KHAN YOUNIS, Gaza Strip -- Health officials said 31 premature babies in "extremely critical condition" were transferred safely Sunday from Gaza's main hospital and will go to Egypt, while over 250 patients with severely infected wounds and other urgent conditions remained stranded days after Israeli forces entered the compound to look for Hamas operations there.
The plight of the babies, along with Israeli claims against Shifa Hospital, have become potent symbols in the devastating war between Israel and Hamas. An Israeli offensive has taken a heavy toll on Palestinian civilians, while Israel has accused Hamas of using Shifa and other hospitals as headquarters for military operations.
The newborns from the hospital, where power was cut and supplies ran out while Israeli forces battled Palestinian militants outside, were receiving urgent care in the southern Gaza city of Rafah. They had dehydration, hypothermia and sepsis in some cases, said Mohamed Zaqout, director of Gaza hospitals. Four other babies died in the two days before the evacuation, he said.
A World Health Organization team that visited Shifa for an hour Saturday said hospital corridors were filled with medical and solid waste, increasing the risk of infection for patients who were "terrified for their safety and health and pleaded for evacuation." Twenty-five staff stayed behind.
The U.N. agency said the vast majority of patients had amputations, burns or other trauma, and many wounds were severely infected, with antibiotics unavailable. Missions were being planned to evacuate the remaining people to southern Gaza in the next 24-72 hours, "pending guarantees of safe passage," the WHO said.
Later Sunday, Israel's army said it had strong evidence supporting its claims that Hamas maintains a sprawling command post inside and under Shifa. Israel has portrayed the hospital as a key target in its war to end Hamas' rule in Gaza, following the militant group's wide-ranging attack into southern Israel six weeks ago.
The army said it found a 60-yard tunnel about 33 feet under the hospital's 20-acre complex, which includes several buildings, garages and a plaza. It said the tunnel included a staircase, blast-proof door and a firing hole that could be used by militants.
The Associated Press could not independently verify Israel's findings, which included security camera video showing what the military said were two foreign hostages, one Thai and one Nepalese, taken to the hospital following the Oct. 7 attack.
The army also said an independent medical report had determined that a female Israeli soldier, Cpl. Noa Marciano, whose body was recovered in Gaza last week , had been killed by Hamas in the hospital. Marciano had earlier been injured in an Israeli strike Nov. 9 that killed her captor, according to Israel's intelligence assessment. The injuries were not life-threatening, but she was then killed by a Hamas militant in Shifa, the army said.
Hamas and hospital staff earlier denied the claims of a command post under Shifa. Critics describe the hospital as a symbol of what they call Israel's reckless endangerment of civilians. Thousands in Gaza have been killed in Israeli strikes, and there are severe shortages of food, water, medicine and fuel in the besieged territory.
Senior Hamas official Osama Hamdan dismissed the Israeli military's announcement and did not deny that Gaza has hundreds of miles of tunnels. However, he said, "the Israelis said there was a command and control center, which means that the matter is greater than just a tunnel."
About 1,200 people have been killed on the Israeli side, mainly civilians during the Oct. 7 attack in which Hamas dragged some 240 captives back into Gaza. The military says 63 Israeli soldiers have been killed.
Hamas has released four hostages, Israel has rescued one and the bodies of two were found near Shifa.
Israeli Prime Minister Benjamin Netanyahu's office said the three-member war cabinet would meet with representatives of the hostages' families this evening.
HEAVY FIGHTING IN THE NORTH
Heavy clashes were reported in the built-up Jabaliya refugee camp in northern Gaza. "There was the constant sound of gunfire and tank shelling," Yassin Sharif, who is sheltering in a U.N.-run hospital there, said by phone.
The commissioner-general of the U.N. agency for Palestinian refugees, Philippe Lazzarini, said 24 people were killed the day before in what witnesses described as an Israeli airstrike on a U.N.-run school in Jabaliya. The Israeli military, which has repeatedly called on Palestinians to leave northern Gaza, said only that its troops were active in the area "with the aim of hitting terrorists."
"This war is having a staggering and unacceptable number of civilian casualties, including women and children, every day. This must stop," U.N. Secretary-General Antonio Guterres said in a statement on that strike and another on a U.N.-run school within 24 hours.
