Israel claims that Hamas has built a complex under the hospital, which serves as a command center and a weapons depot for the militant group.
Hamas denies the allegations and says that Israel is targeting the hospital and other medical facilities to inflict maximum civilian casualties.
The United States, which supports Israel’s right to self-defense, has urged caution and warned against firefights in hospitals.
“„The tanks are in front of the hospital. We are under full blockade. It's a totally civilian area. Only ... hospital patients, doctors and other civilians staying in the hospital. Someone should stop this. We are hardly surviving.- Dr Ahmed El Mokhallalati, a surgeon at the hospital
Israeli snipers and drones were shooting inside Al Shifa, preventing doctors and patients from moving freely, according to Qidra, a spokeswoman for Gaza's Ministry of Health. Israel has ordered hospitals to evacuate patients and people to evacuate the area. It claims it tried to remove newborns from the hospital's neo-natal department and that it placed 300 liters of gasoline to power emergency generators outside the hospital's door, but Hamas refused the help.
According to Qidra, Shifa requires between 8,000 and 10,000 liters (2,100 and 2,600 gallons) of gasoline per day, which the Red Cross or another international organization should provide.
The lights of Al Shifa Hospital in Gaza City last month Israeli officials say that Hamas has spent the better part of 16 years building a vast command complex under the hospital and setting up similar bases underneath other medical facilities in the enclave.
The complex under Al Shifa is one of the principal Israeli targets of the war and will not be left untouched, despite the growing international outcry to spare Al Shifa and other hospitals.
The hospital, Israeli officials said, was spared in past Israeli operations out of concern for civilian life, but at the cost of leaving whatever may be underneath it intact. Chuck Freilich, a former Israeli deputy national security adviser, said that only that way, can Hamas’s rule in Gaza be ended, though “it’s not going to look good.”
“„The hospitals will be surrounded, pressure will be put on people to leave. I don’t see Israel going headlong against the civilians, but the hospital — or at least what’s underneath it — has got to be cleared out.- Chuck Freilich, a former Israeli deputy national security adviser
According to Israeli military intelligence, the leaders of the terrorist group Hamas direct their operations from a number of underground complexes.
The complex relies in part on electricity diverted from Al Shifa and has multiple entrances to it in and around the hospital.
American officials, who also spoke on the condition of anonymity to disclose sensitive intelligence, say they are confident that Hamas has used tunnel networks under hospitals, in particular Al Shifa, for command and control areas as well as for weapons storage.
Hamas, the Islamist group that controls Gaza, has flatly denied the Israeli allegations and accused Israel of using them as a pretext to attack the hospital and other medical facilities.
The hospital’s director, Dr. Mohammed Abu Salmiya, described the Israeli claims as “untrue” in an interview on Friday. He said that the hospital has no basements or tunnels and that it is open to inspection by anyone.
Hamas also says that Israel is deliberately targeting the hospital and other medical facilities to kill and injure civilians and to undermine the health system in Gaza.
A power outage on Saturday caused at least five injured patients, including a premature baby in an incubator, to pass away at the hospital, according to the Hamas-run Health Ministry in Gaza. Without fuel to run generators, the hospital has been plunged into darkness.
Conditions at Al Shifa, Gaza’s main hospital, are dire. Hundreds of seriously ill and wounded patients and displaced people have been trapped inside as Israeli tanks and troops close in on the compound, and close-quarters combat is taking place nearby.
In recent days, Israeli soldiers have surrounded at least one other hospital in northern Gaza, stepping up their push to empty the facilities, according to Israeli military officials.
Childern under treatment in Al Shifa Hospital in Gaza After a weekend of incidents, including patient fatalities reported at the Shifa hospital, President Biden finally spoke out on Monday, saying that hospitals need to be safeguarded.
“„My hope and expectation is that there will be less intrusive action relative to hospitals and we remain in contact with the Israelis.- President Biden
“„Also there is an effort to get this pause to deal with the release of prisoners and that's being negotiated, as well, with the Qataris ... being engaged. So I remain somewhat hopeful but hospitals must be protected.- President Biden
During an interview with reporters, White House national security advisor Jake Sullivan said that the United States "would like to see considerably longer pauses — days, not hours" before the release of hostages.
Another U.S. official, speaking on the condition of anonymity, said the release of dozens of captives may result in a several-day hiatus since discussions were so sensitive.
However, Israel has granted short humanitarian "pauses" that have enabled food and other supplies to flow in and foreigners to escape Gaza, despite its tight siege.
The Al Shifa Hospital in Gaza, built by Israel during its rule, has been a target of Hamas militants since 2005.
Hamas initially built off the original basements of the hospital, later adding floors and connecting it to a network of reinforced tunnels across Gaza.
The hospital has become a symbol of Gaza's suffering and resilience, providing vital medical care to the population under siege and bombardment.
The international community has called for an immediate ceasefire and a humanitarian corridor to allow access to the hospital and other medical facilities.
The United Nations has warned that the situation in Gaza is "unbearable" and that the hospital is "on the verge of collapse."