Death and Despair at Gaza Hospital as Fighting Reaches Its Doors

With Israel’s ground war in the Gaza Strip in its third week, Israeli military vehicles on Monday arrived at the gates of a besieged hospital complex where fuel, medicine and food are running out. Inside the hospital, the nursing staff were moving 36 premature babies to the only department that still had oxygen.

“Their lives are in danger,” said Dr. Nasser Bolbol, the head of the neonatal intensive care unit at the hospital, Al-Shifa. Before the babies were moved, three others had died when the oxygen was cut in the neonatal ward, Dr. Bolbol said.

As near-constant shelling shook the hospital buildings to their foundations, members of the medical staff painted a picture of the increasingly calamitous conditions inside Al-Shifa for the hundreds of patients and the estimated 8,000 people who have taken shelter there.

On Monday, more than 100 bodies were decomposing in the hospital’s front yard, another 50 were inside and about 60 others were in the morgue, said a spokesman for the Gazan Health Ministry, ​​Medhat Abbas. The U.N. High Commissioner for Human Rights said on Monday that a power cut at the hospital had led to at least 12 deaths.

But escaping Gaza’s desperate hospitals carries its own perils.

Fighting on Monday near Al-Quds Hospital, a mile to the south of Al-Shifa, disrupted an effort to evacuate patients and the medical staff from the facility, according to the Palestinian Red Crescent Society, which reported “shelling and violent explosions” along with “heavy gunfire.” A convoy of vehicles that had been traveling from southern Gaza could not reach Al-Quds because of the bombardment, the agency said.

Fears were growing of a wider Middle East conflict as the United States conducted a new round of airstrikes in eastern Syria against facilities it said were tied to Iran and its proxies and as Israeli forces skirmished with Hezbollah fighters at the border with Lebanon.

But the world’s attention was largely focused on the fighting in Gaza and the spiraling humanitarian crisis there.

At the White House on Monday, President Biden said his administration had conferred with the Israeli government on the issue of hospitals. “The position of the United States on this matter is clear,” he said. “Hospitals should be protected.”

The Israeli military did not address specific questions about its actions around Al-Shifa Hospital. In a statement on Monday, it said that it was “engaged in intense battle against Hamas” and that “this currently includes the area surrounding the Shifa hospital, but not the hospital itself.”

In another statement about the fighting near Al-Quds, the Israeli military said that a “terrorist squad” positioned among civilians at an entrance to the hospital had fired rocket-propelled grenades at Israeli soldiers, damaging an Israeli tank. Israeli forces fired back, the statement said, killing “approximately 21 terrorists.” That account of the fighting could not be immediately verified.

The Red Crescent Society said it “strongly condemns the false claims by the occupying forces about armed individuals launching projectiles from inside Al-Quds Hospital.”

Overall, Gazan health officials, who are part of the Hamas government, say more than 11,000 people have been killed in the Palestinian enclave since the war began, following the Oct. 7 Hamas attacks in Israel that killed an estimated 1,200 people.

Al-Shifa and other medical centers in Gaza City have been struggling for weeks to maintain operations as Israeli forces close in and as supplies of fuel and medicine dwindle. The head of the W.H.O. warned on Sunday that Al-Shifa was “not functioning as a hospital anymore” and was struggling to provide care after three days “without electricity, without water and with very poor internet.”

“The situation here is catastrophic in every sense of the word,” said Jihan Miqdad, a head nurse in the emergency room at Al-Shifa, where medical teams are surviving on biscuits and dates. Patients who were on life support in the intensive care unit were dying because the hospital had so little oxygen, she said.

To care for the premature babies at Al-Shifa, the medical staff is putting sheets of reflective foil and blankets over hospital beds and laying the babies close to one another to replicate as much as possible the warmth of an incubator, said Mr. Abbas, the Gazan health ministry official. Four of the premature babies there were born in emergency C-sections after their mothers were killed in strikes, he said.

“Now they have to make it without their mothers — and without electricity or special care,” Mr. Abbas said.

Dr. Bolbol, the neonatal doctor, said he had enough baby formula to last another two or three days. He feels helpless, he said.

“I’m watching patients die in front of my eyes and I can’t provide them the slightest bit of help,” he said.

The Red Cross, Dr. Bolbol said, has been negotiating with Israeli authorities to evacuate the babies, but no agreement has been reached so far.

In addition to the Al-Shifa complex, Israeli troops had reached at least two other hospitals in northern Gaza as of Monday, stepping up their push to empty the facilities, according to Israeli military officials, as fighting around them intensifies.

Israeli officials say Hamas uses hospitals in Gaza, including Al-Shifa, as shields to conceal vast complexes for their fighters in tunnels underneath. Hamas has denied the allegations.

On Monday, the U.N. agency that aids Palestinian refugees condemned the Israeli strikes, saying that a U.N. compound in southern Gaza had sustained three direct hits from Israeli naval forces on Sunday morning, with extensive damage.

“Nowhere in Gaza is safe,” the agency, UNRWA, said in a statement.

The two-story building, near the Rafah area that borders Egypt, stands alone behind a concrete wall on a stretch of coastal road just off the beach. Its location and status as a U.N. building had been formally communicated twice to all parties in the conflict, UNRWA said.

“The disregard for the protection of civilian infrastructure including U.N. facilities, hospitals, schools, shelters and places of worship is testament to the level of horror that civilians in Gaza are living every day,” the agency’s commissioner-general, Philippe Lazzarini, said in the statement.

Jake Sullivan, the U.S. national security adviser, said Monday that American officials were talking to Israeli officials about the fighting outside hospitals.

“We do not want to see firefights in hospitals,” Mr. Sullivan said.

Pentagon officials said the U.S. strikes in eastern Syria took place late Sunday and were in retaliation for a spate of recent attacks against American troops. Officials said the strikes most likely killed or injured an undetermined number of people at the sites.

The airstrikes appeared to be an escalation by the Biden administration, which previously conducted two sets of strikes that officials said were meant to deter Iran’s Islamic Revolutionary Guard Corps and the militias it supports in Syria and Iraq. U.S. officials had said those strikes had caused no known casualties.

On Israel’s border with Lebanon, the Israeli military has continued to engage in hostilities with Hezbollah, the Iranian-backed militia that has been firing missiles and rockets into Israel. Hassan Nasrallah, the head of Hezbollah, told supporters on Sunday that the group intended to keep up pressure on Israel, targeting sites deeper in the country.

Pentagon officials have said that a two-front war for Israel — involving both Gaza and Lebanon — would be a scenario most likely to draw in American military involvement. But during a visit to South Korea on Monday, Defense Secretary Lloyd J. Austin III appeared to play down, for the moment, concerns over an escalated Israel-Hezbollah conflict.

“In terms of the activity we’ve seen up there,” he said, “it’s been tit-for-tat exchanges.”

Reporting was contributed by Lauren Leatherby, Josh Holder, Shashank Bengali, Cassandra Vinograd, Vivian Yee, Eric Schmitt, Andrés R. Martínez, Euan Ward, Matthew Rosenberg and Michael D. Shear.