JERUSALEM (AP) — Gaza’s Shifa Hospital has become the focus of a dayslong stalemate in Israel’s war against the Hamas militant group.

Shifa is Gaza’s largest and best-equipped hospital. Israel, without providing visual evidence, claims the facility also is used by Hamas for military purposes. It says Hamas has built a vast underground command complex center below the hospital, connected by tunnels, something Gaza health officials and Hamas deny.

After Hamas attacked Israel on October 7th, Israel declared war and has since taken control of Shifa. Although Israel claims they will let hospital staff and patients leave safely, Palestinians report that Israeli forces have shot at those trying to evacuate and it is too risky for the most critically ill patients to be moved. Additionally, doctors report that the hospital has run out of fuel and patients are starting to die.

Taking a more in-depth view of the Shifa standoff.

Shifa is the foremost medical facility within a healthcare system that has largely deteriorated due to years of conflict, consistent lack of funding, and an Israeli-Egyptian blockade intended to weaken Hamas.

Shifa Hospital in Gaza has a capacity of more than 500 beds and offers services such as MRI scans, dialysis, and an intensive care unit. According to the Health Ministry in the Hamas-controlled region, Shifa Hospital performs approximately 50% of all medical procedures in Gaza.

Following the outbreak of war, a large number of individuals sought refuge on the hospital premises. As the conflict has encroached upon the hospital, the majority of those seeking shelter have relocated to the south, along with about two-thirds of the region’s 2.3 million inhabitants who have abandoned their residences.

According to staff members, numerous individuals, such as healthcare professionals, premature infants, and other at-risk patients, are still present.

The hospital announced on Saturday that their final generator had depleted its fuel supply. Health authorities report that a minimum of 32 patients, including three infants, have lost their lives. They also warn that an additional 36 infants are in danger of perishing due to the inability of life-saving equipment to operate.

On Monday, the Health Ministry shared a photograph featuring approximately twelve premature infants swaddled in blankets on a bed to ensure their warmth. Medhat Abbas, a spokesman for the ministry, expressed his hope that these babies will survive despite the challenges facing the hospital.

During times of war, hospitals are granted special safeguards under international law. However, if armed individuals use hospitals to conceal fighters or store weapons, they may forfeit these protections as stated by the International Committee of the Red Cross.

However, adequate notice must be given in order to safely evacuate both personnel and patients. According to international law, any attack that causes excessive harm to noncombatants in relation to the intended military target is considered illegal.

Israel has frequently charged Hamas with utilizing innocent civilians as shields. The organization frequently launches rockets towards Israel from densely populated residential regions, and its soldiers have engaged in conflicts with Israeli forces within heavily inhabited neighborhoods.

During the war, Israel has shared images and video evidence claiming to depict weapons and military facilities located within or near mosques, schools, and hospitals.

On Monday evening, Rear Admiral Daniel Hagari, the main military spokesperson for Israel, presented a video of a supposed weapons storage belonging to Hamas that was discovered in the basement of Rantisi Hospital for Children in Gaza.

Hagari said he entered the hospital with Israeli troops on Monday, a day after the facility’s last patients were evacuated. The hospital ran out of fuel last week, and Israel had ordered people to leave as it conducts its ground offensive.

Hagari walked into a room adorned with a vibrant drawing of a tree created by children. The floor was scattered with various weapons such as explosive vests, automatic rifles, bombs, and rocket-propelled grenades, according to him.

He stated that Hamas employs hospitals as a tool of warfare.

He presented a separate location that he claimed may have been utilized for detaining captives.

The scene contained a quickly installed toilet and air vent, along with a baby bottle and a motorcycle. The motorcycle had a bullet hole and seemed to have been used for holding hostages. One of the rooms did not have windows and had curtains on the wall that could potentially be used as a background in a video. Hagari mentioned that forensic specialists were investigating the area.

Hagari stated that there are additional hospitals similar to this one in Gaza, and it is important for the world to be aware of this.

The military has stated that Hamas is active in both the Shifa area and underground in bunkers, with some even being accessible from the hospital. They also allege that following the Oct. 7 attack that killed at least 1,200 people in Israel, hundreds of Hamas fighters took refuge at Shifa.

According to Israel, these allegations are founded on intelligence. However, they have not provided any visual proof to back up the allegations. Last month, Hagari revealed maps displaying the locations of Hamas’ underground command centers as believed by Israel, which include one near the reception area of a hospital and another next to the dialysis department.

He also presented simulated images of the supposed appearance of these centers, but admitted: “This is just a representation.”

Israel has also shared a video in which a purported militant is seen answering questions while being interrogated. The individual, who appears to be under pressure and speaks in a hushed tone, reveals that the majority of tunnels are concealed within hospitals.

According to the militant, Shifa has underground levels and is a large location capable of concealing items.

The military has also made public an audio recording of two unidentified Palestinians in Gaza allegedly discussing a tunnel underneath Shifa. However, the authenticity of the recording could not be confirmed.

Senior Hamas leader Ghazi Hamad refuted Israeli allegations regarding Shifa, deeming them as “false and deceptive propaganda.”

Hamad stated that the occupying forces do not have any evidence to support their claim. He also emphasized that their religion, morality, and principles prohibit the use of civilians as human shields.

On Tuesday, Ashraf al-Qidra, a representative of the Health Ministry, stated that the invitation for international organizations to visit Shifa hospital has been extended multiple times, but no response has been received.

On Sunday, Israel attempted to transport approximately 300 liters (80 gallons) of fuel to the hospital in plastic containers located a few hundred meters (yards) away from the building. However, as of Monday, it seems that the fuel has not yet been collected.

The Palestinian Red Crescent was supposed to deliver the fuel, but hospital officials claim that there was not enough fuel and that Hamas prevented medical workers from retrieving it.

Israel provided a means for individuals to safely exit the area. However, those who attempted to leave reported a frightening ordeal.

A health care worker named Goudhat Samy al-Madhoun reported that approximately 50 individuals departed the establishment on Monday, including a female patient receiving kidney dialysis. According to al-Madhoun, Israeli forces shot at the group multiple times, injuring one man who could not continue with the others.

On Monday, President Joe Biden of the United States stated that the hospital needs to be safeguarded and urged for Israeli forces to take less invasive measures.

Biden expressed his hope and anticipation for less invasive measures in the Oval Office.

The Israeli military acknowledges the challenges involved, but maintains that Hamas cannot expect to be immune.

“We do not intend to gain authority over hospitals. Our goal is to dismantle their structure,” stated Lieutenant Colonel Richard Hecht, another spokesperson for the Israeli army.

“We will enter, complete our task, and depart,” he stated. “It is difficult to predict the outcome.”

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