An Israeli air strike on a school-turned-shelter in southern Gaza killed at least 25 Palestinians on Tuesday, as heavy bombardment in the north forced the closure of medical facilities in Gaza City and sent thousands fleeing in search of increasingly elusive refuge.
Israel’s new ground assault in Gaza’s largest city is its latest effort to battle Hamas militants regrouping in areas the army previously said had been largely cleared.
Large parts of Gaza City and urban areas around it have been flattened or left a shattered landscape after nine months of fighting. Much of the population fled earlier in the war, but several hundred thousand Palestinians remain in the north.
“The fighting has been intense,” said Hakeem Abdel-Bar, who fled Gaza City’s Tuffah district to the home of relatives in another part of the city. He said Israeli warplanes and drones are “striking anything moving” and that tanks have moved into central districts.
The strike at the entrance to the school killed at least 25 people, according to an Associated Press reporter who counted the bodies at Nasser Hospital in Khan Younis. A hospital spokesman said the dead included at least seven women and children and that the toll is likely to rise.
Earlier air strikes in central Gaza killed at least 14 people, including a woman and four children, according to two hospitals that received the bodies. Israel has repeatedly struck what it says are militant targets across Gaza since the start of the war nine months ago.
The military blames civilian deaths on Hamas because the militants fight in dense, urban areas, but the army rarely comments on individual strikes, which often kill women and children.
The Israeli army said the air strike near the school and reports of civilian casualties are under review, and claimed the strike targeted a Hamas militant who took part in the October 7 attack on Israel.
There was also no immediate word on casualties in Gaza City.
Families whose relatives were wounded or trapped were calling for ambulances, but first responders could not reach most of the affected districts because of the Israeli operations, said Palestinian Red Crescent spokeswoman Nebal Farsakh.
“It’s a dangerous zone,” she said.
After Israel called on Monday for an evacuation from eastern and central parts of Gaza City, staff at two hospitals – Al-Ahli and the Patients Friends Association Hospital – rushed to move patients and shut down, the United Nations said.
Ms Farsakh said all three medical facilities run by the Red Crescent in Gaza City have closed.
Scores of patients were transferred to the Indonesian Hospital in northern Gaza, which itself was the scene of heavy fighting earlier in the war.
“We do not know where to go. There is no treatment and no necessities for life,” said Mohammad Abu Naser, who is being treated there. “We are dying slowly.”
The Israeli military said on Tuesday that it told hospitals and other medical facilities in Gaza City they did not need to evacuate. But hospitals in Gaza have often shut down and moved patients at any sign of possible Israeli military action, fearing raids.
The Episcopal Church in the Middle East, which operates Al-Ahli, said the hospital was “compelled to close by the Israeli army” after the evacuation orders and a wave of nearby drone strikes on Sunday.
In the past nine months, Israeli troops have occupied at least eight hospitals, causing the deaths of patients and medical workers along with massive destruction to facilities and equipment. Israel has claimed Hamas uses hospitals for military purposes, though it has provided only limited evidence.
Only 13 of Gaza’s 36 hospitals are functioning, and those only partially, according to the United Nations’ humanitarian office.
Israel’s campaign in Gaza, triggered by Hamas’a October 7 attack, has killed or wounded more than 5% of Gaza’s 2.3 million Palestinians, according to the territory’s Health Ministry.
Nearly the entire population have been driven from their homes. Many have been displaced multiple times, and hundreds of thousands are packed into sweltering tent camps.
The UN humanitarian office said the exodus in Gaza City is “dangerously chaotic”, with people instructed to flee through neighbourhoods where fighting is under way.
“People have been observed fleeing in multiple directions, not knowing which way may be safest,” the agency said in a statement. It said the largest UN bakery in the city has been forced to close, and that the fighting has blocked aid groups from accessing warehouses.
Maha Mahfouz, a mother of two, said she fled twice in the past 24 hours. She first rushed from her home in Gaza City to a relative’s house in another neighbourhood. When that became dangerous, she fled on Monday night to Shati, a decades-old refugee camp that has grown into an urban district where Israel has carried out repeated raids.
She described vast destruction in the areas targeted in the latest raids. “The buildings were destroyed. The roads were destroyed. All has become rubble,” she said.
The Israeli military has said it had intelligence showing that militants from Hamas and the smaller Islamic Jihad group were regrouping in central Gaza City. Israel accuses Hamas and other militants of hiding among civilians.
In Shijaiyah, a Gaza City neighbourhood that has seen weeks of fighting, the military said it had destroyed three miles (6km) of Hamas tunnels.
Hamas has warned that the latest raids in Gaza City could lead to the collapse of negotiations for a ceasefire and hostage-release deal.
Israel and Hamas had appeared to narrow the gaps in recent days, with the US, Egypt and Qatar mediating.
On Tuesday, CIA director William Burns met Egyptian President Abdel Fattah el-Sissi in Cairo to discuss the negotiations, the president’s office said. More talks are due to be held on Wednesday in Qatar, where Hamas maintains a political office.
But obstacles remain, even after Hamas agreed to relent on its key demand that Israel commit to ending the war as part of any agreement. Hamas still wants mediators to guarantee that negotiations conclude with a permanent ceasefire.
Israel has rejected any deal that would force it to end the war with Hamas intact.
On Monday Hamas accused Israeli Prime Minister Benjamin Netanyahu of “putting more obstacles in the way of negotiations”, including the operations in Gaza City.
Hamas’s cross-border raid on October 7 killed 1,200 people in southern Israel, most of them civilians, according to Israeli authorities. The militants took roughly 250 people hostage. About 120 are still in captivity, with about a third said to be dead.
Israel’s bombardment and offensives in Gaza have killed more than 38,200 people and wounded more than 88,000, according to the territory’s Health Ministry, which does not distinguish between combatants and civilians in its count.
