‘Patients are dying’: What we know about Gaza hospitals under Israeli siege

Newborn babies wrapped in blankets and lined up on a bed after being removed from incubators have become the defining image showing the Israeli siege of hospitals in the Gaza Strip.

At least 32 patients, including six premature babies, have died at the al-Shifa Hospital in the last three days, Palestinian Health Ministry spokesperson Ashraf al-Qudra said Monday, as Gaza’s largest medical facility was forced to shut down due to lack of fuel and medicine.

More than 100 bodies are decomposing inside the hospital, waiting to be buried.

“Regrettably, the hospital is not functioning as a hospital anymore. The world cannot stand silent while hospitals, which should be safe havens, are transformed into scenes of death, devastation, and despair,” said Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization (WHO).

Israel imposed a total siege of the territory – home to 2.3 million people – banning fuel, food, electricity and water after launching its military offensive on October 7. Israeli action came in the wake of a Hamas attack that claimed more than 1,200 lives in Israel.

All hospitals in northern Gaza are now “out of service”, as relentless Israeli air strikes have killed more than 11,000 people, most of them women and children, triggering global calls for a ceasefire.

What is happening at al-Shifa Hospital?

Thousands of people, including 650 patients and 500 health workers, are holed up inside the al-Shifa Hospital premises surrounded by Israeli forces.

The Israeli military is calling on people to leave the hospital.

Al Jazeera’s Hani Mahmoud, reporting from Khan Younis, said the “Israeli military is calling on patients to step out of the hospital with their hands above their heads.”

“But some of them need wheelchairs while others are disabled, hence cannot walk,” he said. “It’s hard to comprehend these are the demands of the Israeli military, while at the same time [it is] playing nice with the media, telling journalists ‘we are offering a safe corridor.'”

On Sunday, the hospital’s cardiac wing was bombed by Israel.

“Patients are dying by the minute – even babies in the incubators,” al-Shifa Hospital Director Muhammad Abu Salmiya told Al Jazeera on November 11.

Staff have been forced to line up premature babies on ordinary beds, using the little power available to run the air conditioning to keep them warm. “We are expecting to lose more of them day by day,” Dr Ahmed El Mokhallalati, a doctor working at the hospital, told reporters.

The United Nations Office for the Coordination of Humanitarian Affairs (OCHA) reported three nurses were killed at the hospital on Friday.

Israel’s military said on Sunday that it offered to evacuate newborn babies and had placed 300 litres (80 gallons) of fuel at the entrance of the hospital, releasing video of its soldiers carrying containers and putting them on the ground. It said that Hamas had blocked its efforts.

Hamas denied that it refused the fuel and said the hospital was under the authority of Gaza’s Ministry of Health.

Why has Israel been attacking hospitals?

Hospitals in Gaza have repeatedly come under fire as Israeli forces have accused Hamas fighters of using them for military purposes.

The al-Ahli Arab Hospital, located in Gaza City, was hit by an explosion last month. Nearly 500 people were killed in the attack, whose origin remains unclear until now. Palestinian officials said an Israeli missile was responsible, while Israel claimed the explosion was caused by the misfiring of rockets by Palestinian armed groups.

Israel claims Hamas operates a command centre from under al-Shifa hospital. But Hamas and hospital officials have denied that assertion.

Independent doctors including British-Palestinian doctor Ghassan Abu-Sitta, who is at al-Shifa, and Norwegian doctor Mads Gilbert, who has worked at the hospital previously, have said that they have not seen any evidence of military activity at the hospital during the war.

Palestinian officials and people inside the hospital have reported Israeli forces directly targeting the medical complex with munitions and snipers.

Health Ministry Undersecretary Munir al-Boursh said snipers were firing at any movement inside the compound.

At least 21 of Gaza’s 35 hospitals have stopped functioning, either because of Israel’s siege on them, or because of a lack of fuel and medicines as a consequence of the total blockade imposed by Israel on Gaza since October 7.

What happened at al-Quds Hospital?

Fighting has been ongoing near al-Quds Hospital in Gaza City, according to the Palestine Red Crescent Society (PRCS) as attempts were under way to evacuate patients from the second-largest hospital in the enclave.

Al-Quds has been struggling to care for patients, with access to limited medicine, food and water. It closed its doors to new patients on Sunday.

“The hospital has been left to fend for itself under ongoing Israeli bombardment, posing severe risks to the medical staff, patients and displaced civilians,” the PRCS said in a statement on Sunday.

PRCS, which has been running the al-Quds Hospital since 2001, said it held the international community and signatories of the Fourth Geneva Convention accountable for the complete breakdown of Gaza’s healthcare system and the resulting dire humanitarian crisis.

What about other hospitals in northern Gaza?

They have now all stopped functioning. The al-Nasr Children’s Hospital and al-Rantisi Specialised Hospital for Children can no longer function without access to medical aid. They are also under Israeli fire.

Mustafa al-Kahlout, head of both hospitals said: “We are completely surrounded, there are tanks outside the hospital, and we cannot leave.”

On Friday, more than a dozen children and their parents or guardians were evacuated from the al-Rantisi Hospital to hospitals in neighbouring Egypt and Jordan, according to the UN. It remains unclear what has happened to the 30 children who remain at al-Nasr Hospital.

Another children’s hospital, the Kamal Adwan Hospital in northern Gaza, also suspended operations on Monday after its main generator ran out of fuel, hospital director Ahmed al-Kahlout told Al Jazeera.

The Indonesian Hospital located in north Gaza’s Beit Lahiya neighbourhood has also come under attack. Its director, Atef al-Kahlot, told Al Jazeera on Sunday that the 110-bed hospital is only operating at 30-40 percent of its capacity. He appealed to the international community for help.

“We call on the honourable people of the world, if any of them are left, to put pressure on the occupation forces to supply the Indonesian Hospital and the rest of the hospitals in the Gaza Strip,” he said.

Meanwhile, the al-Awda Hospital has run out of fuel and the Turkish-Palestine Friendship Hospital, run by the Islamic University of Gaza, stopped operating on October 30 after air strikes and as it ran out of fuel and medicines. Israel has denied attacking the hospital, Gaza’s only cancer treatment facility.

Further air strikes reportedly hit and destroyed the Swedish clinic in al Shati camp, west of Gaza City, where some 500 internally displaced people were sheltering. The casualty toll remains unclear. Another strike overnight hit al-Mahdi Hospital in Gaza City, reportedly killing two doctors and injuring others.

Where can the sick and injured go?

The remaining hospitals in southern Gaza are at full capacity, and the Nasser Hospital in Khan Younis, which can accommodate 350 inpatients, is overfull. It too remains in desperate need of fuel, electricity and medical supplies like anaesthesia and saline solution to continue functioning.

The status of the PRCS-run al-Amal Hospital in Khan Younis and the European Gaza Hospital in the same area remain unclear.

Two more hospitals in Rafah – Al-Helal Emirati Hospital and the Mohammed Yousef El-Najar Hospital – are also operating under limited capacity.

Jordan set up a field hospital on November 6 and claims to have treated 817 patients, while the United Arab Emirates and Turkey are planning to set up similar hospitals close to the Rafah border with Egypt.