To people in Gaza, Al Shifa is the biggest and most advanced hospital around — a lifeline, in normal times, and now a place of refuge from relentless Israeli airstrikes.

More than 60,000 people are sheltering there. But to the Israeli military, it is a threat, and, perhaps, a target.

On Friday, hours before the Israeli military stepped up its bombardment of Gaza in retaliation for Hamas’s mass killings of Israelis three weeks ago, it held a news conference in which it said that Al Shifa conceals underground command centers for Hamas — raising fears that the military was laying the groundwork for attacking the hospital.

Hamas “does its command and control in different departments of the hospital,” said Rear Adm. Daniel Hagari, the chief spokesman for the Israeli military, speaking in English and citing intelligence sources that he did not release. He displayed an illustrated map of the hospital marking what he said were several underground Hamas installations in the complex.

“This is where they direct rocket attacks, command Hamas forces,” he said at the news conference held in Tel Aviv.

He also played a recording of a call, whose origins he did not specify, in which an unidentified man tells a woman that Hamas’s military headquarters are below the hospital.

“God forbid!” the woman, who is also unnamed, replies in the audio recording.

Salama Marouf, the head of the Hamas-run Gaza government media office, denied the accusation in a news conference on Friday night, saying Israel had “failed to provide a single piece of evidence” supporting its claims about Al Shifa. He said the recording Adm. Hagari cited was “fabricated.”

Credit…Dawood Nemer/Agence France-Presse — Getty Images

On Saturday, Adm. Hagari said the news conference about the hospital was part of a continuing effort to “expose” Hamas’s “exploitation of the civilian population in the Gaza Strip.”

Also on Saturday, Israel released a pair of videos that it said showed Palestinian prisoners who had been “involved” in Hamas’s Oct. 7 raids on Israel speaking about Hamas’s use of Al Shifa.

“I know, for example, according to what I’ve heard, the Shifa Hospital, they’re using it, they’re hiding there,” says one, who describes himself in the video as a paramedic.

Israel has long viewed civilian infrastructure such as homes, malls and places of worship as legitimate targets for its strikes, saying Hamas runs operations in those kinds of places, using civilians as human shields.

Israel says that when attacking, it attempts to distinguish between civilians and combatants. Gaza’s health ministry has released the names of at least 1,500 children under the age of 10 who it says were killed in Israeli airstrikes from Oct. 7 to Oct. 26.

Smoke rising from northern Gaza after an Israeli airstrike on Saturday. On Friday evening, Israel made incursions into Gaza after launching an intense bombardment, with artillery and airstrikes, military officials said.Credit…Tamir Kalifa for The New York Times

Al Shifa’s usual capacity is 700 beds. But it is now housing more than 60,000 people — the wounded, those trying to care for them and tens of thousands more who have taken refuge there, believing that a hospital would offer them some protection.

The laundry of the displaced hangs out the windows and all along the metal fence around the hospital. Children run down the fluorescent-lit corridors. At night, people huddle together under colorful blankets, while the staff prepare for another day of treating patients without enough fuel, water or critical medications.

Among Al Shifa’s current patients are about 130 newborns who were orphaned just as they were born, according to doctors at Al Shifa.

When their pregnant mothers were pulled dead or dying from the rubble of buildings destroyed in Israeli airstrikes, obstetricians went to work, tugging the infants from their mothers’ bodies. Born premature, they were placed in incubators in Al Shifa’s neonatal intensive care unit.

Most of them are the only survivors in their families, according to Bisan Ouda, a Gazan journalist and filmmaker who filmed inside the hospital this past week and interviewed staff there in videos released by the U.N. Population Fund.


A doctor treating premature babies at Al Shifa Hospital said that many of the newborns were now orphaned.CreditCredit…Mohammed Al-Masri/Reuters

Dr. Ghassan Abu Sittah, a British-Palestinian plastic surgeon volunteering at Al Shifa’s burn treatment unit, told CNN on Oct. 24 that the hospital had coined a new designation, “wounded child with no surviving family,” to refer to more than 50 children who had by that point been pulled from the rubble and taken to Al Shifa.

“The amount of children I treated — they have not a single relative left,” he said in a separate interview with a Lebanese television journalist on Friday. “The father was killed, the mother also, and the brothers, aunts, uncles, grandfather and grandmother.”

He added: “It’s hard not to imagine your own children when you see these people’s children, as they suffer like this in this brutal way. Their only sin is being Palestinian.”

Iyad Abuheweila and Isabel Kershner contributed reporting.

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