As Fighting Empties North Gaza, Humanitarian Crisis Worsens in South

DEIR AL-BALAH, Gaza Strip (AP) -- About 200,000 Palestinians have streamed out of northern Gaza toward worsening conditions in the south in recent days, a U.N. agency said Tuesday, as Israeli troops battled militants around hospitals where patients, newborns and medics are stranded with no electricity and dwindling supplies.

Only one hospital in the north is now capable of receiving patients, according to the U.N. humanitarian office known as OCHA. None of the others are able to function, including Gaza's largest, Shifa, which is surrounded by Israeli troops and and where the lives of dozens of patients, including newborns, are at risk.

The Health Ministry in the Hamas-run territory proposed Tuesday that the facility be evacuated under the supervision of the Red Cross.

The war, now in its sixth week, was triggered by Hamas' surprise attack into Israel, in which militants killed hundreds of civilians and dragged some 240 hostages back to Gaza. The war has killed thousands of Palestinian civilians and wreaked widespread destruction on the impoverished enclave.

DETERIORATING CONDITIONS IN THE SOUTH

Israel has urged civilians to evacuate Gaza City and surrounding areas in the north, but the southern part of the besieged territory is not much safer. Israel carries out frequent airstrikes throughout Gaza, hitting what it says are militant targets but often killing women and children.

U.N.-run shelters in the south are severely overcrowded, with an average of one toilet for 160 people. In all, some 1.5 million Palestinians, more than two thirds of Gaza's population, have fled their homes.

People stand in line for hours for scarce bread and brackish water. Trash is piling up, sewage is flooding the streets and taps run dry because there is no fuel, which is required to produce the electricity that powers water systems. Israel has barred fuel imports since the start of the war, saying Hamas would use it for military purposes.

The onset of rainy, cold weather added to the misery. At a tent camp outside a hospital in the central town of Deir al-Balah, people trudged through mud as they stretched plastic tarps over flimsy tents.

"All of these tents collapsed because of the rain," said Iqbal Abu Saud, who had fled Gaza City with 30 of her relatives. "How many days will we have to deal with this?"

The U.N. agency for Palestinian refugees, which is struggling to provide basic services to over 600,000 people sheltering in schools and other facilities in the south, said it may run out of fuel by Wednesday, forcing it to halt most aid operations. It said it was unable to continue importing limited supplies of food and medicine through Egypt's Rafah crossing, Gaza's only link to the outside world.

PLIGHT OF HOSPITALS

With Israeli forces fighting Palestinian militants in the center of Gaza City, both sides have seized on the plight of hospitals.

Israel accuses Hamas of using hospitals as cover for its fighters, and alleged that the militants have set up its main command center in and beneath Shifa. Israel says these claims are based on intelligence but has not provided visual evidence to support them.

Both Hamas and Shifa Hospital staff deny the allegations, and the Health Ministry says it has invited international organizations to investigate the facility.

On Monday, the military released footage of a children's hospital that its forces entered over the weekend, showing weapons it said it found inside, as well as rooms in the basement where it believes militants were holding hostages. The video showed what appeared to be a hastily installed toilet and ventilation system in the basement.

The Health Ministry rejected the allegations, saying the area had been turned into a shelter for displaced people.

For weeks, Shifa staff members running low on supplies have performed surgery on war-wounded patients, including children, without anesthesia and using vinegar as antiseptic. After the weekend's mass exodus, a few thousand people remain.

The Health Ministry said 40 patients, including three babies, have died since its emergency generator ran out of fuel Saturday. The military said it placed fuel several blocks from Shifa, but Hamas militants prevented staff from reaching it. The ministry disputed that -- and added that the amount was paltry compared to the hospital's needs.

According to the ministry, 36 babies remain who are at risk of dying because there is no power for incubators.

The Israeli military said it had started an effort to transfer incubators to Shifa. Christian Lindmeier, a spokesman for the World Health Organization, said incubators would be useless without electricity and that the only way to save the newborns was to move them out of Gaza.

"Another hospital under siege or under attack is not a viable solution. Nowhere is safe in Gaza right now," he told The Associated Press. He said an evacuation would require specialized equipment and a cease-fire along the route.

Ashraf al-Qidra, a spokesman for the ministry, said Tuesday it has proposed evacuating the hospital with the supervision of the International Committee of the Red Cross and transferring the patients to hospitals in Egypt, but has not received any response. He said 120 bodies will be buried in a mass grave inside the hospital because they are unable to safely transport them to cemeteries.

International law gives hospitals special protections during war. Hospitals can lose those protections if combatants use them to hide fighters or store weapons, but staff and patients must be given plenty of warning to evacuate, and the harm to civilians cannot be disproportionate to the military objective.

The Red Cross tried Monday to evacuate some 6,000 people from another Gaza City hospital, Al-Quds, but said its convoy had to turn back because of shelling and fighting.

As of last Friday, more than 11,000 Palestinians, two-thirds of them women and minors, have been killed since the war began, according to the Health Ministry, which does not differentiate between civilian and militant deaths. About 2,700 people have been reported missing.

Health officials have not updated the toll since then, citing the difficulty of collecting information.

At least 1,200 people have died on the Israeli side, mostly civilians killed in the initial Hamas attack. The military says 46 soldiers have been killed in ground operations in Gaza, and that thousands of militants have been killed.

About 250,000 Israelis have evacuated from communities near Gaza, where Palestinian militants still fire barrages of rockets, and along the northern border, where Israel and Lebanon's Hezbollah militant group have repeatedly traded fire.

The war has also fueled tensions in the Israeli-occupied West Bank, where at least seven Palestinian were killed overnight during an Israeli raid, the Palestinian Health Ministry said Tuesday. There was no immediate comment from the army. More than 190 Palestinians have been killed in the West Bank since Oct. 7.