2nd Gaza hospital attacked

WHO: Health system has collapsed

Demonstrators calling for the return of 40 children who are among the roughly 240 hostages believed held by Hamas militants in the Gaza Strip and to mark World Children's Day, during a protest across from UNICEF offices in Tel Aviv, Israel, Monday, Nov. 20, 2023. The hostages, mostly Israeli citizens, were kidnapped during an Oct. 7 Hamas cross-border attack in Israel and have been held in Gaza since then. (AP Photo/Oded Balilty)
Demonstrators calling for the return of 40 children who are among the roughly 240 hostages believed held by Hamas militants in the Gaza Strip and to mark World Children's Day, during a protest across from UNICEF offices in Tel Aviv, Israel, Monday, Nov. 20, 2023. The hostages, mostly Israeli citizens, were kidnapped during an Oct. 7 Hamas cross-border attack in Israel and have been held in Gaza since then. (AP Photo/Oded Balilty)

JERUSALEM — Another hospital in the Gaza Strip came under fire Monday, and the World Health Organization warned that the enclave’s devastated health system had largely collapsed, with none of its functioning hospitals capable of handling complicated medical cases.

At least 12 people were killed and dozens of others were wounded in the latest attack, on the Indonesian Hospital in the far northern city of Beit Lahia, according to two hospital staff members and the Gaza Health Ministry in the Hamas-run territory.

It came less than a week after Israeli forces raided Gaza’s largest hospital, Shifa, in Gaza City, about 5 miles to the west, in an effort to capture and expose what it says were extensive Hamas operations within and beneath the hospital, including underground bunkers, a command center and a network of tunnels. Hamas and hospital administrators deny that the militant group uses the grounds of Shifa or other hospitals for military operations.

The source of the strike on the Indonesian Hospital could not be independently verified, because heavy fighting raged around it. The Gaza Health Ministry blamed Israeli forces for the attack.

The Israeli military said in a statement that its troops had come under fire overnight “from within” the hospital. It said it had “directly targeted the specific source of enemy fire” but that “no shells were fired toward the hospital.” The statement did not elaborate on the seeming contradiction.

International groups, including the World Health Organization and a United Nations agency, have repeatedly urged that hospitals not be targeted in the war between Israel and Hamas. The group’s director-general, Dr. Tedros Adhanom Ghebreyesus, said he was “appalled” by reports of the latest strike.

“Health workers and civilians should never have to be exposed to such horror, and especially while inside a hospital,” he said in a statement Monday.

At a news conference, two WHO officials painted a dire picture of the health care system in Gaza after weeks of fighting. They said hospitals in the north could not take any more patients and nearly all had stopped operating as health care centers. More are functioning in the south, they said, but more like community clinics without the capacity to treat complex injuries or to perform advanced surgeries.

In a separate development that could relieve some of the pressure on Gaza’s collapsing health system, dozens of trucks entered from Egypt on Monday with equipment from Jordan to set up a field hospital. Jordan’s state-run media said the hospital in Khan Younis would be up and running within 48 hours.

Michael Ryan, executive director of the WHO’s Health Emergencies Program, told reporters that “only 10 of the 36 hospitals that were functioning are now functioning in any way at all, and even they are struggling to function.” He warned that the dire conditions in Gaza, with 1.7 million people displaced from their homes and most of the population now crowded into the south, significantly raised the risk of epidemic disease, with people sheltering in tight quarters or tent camps without adequate food and hygiene.


More than 12,700 Palestinians have been killed in Gaza, according to the Palestinian Health Ministry in the West Bank, which coordinates with officials in the Health Ministry of Hamas-run Gaza. Officials there say another 4,000 are missing. Their counts do not differentiate between civilians and combatants.

Israel says it has killed thousands of militants. About 1,200 people have been killed on the Israeli side, mainly civilians during the Oct. 7 attack. The military says 66 Israeli soldiers have been killed in Gaza ground operations.

Violence also has surged in the Israeli-occupied West Bank, where attacks by Jewish settlers are on the rise and where more than 200 Palestinians have been killed since the start of the war, mostly in gun battles triggered by Israeli military raids.

Strikes in the Nuseirat and Bureij refugee camps Monday killed at least 40 people, according to hospital officials, and residents said dozens more were buried in the rubble. Bundled against a chilly wind from Gaza’s approaching winter, a line of men prayed over more than a dozen bodies on the grounds of the nearby morgue in Deir al-Balah before loading them onto a truck.

Israeli troops were battling Hamas fighters in the Jabaliya refugee camp, a densely built-up district on Gaza City’s northeastern side that has been bombarded for weeks. The military said that after moving through the center of the city to Shifa, its forces were now working to uproot Hamas fighters from eastern areas.

D oze n s of d e ad a n d wounded in airstrikes and shelling overnight flowed into Indonesian Hospital, near Jabaliya, said Marwan Abdallah, a medical worker there. He said Israeli tanks were operating less than 200 yards away and Israeli snipers could be seen on the roofs of nearby buildings. As he spoke on the phone, the sound of gunfire could be heard in the background.

