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Displaced Palestinian families inside Nasser Medical Hospital in the city of Khan Younis in the southern Gaza Strip on Nov. 6, 2023.

Displaced Palestinian families inside Nasser Medical Hospital in the city of Khan Younis in the southern Gaza Strip on Nov. 6, 2023. (Loay Ayyoub/The Washington Post)

JERUSALEM — Israeli tanks launched assaults around Gaza City’s overcrowded hospitals Friday, targeting facilities that Israeli forces say double as Hamas strongholds even as the advance forced thousands more civilians to make dangerous journeys through battle zones.

At least seven hospitals reported being under siege or in proximity to the fighting in Gaza City, the heaviest urban combat yet in the one-month-old war. One Gaza hospital official said at least three hospitals surrounded by fighting were evacuated after being given an exit route by Israel’s military.

“We were carrying white flags, and when we walked out, we passed by the tanks; I was meters away from one,” said Baqr Qaoud, director of al-Nasr Hospital. He said some 4,000 people left as al-Nasr, al-Rantisi hospital and the Gaza Eye Hospital emptied out.

Hospitals have been struggling with scarce resources to deal not only with the inflow of casualties but also thousands of Palestinians seeking refuge. Now many people have streamed from Gaza City toward areas to the south, seeking some safety, but Israeli airstrikes have hit virtually every corner of Gaza.

The Israel Defense Forces, or IDF, confirmed it had surrounded several hospitals and demanded they be evacuated, according to Israel Army Radio. The IDF says the hospitals are used by Hamas as hubs to store supplies and fuel.

Israeli forces have issued steady progress reports on their battles in Gaza City, describing the deaths of dozens of militants as well as compounds captured and weapons factories uncovered.

IDF spokesman Lt. Col. Richard Hecht said Friday that Hamas was firing from hospitals in Gaza. “If we see Hamas terrorists firing from hospitals, then we will do what we need to do,” he said in a briefing. He added, “We’re aware of the sensitivity of the hospitals.”

The militant group and doctors at hospitals in Gaza deny the Israeli allegations of a Hamas presence.

Under international pressure, Israel announced a policy of midday pauses in the fighting for four hours to allow movement of aid convoys and to give residents of Gaza City and the northern part of the Gaza Strip time to trek southward - though strikes are taking place in all parts of the enclave.

Tens of thousands have taken advantage of the pauses to flee, with 50,000 leaving Thursday alone, according to the United Nations humanitarian affairs agency. An estimated 900,000 have packed into the increasingly teeming south since the start of the war.

Secretary of State Antony Blinken said from New Delhi on Friday that “far too many Palestinians have been killed. Far too many have suffered these past weeks,” and he said discussions were underway with Israel about “concrete steps” it could take to minimize civilian casualties.

At the United Nations, World Health Organization Director General Tedros Ghebreyesus called the situation inside Gaza hospitals “impossible to describe,” with medical workers “directly in the firing line.”

“The health system is on its knees,” he told the U.N. Security Council.

In response to a Hamas incursion on Israeli communities near the Strip on Oct. 7, when militants killed at least 1,200 people and took more than 240 hostages, Israel has unleashed a blistering attack on the Gaza Strip that so far has claimed more than 11,000 lives, including thousands of children.

A spokesman for the Israeli Foreign Ministry wrote Friday on X that “about 1,200 people” died in Hamas’s attack, revising the previous figure of about 1,400 cited by Israeli officials. The spokesman, Lior Haiat, told Agence France-Presse that the number was changed because some previously unidentified bodies are now believed to be those of militants and not victims of the attacks.

The World Health Organization on Friday confirmed reports that al-Shifa Hospital, the largest in Gaza City, has come under bombardment. Mohamed Abu Salmiya, the hospital’s director general, told Al Jazeera that there had been at least four strikes on it by Friday, calling it “a day of war against hospitals.”

Medhat Abbas, director of the Hamas-controlled Health Ministry in Gaza, told The Washington Post that Israeli tanks were closing in on al-Shifa on Friday afternoon local time. The Associated Press reported that thousands of Palestinians sheltering there fled south Friday after the strikes.

The IDF said it determined that at least one strike on the hospital was a misfire from militants. The Post could not verify the Israeli military analysis.

“Shifa hospital has collapsed,” Ghassan Abu Sitta, a doctor there, posted on the social media platform X on Friday evening. “Wounded and staff leaving in droves.”

