Israel-Hamas War: Deadly Strike Hits Northern Gaza Hospital Where Many Were Sheltering

At least 12 people were killed and dozens wounded in an attack on a hospital in the northern Gaza Strip on Monday morning as fighting escalated around it, according to two hospital staff members and the Gazan health ministry, which blamed Israel for the strike.

The Indonesian Hospital 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. The precise source of the strike could not be independently verified.

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 on Monday that the second floor of the hospital, where dozens of patients and displaced people were sleeping, was hit by artillery fire, and that medical workers were unable to move the dead bodies as fighting continued outside.

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

Video shot by Palestinian journalists and verified by The New York Times showed a scene of devastation within a ward of the hospital on Monday, with bodies and wreckage sprawled across the floor, and debris hanging from the ceiling. A video made on Sunday showed the same interior intact.

At least 500 patients and thousands of displaced people were inside the building when the attack happened, the administrator said. "It's possible that what happened at Al-Shifa Hospital will also happen to us," he added, referring to Gaza's largest hospital, which was raided by Israeli forces last week.

The Israeli military said that its forces had come under fire overnight "from within the Indonesian Hospital," and that it "directly targeted the specific source of enemy fire" in response. "No shells were fired toward the hospital," the military said in a statement.

Since invading Gaza more than three weeks ago, the Israeli military has steadily surrounded several hospitals in northern Gaza. Israel says that Hamas, the armed group that rules Gaza and launched the devastating Oct. 7 attacks in Israel, has concealed bases inside hospitals, and it has begun releasing videos taken by its forces searching Al-Shifa that it says support its assertion.

Proof of an extensive Hamas command center under Al-Shifa has yet to be revealed. The group has denied Israeli accusations that it uses civilian infrastructure and says Israel is committing war crimes by targeting hospitals.

As they close in on the Indonesian Hospital, Israeli forces have been strengthening their hold over northern Gaza.

Artillery and gunfire have been heard for several days near the Indonesian Hospital, which is in the far northern city of Beit Lahia, and Israeli tanks drew closer to the building on Sunday evening hours before the strike, the administrator said.

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

The Gazan health ministry said 500 injured people had been transferred from the hospital to Khan Younis, in southern Gaza, but it was not clear over what period of time.

A video posted early Monday by a man who had been sharing videos from the hospital for days showed him running out of the hospital compound with others as gunshots rang out. The Times verified that the video was taken at the hospital.

The administrator stayed behind with hundreds of others, including patients on ventilators and in critical condition. "Evacuating them would be very complicated" without coordination with humanitarian organizations and the Israeli military, he said.

The health ministry said in a statement that it was in touch with the International Committee of the Red Cross about a possible evacuation of the wounded. The aid organization said in a statement to The Times that any evacuation would be "extremely complex."

The head of the World Health Organization, Dr. Tedros Adhanom Ghebreyesus, said on social media that the organization was "appalled" at the reports of the attack, adding: "Health workers and civilians should never have to be exposed to such horror, and especially while inside a hospital."

Ameera Harouda, Malachy Browne, Arijeta Lajka, Isabel Kershner and Nader Ibrahim contributed reporting.

— Hiba Yazbek reporting from Jerusalem

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None of Gaza's 36 hospitals are functional enough to treat critical trauma cases or perform surgery, the World Health Organization said on Monday, even as the number of people needing urgent medical treatment was rising daily among the enclave's population of 2.2 million.

Michael Ryan, the W.H.O. executive director, said in a video briefing that most of the hospitals were closed entirely, particularly in Gaza's northern end, where Israel has focused its ground offensive. Of the 11 medical facilities in the southern part of the Gaza Strip, he said, four were not functional and the rest could provide only basic services, making them more akin to community clinics than major hospitals.

"The scale of injuries, the need for supplies, the inability to move around within the Strip and the inability to do that safely is a huge strain on all of the U.N. community and N.G.O. community to serve the people on the ground," he said.

Mr. Ryan also spoke of the Indonesian Hospital, which is in the northern part of Gaza and was struck by a deadly explosion on Monday. He said it was unable to receive new patients and its medical staff might soon request evacuation.

