On war's 37th day, hospitals run out of fuel, civilians continue to flee the fighting, while Israel's security minister hints at occupation of enclave

Thousands of people remain trapped at Gaza's largest hospital, al-Shifa, on Sunday as Israeli forces continue to besiege and bombard the facility for the third day in a row, while a nearby hospital announced it was out of service due to the lack of fuel. 

As of Sunday evening, 22 hospitals and 49 medical centers have completely stopped working in Gaza, due to Israeli bombing and the severance of all fuel and electricity in the Strip since 9 October, a Palestinian government spokesperson said in a press conference from Gaza's Deir al Balah." Israeli forces have targeted the intensive care unit in the al-Shifa hospital, they have also destroyed the maternity ward and the operating room," he said, while updating the number of Palestinians killed since the beginning of hostilities on 7 October to 11,180 people. 

He added that Israeli bombings have also ignited a fire in one of the wards of the hospital, while an oxygen tank was destroyed. "Some doctors have been targeted and wounded while moving around inside the hospital. One person was wounded in the back of the neck." 

Gaza's government media office also stated that Israeli forces have fully destroyed seven mosques and three churches, while 153 mosques have been partially destroyed in bombings. Meanwhile, Palestinian health minister Mai al-Kaila said on Sunday that Israeli forces were "not evacuating people", but rather "forcing wounded patients onto the streets, leaving them to face inevitable death". 

According to the minister, this amounts to "expulsion under the threat of arms". She also noted that there was a "catastrophe unfolding" in all of Gaza's hospitals, with patients dying without being able to be treated.

Some of the worst-affected are those with kidney failure, who have not been able to undergo dialysis, she said. The minister also said that there are 3,000 cancer patients at the Rantisi and Turkish hospitals who face imminent death, while pregnant women were also in danger.

"All pregnant women, especially those with high-risk pregnancies, are now in imminent danger as they cannot find anyone to provide them with medical care and services in Gaza. Every woman about to give birth will find no medical assistance," she said. 

Likewise, a nurse who works in the maternity ward of al-Sahaba hospital in Gaza City told Middle East Eye it was forced to close the end of last week due to the lack of fuel. It was the last maternity ward in Gaza City, which means that pregnant women will not be able to undergo caesarean surgeries.

"There is no place where pregnant women can currently go to give birth. No maternity hospital or clinic is open now," Aya Muhammed, the 25-year-old nurse, told MEE.

"We expect that dozens of pregnant women will die as they will be forced to give birth alone at home."

Eyewitnesses told Middle East Eye that husbands and relatives of pregnant women who are expected soon to give birth roam their neighborhoods in search of doctors living or taking refuge nearby to help them give birth at home.

On Sunday morning, Israeli forces besieging al-Shifa hospital bombed its maternity ward, killing at least three nurses.

"A colleague nurse living in Tal al-Hawa street [southwest of Gaza City] told me she watched multiple bodies of people killed on the street from her window. No one could retrieve or approach them," Muhammed said.

"Those who were injured were left to bleed to death as Israeli snipers were directly shooting at anyone trying to approach them. We are watching the patients and wounded die while we can do nothing to save their lives."

Palestinian health officials say at least seven patients on life support have died since the siege on al-Shifa started on Friday, including two babies. Their deaths were the result of ventilators and infant incubators failing to work due to lack of electricity.

On Sunday morning, the Palestinian health ministry's director-general in Gaza, Dr Munir al-Borsh, told reporters that around 40 displaced people in the hospital attempted to leave through the main gate but were shelled by an Israeli tank stationed on the adjacent road.

Their bodies remained strewn on the street, as ambulance and staff, who were less than 100 meters away, could not get to them as Israeli forces shot at anyone who moved. 

Borsh said that Israeli forces also bombed the water wells in the medical complex overnight. Only one well was operating on Sunday, providing the equivalent of 12 cups of water per hour for 15,000 people trapped inside. 

The intensive care unit was hit again after being struck 24 hours earlier, he said.

WHO loses contact with staff at al-Shifa

The World Health Organization (WHO) said on Sunday morning that it has lost communication with its contacts at al-Shifa hospital.

"WHO has grave concerns for the safety of the health workers, hundreds of sick and injured patients, including babies on life support and displaced people who remain inside the hospital," the organization said.

"Patients seeking health care should never be exposed to fear, and health workers who have taken an oath to treat them should never be forced to risk their own lives to provide care."

WHO added that there have been reports that some people who fled the hospital have "been shot at, wounded and even killed".

Palestinians arrive south of Gaza City on 12 November 2023, after fleeing their homes there and in the northern Gaza Strip  (AFP)

Meanwhile, the Palestinian Red Crescent (PRCS) announced on Sunday that al-Quds hospital in Gaza is now out of service after running out of fuel.

"The cessation of services is due to depletion of available fuel and power outages," the PRCS said in a statement.

"Medical staff are making every effort to provide care to patients and the wounded, even resorting to conventional medical methods amid dire humanitarian conditions and a shortage of medicine, food and fuel."

The PRCS said it had tried to reach out for humanitarian assistance from the international community, a day after al-Shifa hospital said it would be suspending services.

Israeli military officials have been speaking against al-Shifa hospital since the beginning of hostilities, claiming it is being used for military purposes, but have not provided evidence to substantiate the claim.

Palestinian officials and armed factions have denied the accusation, and Human Rights Watch said it found no evidence to corroborate the Israeli claim. 

Mads Gilbert, a Norwegian doctor who worked for 16 years at the hospital, said he never encountered any sign of a "military command center" there. 

Meanwhile, the Israeli rights group Physicians for Human Rights said that even if hospitals are used by armed groups, Israel "still has the obligation to avoid harming them".

Since the onslaught against Gaza was launched on 7 October, of the 11,180 Palestinians killed  by Israeli air strikes, more than 4,500 were children, 3,000 were women and 200 were health workers. 

In Israel, Palestinian-led attacks on 7 October have left around 1,200 people dead, including at least 31 children, according to Israeli officials cited by Israeli media.