Israel-Gaza Situation Report: No Decision Yet To Storm Gaza’s Largest Hospital

The IDF has reached the Al Shifa hospital, that it says is a nexus for Hamas operations, but has yet to move into the facility.

byHoward Altman|
The IDF has reached the gates of Gaza City's largest hospital, but has yet to decide to storm it.


The Israeli Defense Forces (IDF) push into Gaza City has reached the gates of Al-Shifa Hospital, where patients are dying with no medicine or fuel to keep life-saving equipment operating and corpses are stacking. Other hospitals in the city are facing the same dire circumstances. Israel, which maintains some of these hospitals are used by Hamas as military headquarters, has yet to greenlight a direct assault inside the main Gaza health facilities. Such attacks could add to the mounting casualties at a time when Israel is under tremendous international pressure to stop the fighting on humanitarian grounds. Storming the hospitals could also imperil ongoing hostage negotiations.

Doctors Without Borders, a charitable organization, said that in addition to the horrific situation inside the hospital, civilians have been killed trying to leave, either through Israeli bombardment or snipers. The War Zone cannot independently verify that claim.

IDF spokesman Rear Adm. Daniel Hagari on Sunday said the hospital is not under siege and that it is working with hospital staff to provide a safe passage for Gazans wishing to leave.

The IDF also said it tried to provide fuel to the hospital, but that Hamas would not allow officials there to accept it.

An image appeared on social media purporting to be damaged Israeli equipment outside of al-Shifa. The War Zone cannot independently verify where or when it was taken.

Other hospitals in Gaza are under fire as well.

The IDF says it opened fire on Hamas fighters at the Al Quds Hospital in Gaza City who mingled among civilians and fired on Israel troops.

“During operations carried out by the 188th Brigade, RPG fire and small arms fire were directed at the soldiers from the direction of the Al-Quds Hospital in Gaza City,” the IDF said. “The shooting was carried out by a terrorist squad that had embedded itself within a group of civilians at the entrance of the hospital. The soldiers identified a terrorist squad with two RPG launchers amongst the civilians. As a result of the shooting carried out by the terrorists, a tank was damaged.”

As the IDF forces fired at the Hamas fighters, “civilians were seen leaving the hospital building, and other terrorists who came out of adjacent buildings hid among them and joined the attempted attack. After the terrorists fired RPGs, they returned to hide in the hospital.”

The 188th Brigade combat team, with Air Force assistance, responded with firepower. "During the incident, approximately 21 terrorists were killed and there were no casualties to our forces,” the IDF said. “This incident is another example of Hamas' continued abuse of civilian structures, including hospitals, to carry out attacks.”

The IDF released video, which you can see below, it says shows armed Hamas fighters at the hospital entrance firing on Israeli forces.

The Palestinian Red Crescent Society (PRCS) said an evacuation convoy to Al-Quds had to turn back because of "relentless bombardment" and the "dangerous situation where the hospital is located in Tel Al-Hawa. The medical team, patients, and their families; remain besieged in the Hospital with no food, water, or electricity."

The PRCS on Sunday said the hospital was "no longer operational" due to the "depletion of available fuel and power outage."

At the al-Ahli Hospital, site of an Oct. 17 explosion that killed many Palestinians, patients are dying due to lack of medical capabilities, including specialized surgical teams, medical supplies and blood, according to Fadel Naim, head of orthopedic surgery at the hospital.

Israeli Merkava 4 tanks also reached the Rantisi Hospital in the Rimal neighborhood of Gaza City on Nov. 10, which you can see in this video below.

The IDF said soldiers from its Harel Reserve Brigade captured the al-Karameh area in northern Gaza, apparently named after a local hospital.

According to the IDF, during the raids, the troops destroyed Hamas infrastructure in the area, including long-range rocket launchers aimed at Israel, anti-tank missile launch positions, tunnels, and observation posts.

The IDF on Monday said its troops from Flotilla 13 (special forces) and the 401st Brigade Combat Team found indications that Hamas was using the Rantisi hospital as a military facility.

"On the basement floor, a room was found with signs indicating hostages were held there," the IDF said on Telegram. Troops also found "an underground headquarters and a room full of weapons inside the hospital," the IDF said.

"In the operations, IDF troops found many weapons in the basement of the hospital, including explosive belts, grenades, weapons and RPG missiles. Also a motorcycle with gunshot marks found on the floor was, which was used by Hamas terrorists in the October 7th massacre."

IDF troops also "uncovered an operational tunnel shaft, which leads to the area of ​​the home of a senior naval commander."

A US official with knowledge of American intelligence says Hamas has a command node under Al-Shifa hospital and uses fuel intended for it. In addition, Hamas fighters regularly cluster in and around Gaza’s largest hospital, CNN reported Monday.