The dire conditions for civilians and the high death toll in Gaza has drawn international criticism of Israel's military response to the terrorist attacks Hamas launched from Gaza on Oct. 7. On Monday, the U.N. chief, António Guterres, who has repeatedly called for a cease-fire, said, "We are witnessing a killing of civilians that is unparalleled and unprecedented in any conflict since I have been secretary-general." He assumed that post in 2017.

Mr. Ryan, in the W.H.O. briefing, said that the loss of Al-Shifa Hospital, which Israeli forces took over last week, was a major blow, because it has provided cancer, dialysis, trauma and reconstructive surgery, "all of the complicated stuff you would expect of a very high-powered reference center." Al-Shifa, Gaza's largest hospital, has been a key part of the enclave's health care system for 75 years.

Thirty-one premature babies were evacuated Sunday from the hospital, where they had to be removed from incubators because of a lack of fuel. Five others had already died, the U.N. said on Sunday. Twenty-eight were transferred to Egypt on Monday for treatment.

Several hundred thousand civilians remain in northern Gaza, and the conditions there present a major challenge to providing them with urgent medical care, said Rob Holden, W.H.O. senior emergency officer in Gaza, who also spoke by video at the briefing on Monday from the border in Rafah, Egypt.

The areas outside some of the hospitals — including Al-Shifa and Indonesian — were active battlegrounds, Mr. Holden said, and were a major focus of attention. But the struggles of smaller hospitals are also important, he said, because those facilities often serve as the first line of treatment for the sick and injured.

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With the majority of Gaza's population displaced, Mr. Ryan said, overcrowded shelters are struggling with poor hygiene, malnutrition and the approach of cold weather. The likely spread of disease in those conditions will add to the burden on a health care system already unable to treat new waves of patients.

Even though Israel ordered civilians to evacuate to the south, Mr. Ryan said, southern Gaza was not safe. More than a third of all deaths and injuries from Israeli airstrikes have been recorded in Gaza's south, he said.

The logistics of evacuating patients from hospitals in the north are nearly impossible, and such operations could place some patients in "huge danger," Mr. Ryan said, because medical facilities in the south are not equipped to treat them.

"The care of oncology patients, the trauma care, the reconstruction surgery — many of those services are either only available or mainly available in those major hospitals in the north," Mr. Ryan said.

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Twenty-eight premature babies who had been in intensive care at the embattled Al-Shifa Hospital in northern Gaza were transported across the border to Egypt for medical care on Monday, according to the United Nations and an Egyptian state television network, Al Qahera News. But five others who had been cared for at the hospital died before they could be evacuated.

The babies had become a symbol of civilian suffering at the hospital, which was surrounded by Israeli forces last week and then raided. They were taken from there on Sunday to the southern city of Rafah, site of the territory's only functioning border crossing.

"The Palestine Red Crescent ambulance teams departed from in front of the Emirati Hospital in Rafah to transport 28 premature infants to the Rafah Crossing, in preparation for their transfer to receive medical treatment in Egyptian hospitals," the Red Crescent said on X, formerly Twitter. Al Qahera News later reported that the ambulances had crossed the border.

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Samar Abu Elouf

Reporting from Gaza

Thirty-one premature babies had been evacuated from Al-Shifa to southern Gaza, the Red Crescent and the World Health Organization said. It was not immediately clear why three of them had not been taken to Egypt.

One mother, Ayat Al Daour, was reunited with her twin daughters, Mera and Dahab, at the Emirati Hospital on Monday, before they were transferred to Egypt. She said she gave birth at Al-Shifa five days into the fighting and was soon released — but without her daughters. She had not seen them for 39 days.

After being discharged, Ms. Al Daour said, she fled her home for a refugee camp in Gaza City, then heeded warnings about the danger there and headed south — all the while unable to communicate with medical workers at Al-Shifa. Hearing news reports that the babies had been moved to Emirati Hospital, she walked hours to the hospital and finally saw her girls alive and well, she said.