The Gaza Health Ministry also reported “direct attacks and bombardments” around the al-Rantisi pediatric hospital since Thursday that had left it cut off.

Shahad al-Sharafa, 18, who has been sheltering at the hospital, said Thursday night by phone that strikes had set ablaze several ambulances in the hospital’s yard. She said the displaced people living there tried to put out the fires. Emergency crews could not immediately reach the facility because of ongoing bombardments and street fighting.

At the nearby al-Nasr Hospital, a crowd of civilians, including many children, attempted to leave through one of the hospital’s gates while waving white flags, before the official evacuation. As the group began to move onto the street, three gunshots could be heard, forcing people to retreat back into the hospital grounds, according to a video posted on X, formerly known as Twitter, and geolocated by The Washington Post. The Post could not confirm the source of the shots.

Later Friday, the three nearby hospitals - al-Nasr, al-Rantisi and the Gaza Eye Hospital - that had been surrounded by the fighting were evacuated after being given an exit route by Israel’s military.

“We were carrying white flags, and when we walked out, we passed by the tanks; I was meters away from one,” said Baqr Qaoud, director of al-Nasr Hospital. He said some 4,000 people left.

Israel also struck the Indonesian Hospital and al-Quds Hospital in northern Gaza on Friday, Hamas official Basem Naim said in a news conference.

Across Gaza City, panic was spreading fast as thousands of people made desperate dashes for safety. Since Sunday, more than 120,000 have fled south by foot from the city and the enclave’s northern half, according to OCHA, the U.N. humanitarian agency. It’s an arduous, hours-long journey along a road lined with tanks and decaying bodies, Gazans who have made the trip have told The Post.

Al Jazeera’s Gaza City bureau chief, Wael Dahdouh, was among those making the trek south Friday. Dahdouh has been the eyes and ears of the Qatari-owned broadcaster - and of much of the world - in northern Gaza since the war began. He carried on reporting even after receiving news of the deaths of his wife, son, daughter and grandson in an Israeli airstrike on Oct. 25.

A video shared on Instagram Friday showed Dahdouh among a crowd of Gazans walking down a road, carrying a backpack.

“Leaving home is hard,” he told the camera operator.

U.N. High Commissioner for Human Rights Volker Türk, who has condemned atrocities on both sides that he says constitute war crimes, called for an investigation into what he called Israel’s use of “high impact explosive weapons” in Gaza.

“We have very serious concerns that these amount to disproportionate attacks in breach of international humanitarian law,” he added, while reiterating calls for a cease-fire.

Israel has vowed to utterly destroy the Hamas militant movement, which has controlled the Gaza Strip since 2007, but it is not clear what would come afterward. The United States has insisted that the enclave must governed by the Palestinians, though it has acknowledged that Israeli forces could be there for an interim period.

Israeli Prime Minister Benjamin Netanyahu said Friday that Israel would demand “full disarmament” of Gaza and that the military would maintain “total Israeli security control” over the coastal enclave, according to a readout from his office.

On Thursday, he told Fox News, “We don’t seek to conquer Gaza, we don’t seek to occupy Gaza, and we don’t seek to govern Gaza.”

Palestinian leader Mahmoud Abbas, whose Fatah party controls pockets of the Israeli-occupied West Bank, said he would be willing to administer the Gaza Strip as part of a comprehensive political settlement for all Palestinian areas, according to Reuters. Abbas, however, is deeply unpopular among many Palestinians.

But Israel’s invasion of Gaza so far looks to be the start of a long slog - one that raises the risk of a broader regional conflict.

The IDF said Friday that it was striking targets linked to the militant group Hezbollah in Lebanon after three Israeli soldiers were severely injured by an antitank missile launched at a military post in northern Israel.

Hasan Nasrallah, Hezbollah’s leader, said last week that “all the options are on the table, and we could go toward them at any point in time.”

In Saudi Arabia, two emergency summits were planned for this weekend with Arab and Muslim countries, including Iran’s president. On Friday, Saudi Crown Prince Mohammed bin Salman reiterated calls for an end to the war.

Dadouch reported from Beirut, Schemm from London and Keller-Lynn from Tel Aviv. Bryan Pietsch and Karen DeYoung in Washington, Louisa Loveluck in Jerusalem, Michael Birnbaum in New Delhi, and Hajar Harb and Imogen Piper in London contributed to this report.

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