Moving our live coveragepublished at 04:30 Greenwich Mean Time 13 November 2023
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The World Health Organization (WHO) says Al-Shifa hospital in Gaza City "is not functioning as a hospital anymore"
The WHO says "constant gunfire and bombings in the area have exacerbated the already critical circumstances".
Gaza's Hamas-run health ministry says at least 2,300 people are still inside Al-Shifa, in an update shared by the WHO
The BBC has been sent pictures of at least 20 newborn babies being kept in a surgical theatre at the site
The Israeli military says it has agreed to help evacuate babies from the hospital to a "safer" facility but denies Al-Shifa has lost power
Israel's president Isaac Herzog says Hamas has its base underneath the building - something Hamas denies. The Israeli military says it is not hitting the hospital during fighting
Israel began striking Gaza after the Hamas attacks on 7 October, which saw 1,200 people killed and more than 200 taken hostage
The Hamas-run health ministry says more than 11,000 people have been killed in Gaza since - of whom more than 4,500 were children
Edited by Yvette Tan
For technical reasons, our live coverage is moving to a new page - click here for the latest updates.
We'll be pausing our live coverage of the Israel-Gaza War for the next few hours, so here's a quick round-up of all the latest developments.
The World Health Organization has warned of a "dire and perilous" situation at Gaza's main medical facility, Al-Shifa Hospital, which is experiencing a near-complete power outage and shortages of food and water.
WHO chief Tedros Adhanom Ghebreyesus said "constant gunfire and bombings" in the area around the hospital have "exacerbated the already critical circumstances" and that Al-Shifa "is not functioning as a hospital anymore".
The Israeli military has reiterated it is "ready to help" evacuate the dozens of vulnerable newborn babies being cared for at the site to another hospital.
Al-Shifa's head of surgery, Dr Marwan Abu Saada, has told the BBC that a third premature newborn baby has died because of a lack of power.
Dozens of other newborns are currently not receiving the care they need and the surgeon said he is "afraid we are going to lose the lives of all [the] babies".
Also speaking to the BBC earlier, Israeli president Isaac Herzog repeated an allegation that Hamas has its headquarters underneath Al-Shifa. Hamas denies using the hospital for military purposes.
Dr Abu Saada also described Israel's allegation as a "big lie" and issued an "open invitation" to its nearby forces to come and inspect the building.
Gaza's Hamas-run health ministry has issued an update about the situation at Al-Shifa, saying there are at least 2,300 people still inside the hospital.
The numbers have been provided to the World Health Organisation, who shared them in a post, external on X (formerly Twitter).
The update says there are between 600 and 650 inpatients in the hospital, as well as 200 to 500 health workers and around 1,500 displaced people who have sought shelter.
It adds that the lack of power, water, and food at the site is "putting lives at immediate risk".
The WHO repeats its call for an "immediate ceasefire" and the "active protection of civilians and health care".
There is not a "single militant" inside Al-Shifa, the hospital's head of surgery has told the BBC.
Israel has previously accused Hamas of operating an underground command centre beneath the site of Gaza's largest hospital, which Hamas denies.
Asked whether Hamas was operating inside Al-Shifa, Dr Marwan Abu Saada calls the allegation a "big lie".
Quote MessageThis is an open invitation to the international community and even to the Israelis. They are in close proximity to Shifa hospital. Why not enter Shifa hospital and see?
Quote MessageWe are civilians. I am a doctor-surgeon. We have medical staff, we have patients, and displaced people. Nothing else."
In recent days the area around Al-Shifa in northern Gaza has experienced heavy fighting, with Israel being accused of attacking the hospital directly.
The Israeli military says it is operating in the area of the hospital, but denies attacking the facility.
Earlier this evening, the Israeli military gave a media briefing that touched on the situation at Al-Shifa hospital and its military operations in the area.
IDF spokesman Rear Admiral Daniel Hagari said Israel had "opened designated routes" from hospitals in northern Gaza to the south and was speaking with officials at Al-Shifa to offer "assistance to safely transport the sick and the wounded".
He added that Israel was "ready to help" evacuate the dozens of babies being cared for at the site to another hospital.
Rear Adm Hagari also repeated an allegation that the IDF had left 300 litres of fuel close to the hospital overnight but that Hamas had been "preventing and placing pressure on the hospital" not to collect it.
In the last few hours, Hamas has issued a statement denying that it has stopped officials at the hospital from collecting the fuel.
The site's head of surgery has also told the BBC that 300 litres of fuel would only be enough to power its generators for half an hour.
The US says it has carried out air strikes on two Iranian bases in south eastern Syria, following recent attacks against its own military personnel in Syria and Iraq.
US Secretary of Defense Lloyd Austin says the attacks were carried out against sites "used by Iran's Islamic Revolutionary Guard Corps (IRGC) and Iran-affiliated groups".
In a statement, he says: "The strikes were conducted against a training facility and a safe house near the cities of Abu Kamal and Mayadin, respectively.
"The President has no higher priority than the safety of U.S. personnel, and he directed today's action to make clear that the United States will defend itself, its personnel, and its interests."