"When they were saying a premature baby died on the news, I could not know whether that was my baby or not," she said.

The United Nations Office for the Coordination of Humanitarian Affairs, which helped organize the evacuation, said on social media that five babies "had already died due to lack of electricity and fuel" at Al-Shifa. Israel imposed a siege on Gaza that has largely blocked supplies of fuel, food and water after the Oct. 7 attacks by Hamas that killed around 1,200 people in Israel.

The W.H.O., which is a United Nations agency, said in a statement on Sunday that 11 of the babies were in critical condition and that all were fighting serious infections.

UNICEF, which said it had participated in the "extremely dangerous" evacuation effort, said the conditions of the babies had been "rapidly deteriorating." It added that the babies had been moved to Rafah in temperature-controlled incubators.

The Israeli military said in a statement it had helped to facilitate the evacuation from the pediatric ward and provided incubators to Al-Shifa. It was not clear whether those were the incubators used to transport the babies.

The W.H.O.'s director general, Dr. Tedros Adhanom Ghebreyesus, posted a photograph on X of a staff member in a blue United Nations helmet and bulletproof vest scooping up a tiny infant. The babies, along with six health care workers and 10 family members of hospital employees, were evacuated "under extremely intense and high-risk security conditions," he wrote.

The authorities in Israel have said it has evidence that Hamas had a headquarters underneath Al-Shifa, something Hamas as well as doctors there deny.

Israel's push to seize Al-Shifa last week set off a struggle to survive there. Doctors and health officials warned that nearly 40 premature babies were at particular risk. Some had been born to mothers who had been killed in airstrikes or who died shortly after giving birth, doctors at Al-Shifa have said. Some were the only survivors in their families.

Visual Investigations

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Yemen's Houthi militia released a video on Monday showing its forces hijacking the ship Galaxy Leader, a day after announcing it had seized the vessel in the Red Sea as a demonstration of support for "the oppressed Palestinian people."

The video, whose authenticity was verified by The New York Times, shows at least 10 armed men on the deck of the roughly 600-foot-long vessel after jumping out of a military helicopter hovering just above it.

Most of the video appears to come from cameras attached to men's heads, and follows them as they seize control of the bridge from crew members. A later section of the video, taken from a distance, shows a handful of small boats — of a type known to be used by Houthi rebels — moving around and alongside the ship. One flies a Yemeni flag used by the Houthis as well as a Palestinian flag; the same flags are by this point flying on the Galaxy Leader.

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The whereabouts of the Galaxy Leader has been unknown since Saturday, when its last received location signal showed it in the Red Sea, between Saudi Arabia and Sudan. But the new video contains clues about when and where the vessel was hijacked.

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A clock on the wall of the Galaxy Leader's bridge in the video shows a time of just after 1 p.m. Additionally, a navigational computer display shows the ship had traveled almost three quarters of the way down Yemen's coast. The evidence suggests that Houthi fighters took over the vessel when it was within quick and easy striking distance of Yemen's coast, rather than farther north in the middle of the Red Sea.

A Times analysis of a satellite image captured on Sunday morning local time — hours before the time shown on the bridge clock — offers further evidence that the Galaxy Leader had traveled several hundred miles beyond its last known location. In the image, a ship whose visual characteristics and dimensions show it to be the Galaxy Leader is seen transiting the Red Sea near the Zubair group of Yemeni islands. The satellite image was likely captured just hours before the hijacking. Samir Madani, co-founder of TankerTrackers.com, which monitors global shipping, first spotted the ship in the image.

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Hours before the hijacking, the Houthi militia had threatened to target Israeli-flagged, owned and operated ships traversing the Red Sea. Israel's military said the ship was en route to India from Turkey and had an "international crew, without Israelis." The vessel, which is listed as a vehicle carrier, is British-owned and operated by a Japanese company.

The company's beneficial owner — meaning the person who exercises control over it, owns more than a quarter of it or receives substantial economic benefit from it — appears to have at some point been an Israeli billionaire, Rami Ungar, according to the Paradise Papers, a major leak of confidential documents that in 2017 exposed a hidden world of wealth and ownership.