The information comes after comments made Sunday by a top White House official that Hamas is using hospitals and civilian facilities.

“You can see even from open-source reporting that Hamas does use hospitals, along with a lot of other civilian facilities, for command-and-control, for storing weapons, for housing its fighters,” National Security Adviser Jake Sullivan said on CNN’s State of the Union. “Without getting into this specific hospital or that specific claim, this is Hamas’ track record, both historically and in this conflict.”

Those claims line up with what Tomer Israeli, a former member of “Shin Bet” (Israeli Secret Service), a former captain in the Israeli Army Special Forces Sayeret Matkal, told us about Al-Shifa Hospital. He talked about the facility in a story we wrote about the challenges Israel faces in any hostage rescue efforts.

From our story: “It's a very busy hospital, but Hamas is using their own patients and civilians as a human shield. Basically, under the hospital, they have the headquarters of the Hamas regime, the Hamas army is headquartered there. Everything is under al-Shifa Hospital.”

The 27 European Union nations have jointly condemned Hamas for what they described as the use of hospitals and civilians as “human shields" during this war.

EU foreign affairs chief Josep Borrell said Monday that at the same time the bloc asked Israel “for maximum restraint in targeting in order to avoid human casualties,” The Associated Press reported.

At a meeting of the bloc’s foreign affairs ministers, Borrell brandished a statement he issued on behalf of the 27 nations as a show of unity following weeks of often contrasting statements on how the group should address the war.

Hamas "strongly" rejected and denounced Borrell's statement, calling it an "attempt to distort the facts by submitting to the false occupation narrative that claims that Hamas is using hospitals and civilians as human shields. We consider it a cover for the occupation to commit more massacres against children and defenseless civilians, and we call on Borrell to immediately retract those shameful statements. And inhumanity."

"These dangerous statements ignore all the pictures, testimonies, facts, and international reports, which confirm that the occupation army killed more than 11,000 martyrs, the vast majority of whom were women and children, through its deliberate targeting of civilians, in their homes, shelter centers, schools, and internationally protected hospitals, for the purpose of terrorizing and displacing them. Forcibly from their lands, in a crime of genocide, he spoke in audio and video before the eyes and ears of the world."

Having reached the gates of Al-Shifa is an inflection point for Israel.

“This will be our only opportunity to finish off as much of Hamas’s underground network as we can,” says one of the officers, referring to the group’s 500km-long tunnel system, an IDF officer told The Economist in a story reported Monday. “We don’t know how long we have to operate and we need to make the most of it while we can.”

The IDF has “reached a point in its campaign where the Israeli government’s stated objectives—to destroy Hamas’s military infrastructure and to rescue the 239 hostages still held in Gaza—are in increasing tension,” said the publication, reporting from an IDF command center.

The main reason for the Israeli war cabinet’s reluctance to enter the hospitals “is the hope of reaching an agreement with Hamas on the release of a large number of hostages,” according to The Economist. “Israel is holding out for at least a hundred. In return Israel would free some Palestinian prisoners—it holds 4,450 of them in its jails—and allow more supplies, including fuel, into Gaza.”

As we have previously reported, indirect hostage negotiations are ongoing in Qatar and Egypt.

The final say, however, will go to the head of Hamas in Gaza, Yahya Sinwar, who is Israel’s prime target. 

“It is unclear whether any deal would postpone the IDF’s attempt to destroy any Hamas’s facilities near or below the hospital; it seems unlikely to abandon it,” The Economist wrote. “As the tense negotiations continue, Israel is trying to urge as many as possible of the remaining civilians inside Gaza City, who are thought to number around 100,000, to leave for the south as well.”

There has been intense shuttle diplomacy, with the head of Mossad visiting Qatar then Egypt and Hamas leaders visiting Egypt as well.

A possible deal has been made for Hamas to release around 80 hostages from Gaza in exchange for Palestinian women and teenagers held by Israel, a Biden administration official told NBC on Sunday.

The hostages held in Gaza that would be released in this deal are women and children. However, it is currently unclear if the deal will go through and the US is still exploring other options, NBC reported.

Israeli Prime Minister Benjamin Netanyahu told NBC on Sunday that there “could be” a potential hostage deal with Hamas but declined to give any further details, saying doing so could thwart the delicate negotiations to free those taken captive by the militant group. “I think the less I say about it, the more I’ll increase the chances that it materializes,” he said in the interview.

In a joint press conference Sunday, Netanyahu, Defense Minister Yoav Gallant and Minister Benny Gantz "rejected mounting international criticism over the civilian costs of the war." The three urged Western leaders "to throw their support behind the Jewish state since its victory would mean victory for the entire free world as well," The Times of Israel reported.