On Wednesday, the US launched a "self-defence strike" on what it said was a weapons storage used by the IRGC and its affiliates in the Maysulun region of eastern Syria.
You can watch video of the strikes from earlier this week below:
The 300 litres of fuel offered by Israel to Al-Shifa would provide power for just half an hour, a doctor at the hospital has told the BBC.
The lack of fuel has led to a near-complete electricity outage at the hospital in recent days.
The hospital's head of surgery, Dr Marwan Abu Saada, says Al-Shifa typically uses 24,000 litres of fuel a day to run its generators.
Even with only one generator running, the hospital still requires 9,000 to 10,000 litres, he says.
Quote Message“[The 300 litres] means nothing. This will run our generator just for half an hour."
Dr Abu Saada says the hospital's intensive care unit and surgical theatre are now running entirely on solar energy
The lack of power means the hospital has been unable to provide renal dialysis to its 45 patients requiring kidney treatment for two days because of a lack of power.
Over the last 30 days, Al-Shifa workers have had to dig four mass graves for unknown patients, while another 100 dead bodies are currently lying in the open outside its emergency department.
“This is a source of outbreak and infection," he says. "This is a disaster."
Tom Bateman
Reporting from Jerusalem
A UK-based expert in neonatal care has told the BBC that moderately pre-term babies, like those in the picture above from Al-Shifa, must be kept at the right temperature.
Dr Kevin Goss, consultant neonatologist at Princess Anne Hospital in Southampton, says most - although not all - should normally be in an incubator, and have other basic needs.
"Those babies wrapped up in those towels are relying on the ambient temperature."
"Those in the foreground are going potentially to run into trouble quickly if you don’t have a source of heat to keep them warm," he adds.
The Israeli army said yesterday it would help evacuate the babies from Al-Shifa.
Al-Shifa's head of Surgery Dr Abu Saada told me earlier there was nowhere else in Gaza that could accommodate that number of premature infants.
Dr Goss says moving babies like those in the pictures safely would normally require highly specialised equipment including transport incubators.
Tom Bateman
Reporting from Jerusalem
A doctor at Al-Shifa hospital says a third newborn baby has died in their makeshift neonatal care unit.
We reported last night how medics said two babies had already died and a further 37 were at serious risk, after the neonatal intensive care unit stopped working due to power failures.
The infants were transferred to a cardiac surgery room. The BBC was sent pictures of at least 20 babies wrapped in blankets in rows on adult beds.
“I’m afraid we are going to lose the lives of all [the] babies,” says head of surgery Dr Marwan Abu Saada in a voice note sent to us earlier.
He says the third infant died from enteritis - an inflammation of the gut to which premature babies are particularly susceptible.
As we’ve been reporting throughout the day, international organisations have been struggling to make contact with staff at the Al-Shifa hospital, where there is now thought to be a near-complete loss of power.
The World Health Organization (WHO) said earlier today that it had lost communication with contacts at the site, and this evening Doctors Without Borders said it had been unable to contact its own staff there since last night (see our last post).
However, WHO director-general Tedros Adhanom Ghebreyesus has now said the body has been able to re-establish contact.
“@WHO has managed to get in touch with health professionals at the Al-Shifa hospital in #Gaza, external,” he said in a post on social media.
But he added that "constant gunfire and bombings in the area have exacerbated the already critical circumstances" and that the "number of patient fatalities has increased significantly"."Regrettably, the hospital is not functioning as a hospital anymore," he said.
He said the situation was "dire and perilous".
“The world cannot stand silent while hospitals, which should be safe havens, are transformed into scenes of death, devastation, and despair."
More now from the situation at Al-Shifa. Doctors Without Borders says it has been unable to get in touch with its staff in the hospital since last night.
In a post on X, external, the aid group adds that colleagues in Gaza have reported that "hostilities around Al-Shifa have not stopped".
Al-Shifa is the largest hospital in the Gaza Strip. Several reports of fighting around the hospital have emerged over the past two days. Thousands of people are still inside the complex.
The BBC has not been able to get through to contacts in the hospital either.
The International Committee of the Red Cross has called for the "protection of civilians in Gaza trapped in fighting, whether they are trying to evacuate or staying where they are".
It said that hostilities between Israeli forces and Hamas were taking place in populated areas and "around hospitals".
“An unbearable human tragedy is unfolding in front of our eyes," it said, adding staff were getting calls from people "afraid to open their door for fear of getting killed and pleading to help them reach safety”.
It added that the southern Gaza Strip - where Palestinians are fleeing to escape the fighting - is "not equipped" for the waves of people moving there. The Red Cross said humanitarian aid entering the area was "largely insufficient" and refugees "lack essentials like shelter, food, water, and hygiene."
The situation is "rapidly approaching a humanitarian disaster," it added.
The death toll in Gaza since the current conflict began has now reached 11,180, according to the Hamas government in the territory.
The latest set of figures said the dead included 4,609 children and 3,100 women, while another 28,200 people have been injured.