A correction was made on 

Nov. 20, 2023

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An earlier version of this article misstated the location of the Galaxy Leader in a satellite image captured on Sunday. The location was near the Zubair group of Yemeni islands, not the Hanish islands.

How we handle corrections

— Christiaan Triebert and David Botti reporting from the Visual Investigations team

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After weeks of negotiations, officials from Israel and Hamas said early Wednesday that they had reached an agreement for a brief cease-fire in Gaza and the release of 50 of the about 240 hostages taken by the armed group on Oct. 7.

The Israeli decision, announced by the office of Prime Minister Benjamin Netanyahu, said that his government had approved the "framework" for a hostage release over four days, during which there would be a pause in the fighting. Less than an hour later, Hamas said in a statement that it had agreed to a cease-fire and to free hostages in exchange for the release of 150 Palestinian prisoners held by Israel.

Qatar, the lead mediator of the talks, said on Thursday the cease-fire in Gaza would begin at 7 a.m. local time Friday.

Here's what we know about the agreement:

• A four-day cease-fire would be the longest halt in fighting since Oct. 7. During the pause, women and children will be released over four days. Israel said that it would extend the cease-fire by a day for every 10 additional hostages released by Hamas. A pause would bring some measure of relief to Gaza's 2.2 million civilians, more than two-thirds of whom have been displaced and pushed to the limits of survival with diminishing supplies of food and water.

• Israel said 50 women and children would be freed in the "first stage" of the hostage release. The Israeli government had publicly taken a hard line on hostages, saying repeatedly that there would be no cease-fire until captives are released. One Israeli official said that some in the government had wanted all the hostages to be released at once. In closed-door talks, though, there appears to have been wiggle room in Israel's stance. Israel said that the agreement announced early Wednesday was the "first stage" toward its goal of bringing all the hostages home.

• Hamas said 150 Palestinian prisoners would be released and that more aid would be allowed into Gaza. Hamas had previously said it was seeking a full cease-fire and the release of all Palestinian prisoners from Israeli jails, and added as a new condition the delivery of fuel to Gaza's collapsing hospitals. On Wednesday, the group said in its statement that "a humanitarian truce" had been reached, pursuant to which hundreds of trucks with aid and fuel for humanitarian needs would be let into the territory during the cease-fire. It added that despite the truce, "Our hands will remain on the trigger."

• Hostages are expected to be released later Friday. Majed al-Ansari, a spokesman for Qatar's foreign ministry, told reporters that some hostages would be released starting at 4 p.m. on Friday.

Victoria Kim contributed reporting.

— Patrick Kingsley reporting from Jerusalem

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Hezbollah claimed responsibility on Monday for a powerful cross-border rocket attack on an Israeli military base, the latest sign that the Lebanese militia is ramping up its use of newer and more sophisticated weaponry as it tries to sap the strength of Israeli forces already fighting Hamas.

Although the Israeli military reported no casualties in the attack, footage from the scene verified by The New York Times showed damage to at least six buildings, with one entirely reduced to rubble and burning.

Hezbollah said it had struck the Biranit military base, the headquarters for the Israeli army's 91st Division, with two Burkan rockets — a powerful improvised munition that the group is increasingly using against Israeli forces. The group's leader, Hassan Nasrallah, has said the weapons can carry as much as 500 kilograms of explosives.

Video recorded from Lebanon that was released by Hezbollah and verified by The Times shows two munitions apparently hitting the base.

Mr. Nasrallah said during a speech earlier this month that his group intended to keep up the pressure on Israel by striking deeper into Israeli territory with newer and more advanced weapons. "There has been a quantitative improvement in terms of the number of operations and the type of weapon used," Mr. Nasrallah said.

Fabian Hinz, a research fellow for the International Institute for Strategic Studies with an expertise in missile proliferation in the Middle East, said that the use of the Burkan, which has a greater explosive payload than other weapons Hezbollah has used, represents an escalation.

