospital grounds were fired at. Some people were killed, and others injured. And dead bodies and those injured were pulled away by Israeli forces,” he told CNN by phone.
Several people have been arrested, he said. Al Jazeera said in a statement that one of its correspondents, Ismail Al-Ghoul, and his team were detained and “severely beaten” before being taken to an undisclosed location. CNN has reached out to the IDF for comment.
Abdelhadi said that Israeli military vehicles and bulldozers were “demolishing and excavating” inside the hospital grounds and Israeli forces used loudspeakers to order people to stay inside and moved toward the corridors. Those moving between hallways risked being hit, he said.
“The screams of women and children have not stopped. With every artillery shell that’s fired, there’s more screaming,” he said.
Shelling was still ongoing as of Monday afternoon, according to Abdelhadi.
A doctor on the scene, Abdullah Mohammed, said on Monday afternoon that the Al-Shifa surgical building, which is crowded with young people, was on fire after being hit four times by Israeli missile strikes.
“Everyone inside this building has undergone major operations and cannot move from the place,” Mohammed wrote on X, formerly Twitter.
The World Health Organization (WHO) is “terribly worried” about the situation there, according to Director-General Tedros Adhanom Ghebreyesus who said in a post on X on Monday that “hospitals should never be battlegrounds.”
Al-Shifa briefly became the epicenter of the conflictearlier on in the war between Israel and Hamas. Israel accused Hamas of operating what it called a command center in tunnels beneath the hospital complex, a charge the group denied. In November, Israel carried out what it called a “precise and targeted” operation in the complex, but the facility’s main building was heavily damaged and effectively ceased to function, with doctors working by candlelight and wrapping premature babies in foil to keep them alive. Dozens of patients died due to a lack of electricity, according a report released in November.
While the United States backed Israel’s assertion that Hamas operated under Al-Shifa and the IDF brought journalists – including a CNN team – to view the tunnels themselves, the evidence did not establish without a doubt that there was a Hamas command center underneath the hospital as Israel had claimed.
Palestinians have said the fighting around Al-Shifa demonstrates Israel’s wanton disregard for civilian life in Gaza, while Israel points to it as an example of Hamas’ use of civilians as human shields.
During the first round of fighting at Al-Shifa in November, Israel urged Gaza’s northern residents to head south to seek refuge.
Those that remained now face a dire humanitarian crisis in which people in Gaza are starving to death due to the war and a lack of aid. Israeli officials have repeatedly said that issues in delivering aid were not down to Israel blocking trucks’ access to Gaza.
“The speed at which this man-made hunger and malnutrition crisis has ripped through Gaza is terrifying,” said the executive director of the World Food Program, Cindy McCain.
A report compiled by several governments and aid organizations released on Monday found that a famine in northern Gaza is “imminent.”
UN Secretary-General Antonio Guterres said the findings showed that Gaza now has “the highest number of people facing catastrophic hunger ever recorded… anywhere, anytime.”
“This is an entirely manmade disaster — and the report makes clear that it can be halted,” Guterres told reporters.
But life is little better for Gazans who did flee south. The majority of them – about 1.4 million people – are now crammed into a sprawling tent city packed against the Egyptian border in Rafah, the only nominally safe space left in the embattled enclave, and fears there are mounting of an impending offensive.
Israeli Prime Minister Benjamin Netanyahu’s office said Friday that he had approved plans for a ground incursion into Rafah, despite widespread international opposition.
United Nations aid chief Martin Griffiths warned last month that such an offensive could lead to “a slaughter.” Israel intends to move displaced Palestinians from Rafah to “humanitarian enclaves” in Gaza before any assault, IDF spokesperson Rear Adm. Daniel Hagari told reporters Wednesday.
CNN’s Amir Tal, Mostafa Salem and Joshua Berlinger contributed to this report
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