The strike at the Indonesian Hospital only added to the sense of crisis. The hospital, which was financed by the Indonesian government and operated by the Gaza Health Ministry, was hit around 2:30 a.m. after Israeli tanks drew closer to the compound amid constant shelling and gunfire, according to a nurse and a hospital administrator.

Recent video shot in the area and geolocated by The New York Times showed several Israeli tanks within a few hundred yards of the hospital and moving toward it.

The two staff members said Monday that the second floor of the hospital, where dozens of patients and displaced people were sleeping, was hit by artillery fire.

“There was chaos, darkness and fire in the department, which made it very difficult to evacuate the dead and wounded,” the nurse said. He and the hospital administrator asked that their names not be used because they feared for their safety.

Video shot by Palestinian journalists and verified by the Times showed devastation in a ward of the hospital Monday, with bodies and wreckage sprawled across the floor and debris hanging from the ceiling. A video made Sunday showed the same interior intact, with a woman sitting on the floor making bread on a portable stove.

At least 500 patients and thousands of displaced people were inside the hospital when it was struck, the administrator said. “It’s possible that what happened at Al-Shifa Hospital will also happen to us,” he added, referring to Israeli forces seizing that hospital last week.

After the strike and just before sunrise, dozens of people were able to leave in a panic amid shelling and gunfire, he said.

Hamas’ Health Ministry spokesperson, Ashraf al-Qidra, said roughly 200 wounded patients and their companions were evacuated from the hospital to southern Gaza in a rescue effort coordinated by the U.N. and the International Committee for the Red Cross. Many of the evacuees were being treated at al-Nasser hospital in the southern town of Khan Younis, he said.

Between 400 and 500 wounded remain at Indonesia Hospital, Ashraf told Al-Jazeera. About 2,000 displaced Palestinians also are sheltering there.

The administrator stayed behind with hundreds of others, including patients on ventilators and in critical condition. Evacuating them would be difficult and would require coordination with humanitarian organizations and the Israeli military, he said.

The hospital is also running low on fuel, and its main generator could shut down as early as Monday night, the administrator said.

On Monday, 28 premature babies who had been moved from Shifa to another hospital in southern Gaza were taken across the border to Egypt for medical care, according to the United Nations and an Egyptian state television network, Al Qahera News.

The babies were part of a group of 31 infants who had been moved by a U.N.-led team Sunday as medical services at Shifa deteriorated. Three others were transferred to an Emirati-run hospital in Rafah in southern Gaza, the Red Crescent said.

Five other babies who had been cared for at Shifa died before they could be evacuated, according to the United Nations.

250+ REMAIN STRANDED

More than 250 critically ill or wounded patients remain stranded at the Shifa compound. The complex can no longer provide most of the wounded there treatment after it ran out of water, medical supplies and fuel for emergency generators.

Israeli forces battled Palestinian militants outside its gates for days before entering the facility Wednesday.

Israel’s army said it has evidence that Hamas maintained a sprawling command post inside and under the hospital’s 20-acre complex, which includes several buildings.

On Sunday, the military released a video showing what it said was a tunnel discovered at the hospital, 60 yards long and about 33 feet below ground. It said the tunnel ended at a blast-proof door with a hole in it for gunmen to fire out of. Troops have not opened the door yet, it said.

Israeli forces also released security camera video showing what they said were two foreign hostages, one Thai and one Nepalese, who were captured by Hamas in the Oct. 7 attack and taken to the hospital. Hamas said its fighters brought them in for medical care.

The army also said an investigation had determined that Israeli army Cpl. Noa Marciano, another captive whose body was recovered in Gaza, had been wounded in an Israeli strike on Nov. 9 that killed her captor but was then killed by a Hamas militant in Shifa.

The military has previously released images of several guns it said were found inside an MRI lab and said the bodies of two hostages were found near the complex.

The Associated Press was not able to independently confirm the military’s findings.

As concerns mounted about the toll of the war, diplomatic efforts were continuing to end or at least to pause the fighting and potentially secure the release of some of the more than 200 hostages who were taken by Hamas during the Oct. 7 attack on Israel.

Israel, the United States and Qatar, which mediates with Hamas, have been negotiating a hostage release for weeks. Israel’s three-member war Cabinet met with representatives of the hostages’ families Monday evening, and a relative of a hostage said the officials, including Prime Minister Benjamin Netanyahu, told families the government will not prioritize the hostages’ release to defeating Hamas.

U.S. President Joe Biden, asked Monday if negotiators were close to a deal to free hostages, said: “I believe so” and “Yes.”

Information for this article was contributed by Hiba Yazbek of The New York Times and by Wafaa Shurafa, Samy Magdy, Jack Jeffery, Najib Jobain, Tia Golden-berg, Melanie Lidman and Nebi Qena of The Associated Press.

CORRECTION: A strike on the Indonesian Hospital in the Gaza Strip killed 12 people on Monday during heavy fighting outside hospital gates between Israeli Defenses Forces and Hamas militants. In a statement, the Israeli military said its troops responded to fire that came “from within” the hospital but didn’t clarify what was targeted. An earlier version of this story's headline misstated the available information about the fighting, which was not specific enough to say who had attacked the hospital.