"It is a heavier weapon that is being used," he said. But, he added, using the Burkan — which is short range and can only hit targets immediately across the border — may have less escalatory potential than using "longer-range rockets to conduct strikes deeper into Israel."

Hezbollah, which exercises de facto control over southern Lebanon, also claimed responsibility Monday for a separate Burkan rocket attack on another Israeli military base, as well as three strikes by exploding drones on Israeli soldiers near Kiryat Shmona, Israel's northernmost city.

The Israeli military said it had responded to the attacks by hitting Hezbollah operational command centers and infrastructure inside Lebanon. Photographs verified by The Times showed damage to Saint George Church in Yaroun, as well as a collapsed residential building in Khiam. In Mays al-Jabal, the home of a Lebanese lawmaker was also hit by an Israeli strike, according to the country's state-run news agency.

The strikes were the latest in a series of tit-for-tat exchanges that have grown increasingly severe since Oct. 7, when members of Hamas launched a deadly cross-border assault from Gaza.

After an Israeli drone strike killed a woman and three girls in southern Lebanon earlier this month, Hezbollah targeted Kiryat Shmona with a barrage of Grad rockets, the first time the group had deployed the weapon since the fighting began. Just over a week later, a group of Israeli electrical workers were struck by an anti-tank missile while working along the border, killing one person and injuring several others.

And on Saturday, Hezbollah claimed to have used a surface-to-air missile to down an Israeli Hermes 450 drone. The Israeli military said that a drone had been forced to make an "emergency landing" in northern Israel, and that they had responded by striking what they called an "advanced" surface-to-air missile system.

Video released by the Israeli military of the strike, and located by The Times, shows that it was carried out some 10 miles away from the border — further into Lebanon than much of the fighting so far.

"The Burkan is something new. Surface-to-air missiles are something new. The suicide drones are new," said Elias Hanna, a military analyst and former general in the Lebanese military. "They are using them to send a message — we have the firepower, and we have the will to use it."

Hwaida Saad contributed reporting from Beirut.

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A group of foreign ministers from Arab and Muslim-majority countries met with China's foreign minister in Beijing on Monday on the first stop of a tour aimed at building support to end the war in the Gaza Strip.

It was unclear how the ministers' tour may affect that conflict. China, unlike the United States, has little leverage over Israel, which has voiced "deep disappointment" over Beijing's relatively muted reaction to Hamas's attack in southern Israel on Oct. 7. Hamas gunmen killed about 1,200 people and took more than 200 hostage in the attack, according to Israeli authorities.

Six weeks after the assault, there is growing international pressure on Israel to pause fighting in Gaza to allow for more aid to enter the enclave. Israel's staunchest allies, including the United States, have urged the nation to do more to protect civilians. So far, Israel's military campaign has killed more than 12,000 people in Gaza, according to health authorities there.

After Beijing, the group will travel to "a number of capitals," Prince Faisal bin Farhan, the foreign minister of Saudi Arabia, told journalists in Manama, Bahrain, on Saturday. Their goal is to "deliver a clear message that there needs to be an immediate cease-fire and that humanitarian aid needs to enter Gaza immediately," he said. "We need to work to end this crisis and end this war being waged on Gaza as soon as possible."

On Monday, the delegation met with China's foreign minister, Wang Yi, China's state-run broadcaster reported. The delegation's talks in Beijing aimed to achieve "thoroughgoing communication and coordination to promote a cooling of the current Israeli-Palestinian conflict, protection of civilians and a just resolution of the Palestinian issue," the report said.

The delegation included officials from Saudi Arabia, Jordan, Egypt, Indonesia and the Palestinian Authority, China's foreign ministry said on Sunday.

Saudi Arabia and other Arab countries have attempted to deliver their message to the United States, Israel's main international backer. But senior Israeli and American officials have continued to reject calls for an unconditional cease-fire with Hamas. Instead, they have said that in order to institute "humanitarian pauses" — brief halts in the fighting — Hamas must release the more than 200 people it took captive during the attacks.

