Gaza's main hospital goes dark in intense fighting as Israel's attacks put it at odds with allies

DEIR AL-BALAH, Gaza Strip (AP) — Israeli troops and Hamas gunmen battled Saturday outside Gaza 's largest hospital where frantic doctors said the last generator had run out of fuel, causing the death of a premature baby and four other patients. Thousands of war-wounded, medical staff and displaced civilians were caught in the fighting.

In recent days, fighting near Shifa and other hospitals in northern Gaza has intensified and supplies have run out. The Israeli military has alleged, without providing evidence, that the militant group Hamas has established command posts in and underneath hospitals, using civilians as human shields. Medical staff at Shifa have denied such claims and accused Israel of harming civilians with indiscriminate attacks.

Shifa hospital director Mohammed Abu Selmia said the facility lost power Saturday.

“Medical devices stopped. Patients, especially those in intensive care, started to die," he said by phone, with gunfire and explosions in the background. He said Israeli troops were “shooting at anyone outside or inside the hospital” and prevented movement between buildings.

An Israeli officer, Col. Moshe Tetro, confirmed clashes outside the hospital but denied Shifa was under siege or direct attack. He said he was in touch with the director and had offered safe passage for those willing to leave through the hospital's east side.

Amos Yadlin, a former head of Israeli military intelligence, told broadcaster Channel 12 that as Israel aims to crush Hamas, taking control of the hospitals would be key but require "a lot of tactical creativity,” without hurting patients, other civilians and Israeli hostages.

Five patients died at Shifa after the generator shut down, including a premature baby, said Medhat Abbas, a Health Ministry spokesman.

The “unbearably desperate situation” at Shifa must stop now, the director general of the International Committee of the Red Cross, Robert Mardini, said on social media. U.N. humanitarian chief Martin Griffiths posted that “there can be no justification for acts of war in health care facilities, leaving them with no power, food or water."

Elsewhere, the Palestinian Red Crescent said Israeli tanks were 20 meters (65 feet) from al-Quds hospital in Gaza City’s Tal al-Hawa neighborhood, causing “a state of extreme panic and fear" among the 14,000 displaced people sheltering there.

Prime Minister Benjamin Netanyahu said the responsibility for any harm to civilians lies with Hamas, repeating long-standing allegations that the militant group uses civilians in Gaza as human shields. He said that while Israel has urged civilians to leave combat zones, “Hamas is doing everything it can to prevent them from leaving.”

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His statement came after French President Emmanuel Macron pushed for a cease-fire and urged other leaders to join his call, telling the BBC there was “no justification” for Israel's ongoing bombing.

Israel's military has said soldiers have encountered hundreds of Hamas fighters in underground facilities, schools, mosques and clinics during fighting in Gaza. Israel has said a key goal of the war is to crush Hamas, a militant group that has ruled Gaza for 16 years.

Following Hamas' deadly Oct. 7 attack on Israel, in which at least 1,200 people were killed, Israel's allies have defended the country's right to protect itself. But now into the second month of war, there are growing differences in how many feel Israel should conduct its fight.

The U.S. has been pushing for temporary pauses that would allow for wider distribution of badly needed aid to civilians in the besieged territory where conditions are increasingly dire. However, Israel has only agreed to brief daily periods during which civilians can flee the area of ground combat in northern Gaza and head south on foot along the territory’s main north-south artery.

Since these evacuation windows were first announced a week ago, more than 150,000 civilians have fled the north, according to U.N. monitors. On Saturday, the military announced a new evacuation window, saying civilians could use the central road and a coastal road.

On the main road, a stream of people fled southward, clutching children and bags, many on foot and some on donkey-drawn carts. One man pushed two children in a wheelbarrow.

“I am diabetic, and I have blood pressure issues. Where to go, and what do they want from us?” said Yehia al-Kafarnah, a resident fleeing south.

Palestinian civilians and rights advocates have pushed back against Israel’s portrayal of the southern evacuation zones as “relatively safe,” noting that Israeli bombardment has continued across Gaza, including airstrikes in the south that Israel says target Hamas leaders but that have also killed women and children.

Saudi Arabia hosted Muslim and Arab leaders Saturday in Riyadh with the aim of devising their own cohesive strategy on Gaza. Iran’s President Ebrahim Raisi called on them to end cooperation, including trade, with Israel.

“The sole solution to the Palestinian cause is resistance,” he told the gathering.

Demonstrations and outrage continued. Police said 300,000 Palestinian supporters marched peacefully in London, the largest such event there since the war started. Right-wing counterprotesters clashed with police.FEAR GROWS INSIDE SHIFA

Thousands of civilians had been sheltering in the Shifa compound in recent weeks, but many fled Friday after several nearby strikes in which one person was killed and several were wounded.

“Shelling and explosions never stopped,” said Islam Mattar, one of thousands sheltering at Shifa. “Children here are terrified from the constant sound of explosions and the scenes they are watching.”

Abbas, the Health Ministry spokesman, told the satellite television channel Al Jazeera that there are still 1,500 patients at Shifa, along with 1,500 medical personnel and between 15,000 and 20,000 people seeking shelter.

Thousands have fled Shifa and other hospitals that have come under attack, but physicians said it's impossible for everyone to get out.

“We cannot evacuate ourselves and (leave) these people inside," a Doctors Without Borders surgeon at Shifa, Mohammed Obeid, was quoted as saying by the organization.CASUALTIES RISE

More than 11,070 Palestinians, two-thirds of them women and minors, have been killed since the war began, according to the Health Ministry in Hamas-controlled Gaza, which does not differentiate between civilian and militant deaths. About 2,700 people have been reported missing and are thought to be possibly trapped or dead under the rubble.

The Hamas-run Interior Ministry said six people were killed early Saturday in a strike on the Nuseirat refugee camp that hit a house. The camp is in the southern evacuation zone.

At least 1,200 people have been killed in Israel, mainly in the initial Hamas attack, and 41 Israeli soldiers have been killed in Gaza since the ground offensive began, Israeli officials say.

Nearly 240 people abducted by Hamas from Israel remain captive.

About 250,000 Israelis have been forced to evacuate from communities near Gaza and along the northern border with Lebanon, where Israeli forces and Hezbollah militants have traded fire repeatedly.

“Hezbollah is dragging Lebanon into a possible war," Israeli Defense Minister Yoav Gallant said after meeting with soldiers stationed along the border.

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Mroue reported from Beirut. Associated Press writers Julia Frankel in Jerusalem, Samy Magdy in Cairo and Baraa Anwer in Riyadh, Saudi Arabia, contributed to this report.