Israeli forces surround north Gaza hospitals

Shelling, gunshots and explosions took place outside Gaza City hospitals on Friday as Israeli forces continued their ground operation against Hamas.

Social media videos showed panicked and injured people running for cover.

Israel has always maintained that Hamas fighters hide in tunnels under hospitals, making the structures legitimate targets.

The Red Cross warned that hospitals in Gaza had "reached a point of no return".

It added that its staff attempting to deliver medical supplies had witnessed "horrendous" scenes, and described the destruction as "unbearable".

In Gaza as a whole, the Hamas-run health ministry says 11,078 people have been killed since the start of the war and more than 27,000 others have been injured.

Israel's bombardment of Gaza and ground operations followed Hamas's unprecedented mass attack on southern Israel on 7 October.

On Friday evening, Israel revised down the number of people killed during the attack to about 1,200, from the earlier figure of 1,400.

Foreign Ministry spokesman Lior Haiat said the revised number was because many bodies were not immediately identified after the attack, and "now we think those belong to terrorists... not Israeli casualties".

Reports that Israeli forces in Gaza were surrounding several hospitals in Gaza City began to emerge early on Friday morning.

One person inside the Al-Quds hospital told the BBC that they could hear "continuous clashes and explosions", while eyewitnesses near the Al-Rantisi Paediatric Hospital said that Israeli troops were using megaphones to order anyone who was not medical staff or patients to leave the premises.

In one video posted on social media and verified by the BBC, a large group of civilians - many of them carrying white flags - can be seen trying to leave the courtyard of another hospital, Al-Nasr, when gunshots ring out, sending panicked people running for cover.

Videos posted on social media appeared to show the aftermath of a missile or mortar striking the courtyard at Al-Shifa, the city's largest hospital, while others appeared to show dead children and scenes of panic outside the outpatients' clinic.

Dr Ashraf al-Qudra, a spokesman for the Hamas-run health ministry in Gaza, said that up to five Israeli strikes had damaged parts of Al-Shifa hospital, including the maternity ward.

"If Al-Shifa hospital goes out of service it will be a disaster for the people of Gaza City," Dr Al-Qudra said, adding that staff were afraid.

The Hamas government reported 13 deaths at Al-Shifa, while Dr Al-Qudra said he knew of one fatality but could not confirm any others.

By Friday evening, tensions in Gaza City remained high.

People inside Al-Shifa said they could still hear explosions and firing around the hospital and that Israeli tanks were about 100m (328ft) away.

The director of the hospital told the BBC that around 15,000 people remained in the structure - largely the elderly and the sick who cannot make the journey further south to where Israel has promised greater safety. He added that staff were overwhelmed by the number of injured people and were having to treat people in corridors and on the floor.

Al-Shifa - where 15,000 people are thought to be sheltering - is Gaza City's largest hospital

The fighting around Al-Quds hospital also intensified as night fell. The BBC understands an Israeli navy ship was involved as well as tanks, which have surrounded the hospital.

Speaking at the UN Security Council on Friday, World Health Organization chief Tedros Adhanom Ghebreyesus said the situation on the ground in Gaza was "impossible to describe".

Dr Tedros said that hospital corridors were "crammed with the injured, the sick, the dying", that morgues were "overflowing", and that surgeries was being performed without anaesthesia.

He added that half of the Gaza Strip's 36 hospitals were not functioning at all, and that the remaining ones were operating "way beyond their capacities". He said that civilians in Gaza "are not responsible for this violence, but are suffering in ways that we in this room cannot imagine."

A spokesman for the Israel Defense Forces (IDF) said the IDF "does not fire on hospitals" but that "we'll do what we need to" if Hamas fired from hospital grounds.

When asked what the plan was to deal with patients in the hospitals who could not walk, or those who were on drips and with broken bones, he said: "Our plan is - and we're taking an operational risk here - we're saying to Hamas to move people south."

Hamas has previously denied claims that it places command posts under Gaza hospitals to use them as shields.

The US says Israel has agreed to daily four-hour military pauses in northern Gaza for humanitarian purposes - yet the fighting remained intense on Friday.

More on Israel-Gaza war

• Follow live: Latest updates

• From Gaza: Palestinian given two hours to evacuate whole neighbourhood

• From Israel: Pain still raw a month after Hamas attacks

• Watch: BBC's Jeremy Bowen in Gaza with Israeli forces

• Explained: Who are the hostages taken by Hamas from Israel?

• History behind the story: The Israel-Palestinian conflict