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Gaza's hospitals have become battlegrounds once again as Israeli forces conduct deadly raids on hospitals where civilians are sheltering and patients are unable to access vital treatment with no fully functioning hospitals left in the enclave.
Israeli forces currently occupy Al Shifa Hospital after storming it on March 18, having previously besieged the complex in November, and have also recently raided Al Amal Hospital in the south.
These military operations in and around hospitals are "making an already tense situation even worse," said Arvind Das, Gaza Team Lead at the International Rescue Committee.
"Israeli attacks have injured more than 73,000 Palestinians in Gaza in just five months, including people with life-changing injuries, while simultaneously systematically dismantling the health system, leaving only 12 hospitals partially functioning and no fully functioning hospitals in Gaza," he said.
At least 170 people have been killed in the latest Israeli raid on Al Shifa in Gaza city, while in Al Amal Hospital in Khan Younis, more than 20 people have been killed. Dozens more have been injured and hundreds arrested across both facilities.
Israel accuses Hamas and Palestinian Islamic Jihad of using hospitals as military bases. The Israeli military claims it has apprehended hundreds of "terrorists" and killed dozens more inside both the Al Shifa and Al Amal hospitals.
Israeli army spokesman Admiral Daniel Hagari has accused members of Hamas of firing at Israeli forces from inside Al Shifa Hospital's emergency and maternity wards.
The Hamas-run government media office said they "categorically refute this".
"How can they claim this while their soldiers roam and frolic inside the complex with ease, conducting interrogations with displaced persons, patients, and the wounded," said the media office director Ismail Al Thawabta.
People inside Al Shifa and Al Amal say people are dying of hunger there. Eyewitnesses in Al Shifa said civilians, including medical staff, had been killed.
At least five people trapped in Al Shifa have died due to lack of treatment, food, water and the lack of power in the intensive care units, the Palestinian state news agency Wafa reported.
Witnesses have also accused the Israeli military of detaining, stripping, and beating detainees during the raids on hospitals.
Speaking to the Euro-Mediterranean Human Rights Monitor (Euromed), an eyewitness said Israeli soldiers "detained me and handcuffed me in the hospital courtyard", leaving him "undressed for more than nine hours".
He said he saw Israeli soldiers bring detainees to the hospital morgue, then heard gunshots, and then saw the soldiers emerge without the prisoners.
The Palestinian Red Crescent (PRCS), which runs Al Amal Hospital in Khan Younis, said at least two of its members were killed, and that those remaining inside the hospital include a displaced family with children with special needs.
"All of our teams are in extreme danger at the moment and are completely immobilised," it said, adding that PRCS members are unable to bury their colleagues in the hospital's backyard.
Nine patients and 10 of their staff remain inside the facility, the Red Crescent said.
The sieges and raids on hospitals are having ripple effects on other already overstretched facilities, rights groups said.
Following Israel's raid on Al Nasser Hospital in Khan Younis, more casualties have been taken to the European Gaza Hospital (EGH).
Anaesthetist Dr Konstantina Ilia Karydi said the European Hospital already has 22,000 people displaced from other parts of Gaza. She said people are dying due to infections in the overcrowded hospital and the inability to provide post-operative care.
"This is due to the intense security situation that forced healthcare workers to evacuate hospitals and hindered their access," she said.
Restrictions placed by Israel on the aid entering Gaza have also left doctors unable to deal with the types of injuries associated with war.
Orthopaedic surgeon Dr Husam Basheer said he could not perform a standard plate and screw procedure for bone fixation because of a lack of equipment.
"Sometimes we’ve also lacked gauze, which is a basic supply for surgery," he said.
Earlier this month, UNRWA's Commissioner General Philippe Lazzarini said an entire lorry load of aid was returned because it contained scissors used in children's medical kits.
As of March 3, Israel had conducted more than 400 attacks on healthcare facilities and personnel in Gaza since October 7, the World Health Organisation said (WHO) in a situation report.
This means "every single hospital has been impacted," the International Rescue Committee said.