Netanyahu also indicated that Israel would oppose the return of the Palestinian Authority (PA) to Gaza following the war — a goal declaredly sought by Washington. He lambasted the PA as an entity that educates children to want to eliminate Israel, supports terrorism and hasn’t condemned Hamas’s October 7 massacres, which sparked the ongoing war. He also said Israel would retain overall security control in the enclave, the publication reported.

Israel is striking elsewhere in Gaza, including Khan Younis, where Palestinians were digging in rubble to find survivors in a destroyed house.

Palestinians look for survivors under the rubble of a destroyed house following an Israeli airstrike in Khan Younis refugee camp, southern Gaza Strip, Monday, Nov. 13, 2023. (AP Photo/Mohammed Dahman)

The IDF on Saturday released a video shot from the vantage point of a Merkava 3 tank operating in northern Gaza. The video, which you can see below, shows the tank firing several times in the rubble of the city, with flames erupting in one case after its 120 mm shells hit a structure.

As part of the fighting in the Gaza Strip, the IDF said that "aircraft of the Air Force and the ground forces attacked 4,300 strikes, hundreds of anti-tank launching positions, about 300 tunnel shafts, attacked about 3,000 terrorist infrastructures, including over a 100 captured buildings and hundreds of Hamas terrorist organization's weapons and command targets and control of the terrorist organization."

The IDF said it killed three more Hamas leaders - Tahsin Maslam, commander of the combat support company who was in charge of the special forces in Beit Lahia; Jahad Azzam, an investigative officer of the military intelligence of Hamas in Zeyton. and Menir Harev, head of the information system at the Rafah Brigade.

The IDF released more video of his combat search and rescue efforts.

The Israeli Navy's underwater task force YALTAM found dozens of weapons and other combat equipment in a scan of the Gaza Strip's shores, the IDF said on Monday.

The YALTAM unit recovered explosive belts, other improvised explosive devices, and ammunition.

According to the IDF, these were likely used by Hamas terrorists who were killed by Israeli forces while attempting to infiltrate southern Israel through the Mediterranean Sea on October 7.

Israeli troops held a graduation ceremony for new members of the Givati Infantry Brigade, inside Gaza.

Israel's Golani forces posed for a picture in the captured Hamas parliament.

Israeli troops celebrated reaching the Mediterranean Sea.

The IDF says attacks in Gaza have broken the effectiveness of 10 out of 24 Hamas battalions.

For the first time since the start of the war, the IDF on Monday provided its official estimates of the size and make-up of Hamas's forces on the eve of the war which started on October 7, the Jerusalem Post reported Monday. In addition, the IDF gave its estimate of the impact it has had on Hamas's forces through around five weeks of air strikes and two-and-a-half weeks of a ground invasion.

“According to the IDF, Hamas started the war with 30,000 men who were split into five regional brigades, which themselves split into 24 battalions, which themselves split into 140 companies. Each battalion had around 1,000-plus men. Prior unofficial estimates had set Hamas's forces as between 15,000 to 40,000.”

The Hamas Shaati Battalion, which oversees operations around Al-Shifa Hospital, has been hit particularly hard, the Post reported.

It lost 200 men, “including many battalion and company commanders as well as most of its battalion-level and lower-level command centers and positions.”

As a result, the coordination of operations against the IDF suffered.

Hamas said it has destroyed Israeli several tanks, troop carriers and other armored vehicles during fierce fighting in Gaza.

The Palestinian Islamic Jihad group, also fighting Israel, claims to have hit an Israel Heron drone over Gaza with a man-portable air defense system. However, the video, which you can see below, does not show the results of the engagement.

The northern front continues to be hot, with Israel launching attacks in both Syria and Lebanon.

Israeli Air Force fighters attacked targets in Syria on Sunday in response to launches towards the Golan Heights area, the Jerusalem Post reported.

On Monday, the IDF continued to hit targets in Lebanon.

"Earlier today, terrorists fired toward several locations in northern Israel," the IDF said. "In response, IDF artillery struck the source of the fire. In addition, the IDF struck launch posts and a terrorist who carried out launches toward Israel. Furthermore, a short while ago, a terrorist cell that attempted to launch anti-tank missiles toward the area of Shtula in northern Israel was struck by an IDF tank."

With Hezbollah and the Israeli military stepping up cross-border attacks against each other and other Iran-backed militias in Syria, and Iraq striking Americans, Israel and the U.S. are warning about the potential that the war could expand.

Israel’s defense minister has also warned in recent days that increased attacks by Iranian-backed militants in Lebanon could lead to a larger confrontation in the north, The Wall Street Journal reported. A worker for Israel Electric was killed and at least nine other Israeli civilians and seven soldiers were wounded Sunday by a combination of mortar, rocket and antitank missiles fired on northern Israel from Lebanon, the publication reported, citing Israeli military and medical authorities.