More than 11,500 Palestinians have been killed in Gaza, according to Palestinian health authorities. Another 2,700 have been reported missing, believed buried in rubble. The count does not differentiate between civilians and combatants; Israel says it has killed thousands of militants.
Attacks by Israeli forces and settlers have killed 215 Palestinians in the West Bank since the war began, according to Palestinian health officials.
COLDER WEATHER ARRIVING
More than two-thirds of Gaza's population of 2.3 million have fled their homes. The U.N. agency for Palestinian refugees, or UNRWA, is struggling to provide basic services to hundreds of thousands of displaced people. Seventeen of its facilities have been directly hit, the agency said.
Their misery has worsened in recent days because of cold winds and driving rain.
Over the weekend, Israel allowed UNRWA to import enough fuel to continue humanitarian operations for another couple of days and to keep internet and telephone systems running. Israel cut off all fuel imports at the start of the war, causing Gaza's sole power plant and most water treatment systems to shut down.
Defense Minister Yoav Gallant on Saturday gave the clearest indication yet that the military plans to expand its offensive to the south, where Israel has told Palestinian civilians to seek refuge. Israel has repeatedly struck what it says are militant targets across the south, often killing civilians.
Palestinian-Canadian Khalil Manaa, 71, left Gaza for Egypt on Sunday. After fleeing to southern Gaza, he said he and relatives shared a crammed home of 40 people. "And there, we also were subjected to intense strikes. ... A rocket hit our house," he said.
The evacuation zone is already crowded with displaced civilians, and it was not clear where they would go if the offensive moved closer. Egypt has refused to accept any influx of Palestinian refugees, in part because of fears that Israel would not allow them to return.
But some patients and foreign nationals reportedly got through. Turkey's Health Ministry said it evacuated 110 people -- including patients and their relatives -- from an unspecified part of Gaza to Egypt. Another 87 people who were from Turkey or breakaway northern Cyprus entered Egypt from Gaza late Sunday, Turkish officials said, with the groups to be flown to Turkey today.
Information for this article was contributed by Julia Frankel and Robert Badendieck of The Associated Press.
Palestinians mourn relatives killed in the Israeli bombardment of the Gaza Strip in front of the morgue in Deir al Balah, Sunday, Nov. 19, 2023. (AP Photo/Hatem Moussa)
Trucks carrying humanitarian aid line up at the Rafah Border Crossing, Egypt, on the way to Gaza, Sunday, Nov. 19, 2023. (AP Photo/Amr Nabil)
A nurse cares for prematurely born Palestinian babies that were brought from Shifa Hospital in Gaza City to the hospital in Rafah, Gaza Strip, Sunday, Nov. 19, 2023. (AP Photo/Hatem Ali)
Palestinian relative carries the body of child Fawze Musleh, killed in the Israeli bombardment of the Gaza Strip at the morgue of al Aqsa Hospital in Deir al Balah, Gaza Strip, Sunday, Nov. 19, 2023. (AP Photo/Adel Hana)
Palestinians carry the bodies of relatives killed in the Israeli bombardment, at the Nasser hospital in Khan Younis, southern Gaza Strip, Sunday, Nov. 19, 2023. (AP Photo/Mohammed Dahman)
Israeli soldiers carry the flag-draped casket of Staff Sergeant Shachar Fridman, during his funeral in Mt. Herzl military cemetery in Jerusalem Sunday, Nov. 19, 2023. Fridman was killed during a military ground operation in the Gaza Strip. (AP Photo/Ohad Zwigenberg)
Palestinians mourn relatives killed in the Israeli bombardment of the Gaza Strip in front of the morgue in Deir al Balah, Sunday, Nov. 19, 2023. (AP Photo/Hatem Moussa)
Israeli soldiers are seen during a military operation in the Balata refugee camp, West Bank, Sunday, Nov. 19, 2023. (AP Photo/Majdi Mohammed)
FILE - This photo released by Dr. Marawan Abu Saada shows prematurely born Palestinian babies in Shifa Hospital in Gaza City on Sunday, Nov. 12, 2023. As Palestinian authorities are proposing an evacuation of Gaza's biggest hospital, experts warn that transporting vulnerable babies and other patients is perilous even under the best circumstances. (Dr. Marawan Abu Saada via AP, File)