The Japan Times - MSF doctor warns of 'inhuman' conditions in main Gaza hospital

Israel argues its Hamas enemies built their military headquarters under the Al-Shifa hospital complex -- a charge Hamas denies -- while UN agencies and doctors in the facility warned a lack of generator fuel was claiming lives, including infants.

Witnesses reported intense air strikes, with tanks and armoured vehicles just meters from the gate of the sprawling Al-Shifa compound at the heart of Gaza City, now an urban war zone.

"The situation is very bad, it is inhuman," a surgeon with Doctors Without Borders (MSF), the medical charity group, wrote on social media.

"We don't have electricity. There's no water in the hospital," added the doctor, who was not named.

The Hamas government's deputy health minister Youssef Abu Rish said the death toll inside Al-Shifa rose to 27 adult intensive care patients and seven babies since the weekend as the facility suffered fuel shortages.

Gaza has been reliant on generators for more than a month after Israel cut off power supplies following the October 7 attack and the besieged territory's only power plant ran out of fuel.

A lack of fuel was also hitting the UN agency for Palestinian refugees UNRWA. The group's Gaza chief Thomas White said operations "will grind to a halt in the next 48 hours as no fuel is allowed to enter" the territory.

The World Health Organization in the Palestinian territories said early Monday that at least 2,300 people -- patients, health workers and people fleeing fighting -- were inside the crippled Al-Shifa facility.

The Israeli army pushed on with their campaign, determined to destroy the movement whose gunmen it says killed at least 1,200 people, mostly civilians, and took about 240 hostages in the country's worst ever attack when they stormed across the militarised border from Gaza.

Israel said 44 of its troops have been killed in its Gaza ground operation.

But Israel is facing intense international pressure to minimise civilian suffering amid its massive air and ground operations that Hamas authorities say have killed 11,180 people, including 4,609 children.

Israel's top diplomat, as quoted by his spokesman, said the nation has "two or three weeks until international pressure really steps up."

Foreign Minister Eli Cohen added that Israel is working to "broaden the window of legitimacy, and the fighting will carry on for as long as necessary."

- Fear of regional conflict -

The Israel Defense Forces on Monday reported more heavy fighting and again stressed its claim that Hamas was hiding in civilian infrastructure.

"IDF troops are continuing to conduct raids... targeting terrorist infrastructure located in central governmental institutions in the heart of the civilian population, including schools, universities, mosques and residences of terrorists," it said.

Teams of Israeli troops ran between jagged ruins in Gaza while air strikes shown on grainy military-released video shattered buildings.

Israel's Prime Minister Benjamin Netanyahu has said Hamas must first release the hostages before any ceasefire would be considered, but he told US media on Sunday that "there could be" a potential deal.

Israelis are stunned by the October 7 attack and worried for the fate of the captives, whose families plan to deliver a letter at the UN headquarters in Jerusalem seeking action.

The war in Gaza has also spurred concerns of a wider regional conflict.

At least eight pro-Iran fighters were killed in US strikes on eastern Syria, a war monitor said, in response to attacks on American forces.

It was the third time in less than three weeks that the US military has targeted locations in Syria, amid a spike in attacks on American forces in the Middle East linked to the Israel-Hamas war.

- International concern -

International attention has focused on the plight of Palestinians, and protests have been held worldwide in solidarity with the 2.4 million under bombardment and near-total siege for more than five weeks.

About 980 trucks carrying humanitarian aid have been let into Gaza since October 21, according to the UN humanitarian agency.

Before the war, 500 trucks entered every day, it said.

Palestinian prime minister Mohammad Shtayyeh called on the European Union and the United Nations to "parachute aid" into Gaza.

Fuel is a crucial need, especially for hospital generators, but Israel has been concerned that any fuel deliveries could be diverted to Hamas militants.

Palestinians in Gaza's south have been forced to adapt to the lack of basic resources.

"People are using now (traditional) ovens in order to cook. What else can they do?" said a woman, who asked not to be named, making the ovens in southern Khan Yunis.

Almost 1.6 million people -- about two-thirds of Gaza's population -- have been internally displaced since October 7, according to UNRWA.

Some people were being allowed to leave the besieged territory via the Egypt-controlled Rafah crossing and on Monday more than 550 foreigners passport holders and nine wounded Palestinians wounded and companions crossed.

The area of fighting "currently includes the area surrounding the Al-Shifa hospital but not the hospital itself", an IDF spokesperson told AFP.

The Israeli army also said its ground soldiers had hand-delivered 300 litres (80 gallons) of fuel near the hospital "for urgent medical purposes".

Al-Shifa director Abu Salmiya said he told Israeli authorities he needed far more -- at least 8,000 litres to run the main generators and "save hundreds of patients and wounded, but they refused".

AFP was unable to independently verify his account or Israel's claim that Hamas forbade the hospital from taking the fuel.

H.Nakamura--JT