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Israel has destroyed roads leading to the Gaza Strip's main hospitals after giving a final warning to the occupants to evacuate immediately.
The warning came amid heavy shelling overnight, mostly in the north, as Israeli troops press into the besieged enclave with ground assaults.
Israeli rockets landed near the hospital on Sunday evening, destroying roads and access, though the main building remains intact.
Air strikes hit areas near Gaza's Al Shifa Hospital, which is sheltering thousands of displaced Palestinians.
Chief military spokesman Rear Admiral Daniel Hagari on Monday said the military had killed dozens of militants overnight, without giving details of the location of ground forces.
The death toll among Palestinians has passed 8,000, mostly women and children, the Gaza Health Ministry said. More than 1.4 million people in Gaza have fled their homes.
Medical staff from Al Quds Hospital said they received the warning to evacuate at 9pm on Sunday.
Several senior staff members and nurses at the Palestinian Red Crescent-run Al Quds Hospital were called by Israeli forces, Mohammad Abu Sabbah, PRC spokesman in Gaza, told The National.
"One of [the calls] was to the head of the hospital from the Israeli army," he said.
The hospital official told the man that 14,000 civilians, 100 staff members and 110 people injured and recovering were sheltering in the building, as well as at least seven children in incubators and 10 people in the intensive care unit.
"An hour later, an area 40 metres away was hit in an air strike, causing damage to parts of the hospital and the evacuation of one of the wings to another part of the facility," he said.
Mr Abu Sabbah said 70 per cent of the people taking shelter in the hospital were women and children.
"And the number of people taking shelter goes up at night because they come in from the UNRWA schools nearby, which are no longer safe because the staff running these facilities have fled to the south of Gaza," he said.
Al Quds Hospital's general manager told The National people who had been discharged returned when the shelling began.
"It is unsafe for them to leave," he said.
Images on social media showed Israeli tanks advancing on a main road in Gaza.
An official from the International Committee of the Red Cross said there was concern over warnings directed at Al Quds, which is managed by the Palestine Red Crescent Society.
“The hospital is protected and relocating the significant numbers of injured, ill, those with mobility challenges, individuals in intensive care and others is not feasible,” ICRC Middle East's spokeswoman Jessica Moussan told The National.
The Palestinian Red Crescent said the hospital was overwhelmed, with about 500 patients and more than 12,000 displaced civilians seeking refuge.
“There are babies in incubators and individuals receiving oxygen,” she said. “A viable evacuation alternative is essential. Currently, no such option exists in Gaza.”
Faris Al Jawad, Doctors with Borders (MSF), communications manager, told The National that evacuating hospitals in Gaza is impossible for medical staff.
"Our staff are staying to provide life saving care in Al Quds and Al Shiffa hospitals," he said, adding that "It’s an impossible choice for our doctors to leave and choose their lives over the lives of the patients."
Mr Al Jawad said MSF continues to call for a ceasefire and for desperately needed supplies as basic necessities are running out.
"There is a huge shortage of medical supplies such as painkillers and morphine are really running low. Some surgeons and doctors have had to do amputations without proper anesthesia," he said.
During the last 24 hours, the Israeli military said it has targeted more than 600 Hamas fighters in the past few days amid expanded ground operations in the Gaza Strip.
About 20 Palestinians were killed in overnight clashes in Gaza with Israeli forces, Palestinian medical officials said.
Palestinian militants clashed with Israeli forces in a border area near the city of Khan Younis in the south, reports said.