On Monday, President Xi Jinping of China sought to find common ground with the French president, Emmanuel Macron, in a phone call that included discussion of the fighting in Gaza. The official Chinese summary of their conversation issued by the Xinhua news agency said: "The two leaders agreed that it is imperative to avoid a further worsening of the Palestinian-Israeli situation, and in particular avoid the emergence of an even more serious humanitarian crisis."

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"My experience during childbirth was a nightmare in every sense of the word, or something like a horror film," said 29-year-old Wajiha al-Abyad.

Her contractions started at around 9 p.m. on Oct. 29. "We called for an ambulance, but they told us they couldn't come. The streets were empty and pitch-black, and there was no sound to be heard except for the noise of planes and shelling."

After about 40 minutes, an ambulance did turn up. It transported her at high speed through Deir Al-Balah, in the central Gaza Strip. "Most of the streets were badly damaged. I was stuck inside contending with contractions and jolts as the ambulance raced through ruined roads."

Women, children and newborns in Gaza are disproportionately bearing the burden of the war, both as casualties and in reduced access to health care services. The U.N. estimates there are around 50,000 pregnant women in Gaza, and that more than 160 babies are delivered every day.

In the space of a few weeks, Ms. al-Abyad's life had been turned upside down. She fled her home in Gaza City with many of her relatives on Oct. 14, after the Israeli military ordered over a million people to leave northern Gaza. She dreaded the idea of giving birth in these circumstances. "The tension and anxiety I felt were more painful than the contractions," she said.

Since the outbreak of the war, crossings into Gaza had been closed, making it impossible for her husband in the United Arab Emirates to be by her side. Instead, her mother joined her in the ambulance.

Together, they made it to Al-Awda Hospital in Nuseirat, around a 20-minute drive from their home. They found the hospital's maternity ward was no longer functioning: It had been repurposed to treat the large numbers of war casualties.

"There was a lot of tension and screaming, and the doctors were under extreme pressure," Ms. al-Abyad said. "Patients there were bleeding, and they didn't know what to do for them."

Less than an hour later, Ms. al-Abyad gave birth to a baby boy named Ahmed. "Every five minutes, there was shelling right outside the hospital, so close that mothers would hide their newborn babies under their clothes, afraid that the windows might shatter and the glass would fall onto them," she said.

"All I could think about was how will I leave? How will I go back home?"

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Early the next morning, mere hours after giving birth, she left the hospital with her mother and newborn son. They walked through the streets for over three hours before she was finally able to flag down a car. "I was just praying that we would reach our destination," she said.

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Palestinian health officials say more than 3,300 women and 5,000 children have been killed since the war in Gaza began. The territory has been under siege since Hamas led attacks in southern Israel on Oct. 7 that killed around 1,200 people, according to Israeli officials.

The bombardment, massive levels of displacement, collapsing water and electricity supplies — as well as restricted access to food and medicines — are severely disrupting maternal, newborn, and child health care. About two-thirds of the Gaza Strip's hospitals and primary care clinics are no longer functioning, according to the U.N. For weeks, Gazan Health Ministry officials have been warning of the health care system's collapse.

"The last time I was able to check on my baby's health was a month before the war started," said 24-year-old Noor Hammad, who is seven months pregnant. "I'm very concerned that I might lose my baby."

Ms. Hammad worked as a nutritionist before the war broke out. She fled her home in Deir Al-Balah after her apartment was bombed, and now works as a volunteer nurse at Nasser Hospital in Khan Younis for six hours a day. Like many Palestinians in Gaza, she's drinking dirty water and eating small amounts of processed canned food to survive. And she is worried about the consequences for her unborn child.

"These meals don't have any nutritional value for me or my baby," she says.

After giving birth, Ms. al-Abyad and her son Ahmed finally made it back to the apartment in Deir Al-Balah where they are staying with her mother, her 3-year-old son Taim, as well as her siblings, aunt and cousins — around 20 people in total. She says that, right now, Gaza is no place to raise a newborn.

"We're trying to get out of Gaza any way we can," she said. "I want to be in a place that's safer, where there's electricity, water and food. A place where children are respected."