Israeli soldiers raided Al-Shifa Hospital in Gaza early Wednesday morning, local time, looking for Hamas militants after giving Health Ministry officials a few minutes warning.
"Based on intelligence information and an operational necessity, IDF forces are carrying out a precise and targeted operation against Hamas in a specified area in the Shifa hospital," the Israel Defense Forces said in a statement. It urged all Hamas fighters to surrender.
The IDF said its forces consisted of "medical teams and Arabic speakers, who have undergone specified training to prepare for this complex and sensitive environment, with the intent that no harm is caused to the civilians."
The director-general of the Gaza Health Ministry, Dr. Munir al-Bursh, told Al Jazeera television that Israeli forces had raided the western side of the medical complex.
Earlier, the U.S. backed up Israel's claims that Hamas is using hospitals as cover for its fighters. Israel says Al-Shifa has a command center underneath it, something Hamas again denied.
Hamas says about 650 patients and 5,000-7,000 Palestinian civilians have taken shelter on the hospital grounds.
Hospital must be protected
Earlier Tuesday, U.S. President Joe Biden said hospitals in Gaza "must be protected" as Israeli forces continue to target health care facilities in the Palestinian enclave over claims Hamas is using them as cover to hide its command centers and weaponry.
The president was responding to reports of the worsening crisis at Al-Shifa hospital, Gaza City's main medical center, which has been surrounded and under siege by Israeli forces for several days.
National Security Council spokesperson John Kirby told reporters aboard Air Force One that Hamas and Palestinian Islamic Jihad members operate a command-and-control node from Al-Shifa and use tunnels underneath to support their military operations and hold hostages. He said the militants have stored weapons there and are prepared to respond to an Israeli military operation against that facility.
"Now to be clear, we're not supporting striking a hospital from the air, and we do not want to see a firefight in the hospital where innocent people, helpless people, sick people are simply trying to get the medical care that they deserve not to be caught in a crossfire," said Kirby on Tuesday, adding that the actions of Hamas "do not lessen Israel's responsibilities to protect civilians in Gaza."
United Nations Secretary-General Antonio Guterres said in a statement Tuesday that he is "deeply disturbed by the horrible situation and dramatic loss of life in several hospitals in Gaza."
"In the name of humanity, the secretary-general calls for an immediate humanitarian cease-fire," the spokesman said.
Out of fuel
Doctors Without Borders said bullets were fired Tuesday into one of three of its premises near the Al-Shifa facility, where more than 100 of its staff and family members have been staying. The group, which includes 65 children, said it ran out of food late Monday and has been asking the Israeli army and Hamas for safe passage away from the fighting.
The Palestinian Health Ministry said Monday that 32 patients there, including three infants, have died since the siege began due to the lack of electricity.
Doctors running low on supplies are reported to be performing surgery without anesthesia on war-wounded patients, including children. One medic shared a photo showing nine premature babies sharing a crib.
The Israeli military said Tuesday it will transfer incubators, which are used to keep premature newborn infants warm, from Israel to Al-Shifa hospital.
World Health Organization Director-General Tedros Adhanom Ghebreyesus said the medical center "is not functioning as a hospital anymore," and the situation at Gaza's largest hospital is "dire and perilous."
Al-Quds, another Gaza hospital, shut down Sunday after it ran out of fuel.
Israel says Hamas, a U.S.-designated terror group, is shielding itself among civilians at Al-Shifa Hospital and has a command center in and beneath the medical compound.
Israel has not provided photos or videos to back up its claims about Hamas militants at Al-Shifa, although it has shared footage of militants operating in residential neighborhoods and positioning rockets and weapons near schools and mosques.
Both Hamas and the hospital staff deny the Israeli allegations.
"It is my hope and expectation that there will be less intrusive action relative to the hospitals," Biden told reporters during an event in the Oval Office.
The president also said he believes hostages being held by Hamas militants in Gaza are going to be released, but he gave no timetable.
"I have been talking to people involved every single day," Biden told reporters at the White House. "I believe it is going happen, but I don't want to get into details."
He sent a message to the estimated 240 hostages being held by U.S.-designated terror group Hamas: "Hang in there. We are coming."
The U.S. says that among the hostages are nine Americans and a foreign national with U.S. employment rights.
Death toll
Palestinian authorities in Gaza say more than 11,000 people - about 40% of them children - have been killed since Israel launched a major air and ground offensive in response to the attack by Hamas militants on southern Israel on October 7 that left 1,200 people dead. About 240 people were kidnapped and are currently being held hostage by Hamas.
The United Nations humanitarian office said Tuesday that more than two-thirds of Gaza's population of 2.3 million have fled their homes since the war began.
The Israeli military on Tuesday confirmed the death of a 19-year-old soldier who was captured in the October 7 attacks.
The military wing of Hamas issued a video Monday of a woman who identified herself as Noa Marciano. She said she had been held in Gaza for four days and urged Israel to end the bombing campaign. The video then showed still images of the woman's lifeless, bloodstained body lying on a sheet. Hamas said she had been killed by Israeli airstrikes last Thursday.
Israel's military confirmed the video was of Marciano, who was attached to a unit deployed at the Israel-Gaza border.
The Israeli military said it has seized several government facilities in Gaza City, including the territory's legislature building, the Hamas police headquarters and a compound housing Hamas' military intelligence headquarters."In every location, the enemy forces were eliminated, the location was demolished," an Israeli commander said.
But as its military incursion advances, Israel has rejected growing and intense international pressure to impose a cease-fire to allow for the delivery of critically needed humanitarian aid to Gaza. But it has agreed to four-hour daily humanitarian pauses to allow the opening of two corridors to let Palestinians evacuate northern Gaza.
The NSC's Kirby said Tuesday that in the past 24 hours around 115 more trucks carrying humanitarian aid were able to enter Gaza, bringing the total to 1,100.