Palestinian militants in Lebanon said they fired rockets on Sunday that reached deep into northern Israel. Israeli officials say such rocket attacks are done with the approval of Hezbollah, which is backed by Iran. Hezbollah has claimed responsibility for using armed drones to attack Israeli military positions along Israel’s northern border in recent days.

The attacks signal a larger scale and scope of shelling from southern Lebanon, said Israeli officials, who warned that Israel would keep responding forcefully to the attacks by hitting back at Hezbollah deep inside of Lebanon. Tens of thousands of residents have been displaced on both sides of the border, according to local officials.

“What we can do in Gaza, we can also do in Beirut,” said Israeli Defense Minister Yoav Gallant. Hezbollah has vowed to continue to attack Israel and said all options are on the table as long as Israel continues its ground offensive in Gaza.

The Pentagon on Monday released the names of the five crewmembers of a 160th Special Operations Aviation Regiment (SOAR) MH-60 Black Hawk helicopter killed in a crash during a nighttime training flight in the Mediterranean Sea Friday.

“The MH-60 Blackhawk was conducting aerial refueling training when the aircraft experienced an in-flight emergency, resulting in the crash,” U.S. Army Special Operations Command said Monday in a media release. “The aircraft and soldiers were assigned to 1st Battalion, 160th Special Operations Aviation Regiment (Airborne).”

Those killed in the crash are:

Chief Warrant Officer 3 Stephen R. Dwyer, 38, of Clarksville, Tennessee;

Chief Warrant Officer 2 Shane M. Barnes, 34, of Sacramento, California;

Staff Sgt. Tanner W. Grone, 26, of Gorham, New Hampshire;

Sgt. Andrew P. Southard, 27, of Apache Junction, Arizona;

and Sgt. Cade M. Wolfe, 24, of Mankato, Minnesota.

USASOC didn’t release any further details about the incident or the other aircraft involved. MH-60s are typically refueled by MC-130s. The Black Hawks have a boom holding an inflight refueling probe, which extends out forward when in use to help keep the tanker and the trailing drogue clear of the rotor blades.

The crash occurred as more than 10,000 U.S. troops, two Navy aircraft carrier strike groups, an amphibious strike group, air defense systems, many USAF fighters, and more have been deployed to the region as part of the Pentagon’s response to the Oct. 7 invasion of Israel by Gaza and the ongoing war.

Special operations forces teams from the Joint Special Operations Command, including the Army’s Delta Force and the Navy’s SEAL Team 6, have been quietly sent to Cyprus, The New York Times reported Sunday. They are standing by in case they are needed to help evacuate American citizens from the region.

The commandos are also trained in hostage rescue operations. About a dozen or so American hostages were seized when Hamas attacked Israel on Oct. 7, but Biden administration officials have indicated they have no plans to put American boots on the ground in the densely populated Gaza Strip, where the Israel military is now conducting major ground operations.

As The War Zone has noted in the past, the 160th SOAR, an elite unit also known as the 'Night Stalkers,' has a well-established history of conducting maritime training exercises, and operations, with U.S. Navy assets and units.

On Sunday, the U.S carried out its third set of airstrikes on Islamic Revolutionary Guards Corp (IRGC) related targets in Syria in response to attacks on U.S. forces in the region. The U.S. previously attacked facilities associated with IRGC on Oct. 26 and again on Nov. 8.

Defense Secretary Lloyd Austin said Sunday's strikes were conducted against a training facility near Abu Kamal and a safe house near Mayadin.

The Syrian Observatory for Human Rights (SOHR) said several U.S. bases in the region were targeted after the latest airstrikes.

The International Coalition’s Koniko gas facility in the northern countryside of Deir Ezzor, “was subjected to a rocket attack by the Iranian-backed militias. The base was hit with 15 rockets “in the heaviest shelling from inside the Syrian territory,” according to SOHR. “No causalities were reported.”

Milita drones also attacked Al-Omar oil field base of the International Coalition east of Deir Ezzor, SOHR reported. There were also explosions heard in the Al-Shadadi base area of the International Coalition in the Al-Hassakah countryside.

In addition, after midnight today, “violent explosions were heard in the vicinity of Al-Mayadeen city in the countryside of Deir Ezzor, in conjunction with the continued outbreak of fire in the area. This coincided with the fall of missiles at the Al-Omar field base, east of Deir Ezzor, which is the largest American base in Syria.”

We contacted U.S. Central Command for comment and will update this story with any information they provide.

Images emerged on social media purporting to be remnants of rockets fired at one of those bases. The images include remnants of a 220mm cluster munition warhead from a Soviet-era Uragan multiple launch rocket system. The War Zone could not independently verify that claim.

This is a developing story. We will update it when there is more news to report about the Israel-Hamas war.

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