Paul Adams
Reporting from Jerusalem
Israel is still trying to “facilitate and assist” in the evacuation of an unknown number of babies from Al-Shifa hospital but Hamas “meddling” is holding it up, IDF spokesman Richard Hecht has said.
“We're trying to come to a solution, maybe via a third party,” he told reporters. “We're trying to move this thing ahead.”
Col. Hecht said that 300 litres of fuel delivered by the IDF last night to a location close to the hospital had not yet been collected. Again, he said the assumption was that Hamas was preventing it from being delivered.
He said that if the fuel was delivered, it would allow the hospital to run incubators (although he admitted he did not know how much electricity 300 litres of fuel would generate).
“If that doesn't happen, then we'll have to see how the night unfolds,” he said. “But in the end for us to help or assist, you need someone on the other side to be part of it.”
“Sadly, the only thing standing between Shifa Hospital and the fuel it needs is Hamas,” he said.
Col. Hecht added that the IDF was “closing in” on Hamas and could see that the group’s command and control was being affected.
An update now on the US reaction to the fighting reported around Al-Shifa hospital, the largest in Gaza.
Israel has been accused of attacking the facility, something it denies. Humanitarian organisations describe a dire situation for patients and staff - including two premature babies reportedly dying.
Speaking to CBS, external, the BBC's US partner, National Security Advisor Jake Sullivan noted Israeli concerns that Hamas was using hospitals and other civilian infrastructure "for command and control, for weapons storage, [and] to house its fighters". Hamas denies this.
"That being said... the United States does not want to see fire fights in hospitals, where innocent people, patients receiving medical care, are caught in the crossfire," he said.
Mr Sullivan went on to talk about the role of the US in negotiating the release of hostages captured by Hamas, some of whom are US citizens.
He said negotiations were "under way between Israel and Qatar, who is communicating with Hamas" and that the US is "very much involved in those discussions".
A doctor at the Al-Ahli hospital in Gaza City has described the numbers of patients arriving there as "overwhelming".
Dr Fadel Naim, an orthopaedic surgeon, has been posting regular updates on social media about the situation in the facility. Today, he posted: "We don't have a blood bank at Al-Ahli Hospital, and now our blood supply has run out."
Dr Naim added that doctors were having to perform surgeries without replacing blood lost through bleeding.
He called Al-Ahli the last functional hospital in Gaza. Al-Shifa and Al-Quds, the two biggest hospitals in Gaza, have reportedly run out of fuel (although Israel has denied that Al-Shifa is without power).
Dr Naim also said he was struggling emotionally, saying: "I am trying to hold myself together despite the difficulty of the cases I witness."
The doctor continued, "But today, I couldn't bear it and I cried from the bottom of my heart."
Earlier today Israeli Prime Minister Benjamin Netanyahu spoke to US broadcaster NBC, external, reacting to the events at the Al-Shifa hospital.
"We offered last night, actually, to give them enough fuel to operate the hospital, operate the incubators and so on," he says, claiming that the fuel was refused.
"Because we obviously have no battle with patients, or with civilians at all. I think every civilian death, every dead baby is a tragedy."
Israeli military has released video that it says shows the fuel being offered, but we have not independently verified the footage, and we have not been able to talk to staff at the hospital about it.
A doctors' group has said that two premature babies have died at the hospital because of a lack of electricity, and the Hamas-run health ministry has said five wounded people have died because of a lack of power for operations.
Netanyahu said Israel had also sought to build field hospitals to where patients could be moved.
Israeli President Isaac Herzog told the BBC this morning that "everything is operating" at Al-Shifa and that claims about a lack of power were "spin by Hamas".
If you're just joining us, here are the big developments of the day...
Hugh Schofield
BBC News, Paris
Tens of thousands of people have marched through central Paris in a demonstration against antisemitism. A massive crowd filled the Invalides esplanade then headed across the Left Bank towards the Senate building.
Many were Jews; but many non-Jews were there too, answering the call for a big display of support for France’s “Republican” values, and the notion that no-one should be singled out because of their religion or ethnic type.
Jews on the march said the last month had left them feeling anxious and scared. Many in their day-to-day lives have taken steps to avoid being identifiable as Jews, for fear of verbal or physical abuse.
Two former presidents – Sarkozy and Hollande – were at the head of the march, along with a host of political leaders.
Further back was another figure, Marine Le Pen, head of the hard-right National Rally – a party with historic roots in antisemitism, but now defending French Jews.
It's a measure of how politics is changing here that most Jews on the march found her presence perfectly acceptable.
Our Gaza reporter Rushdi Abualouf has been in contact with someone who was at the UN office in Gaza City that was attacked overnight.
The compound is about 250m (820ft) from Al-Shifa hospital and hundreds of civilians who had fled fighting around the Al-Shati refugee camp had been taking refuge there.
Rushdi's contact told him an explosion hit the compound - wounding several people - and there were about 40 Israeli tanks and armoured vehicles nearby.
The Israeli army had dropped leaflets telling people the area was in the middle of a military operation area, the contact added. Officers also gave civilians water and told them they should leave.
The contact said the Israeli military told civilians they should go north if they couldn't evacuate south.