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Gaza’s hospitals have been a flashpoint of fighting, claims and counterclaims.

Tens of thousands of people sought shelter in medical facilities after being driven from their homes by the risk of airstrikes.

But many have fled elsewhere as hospitals ran out of fuel and power and the fighting circled closer.

Al Shifa, the largest hospital in Gaza, is now surrounded by Israeli troops as gunfire and explosions rage around it.

The hospital’s last generator ran out of fuel at the weekend, leading to the deaths of at least 32 patients, including three babies, according to the Hamas-run Gaza health ministry.

Al Quds hospital is also now also closed to new patients. The Red Cross tried to evacuate about 6,000 people from the hospital but said its convoy had to turn back because of shelling and fighting.

Hospitals have protected status in wartime – but there are caveats to when this applies.

Here Sky News looks at what the rules are, and what both sides are saying.

Follow Israel-Gaza latest: Communications in Gaza could fail in two days

What are the rules on the protection of hospitals?

The International Criminal Court’s Rome Statute states it is a war crime for combatants to “intentionally direct attacks against… hospitals and places where the sick and wounded are collected, provided they are not military objectives”.

Under international humanitarian law (IHL) hospitals have protected status during war.

This means they cannot be attacked or otherwise prevented from performing their medical functions, according to the International Committee of the Red Cross (ICRC).

However, hospitals can lose those protections if they are used in a way that is harmful to the enemy – this includes being used to hide fighters or store weapons, the ICRC said.

But this does not give the other party free licence to attack, ICRC legal officer Cordula Droege said.

A warning must be given – first to stop the misuse of the hospital and then to allow evacuation of staff and patients if the misuse continues.

Any attack must be proportionate, Ms Droege added. If harm to civilians from an attack is disproportionate to the military objective, it is illegal under international law.

Also, using hospitals for military purposes is a violation of international humanitarian law, according to Amnesty International.

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What status do hospitals have in war? Sky military analyst Sean Bell explains

What does Israel say?

Israel claims Hamas uses hospitals for military purposes – but has not provided verified visual evidence of this.

It says Hamas has built a vast underground command complex centre below al Shifa hospital, connected by tunnels.

Israel also claims hundreds of Hamas fighters sought shelter at al Shifa after the 7 October attack.

The IDF released footage on Monday of a children’s hospital that its forces entered over the weekend, showing weapons it said it found inside, as well as rooms in the basement where it believes Hamas was holding hostages.

“Hamas uses hospitals as an instrument of war,” said Israel’s chief military spokesman Rear Admiral Daniel Hagari from a room at the Rantisi Children’s Hospital where explosive vests, grenades and RPGs were displayed on the floor.

Israel also accuses Hamas of using ambulances to carry fighters, using this as justification for a strike on an ambulance convoy that officials in the Hamas-run health ministry said killed and injured scores of people.

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Ambulance convoy hit by airstrike

What does Hamas say?

Both Hamas and al Shifa hospital staff deny Israeli allegations militants are operating a command centre from within its grounds.

Ghazi Hamad, a senior Hamas official, rejected the Israeli claims about al Shifa as “false and misleading propaganda”.

“The occupying forces have no evidence to prove it,” he said. “We have never used civilians as human shields because it goes against our religion, morality and principles.”

In a statement on its Telegram channel, Hamas said the video of Rantisi hospital showed “fabricated scenes that misled public opinion”, adding that it was a “failed attempt” by Israel to justify the targeting of hospitals.

At al Shifa, spokesperson for the health ministry Ashraf al Qidra said Israeli snipers and drones were firing into the hospital, making it impossible for medics and patients to move around.

Israel said the east side of the hospital was a safe passage for people to leave al Shifa, but people who tried to leave said Israeli forces had fired at evacuees and that it was too dangerous to move the most vulnerable patients.

The World Health Organisation said there was “no safe passage out of the hospital”.

Goudhat Samy al Madhoun, a healthcare worker, told the AP news agency that about 50 people left on Monday and were fired at several times, wounding one man who had to be left behind.

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This photo released by Dr. Marawan Abu Saada shows prematurely born Palestinian babies in Shifa Hospital in Gaza City on Sunday, Nov. 12, 2023. Gaza's Shifa Hospital has become the focus of a days-long stalemate in Israel's war against Hamas.(Dr. Marawan Abu Saada via AP)
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Premature babies share a bed at Shifa hospital. Pic: Dr Marawan Abu Saada via AP

What has the international response been?

The international NGO Human Rights Watch has called for the attacks on “medical facilities, personnel, and transport” to be investigated as war crimes.

Israel’s claims about Hamas activity in hospitals are contested, Human Rights Watch said.

“Human Rights Watch has not been able to corroborate them, nor seen any information that would justify attacks on Gaza hospitals,” it said.

It added that Israel’s general evacuation warning to hospitals in northern Gaza was “not an effective warning” because it did not account for the safety needs of patients and medical staff.

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

US president Joe Biden said hospitals “must be protected” as he called for “less intrusive action” in relation to hospitals.

Insecurity Insight collects data on attacks on healthcare in Israel and Gaza. Its data – which it notes is not complete – from 7 October to 5 November records 219 incidents of violence against or obstruction of access to healthcare facilities in Gaza and 10 in Israel.

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White House rages at ‘appalling’ attempt to return wrongly deported man from El Salvador

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White House rages at 'appalling' attempt to return wrongly deported man from El Salvador

The White House has hit out at an “appalling” attempt by a Democratic senator to return a father wrongly deported to El Salvador.

Chris Van Hollen arrived in El Salvador on Wednesday to speak to the country’s leaders about Kilmar Abrego Garcia, who was removed from the US by the Trump administration in March despite an immigration court order preventing his deportation.

Washington acknowledged Mr Garcia was deported due to an “administrative error”.

The US Supreme Court has called on the administration to facilitate his return, upholding a court order by Judge Paula Xinis, but Trump officials have claimed Mr Garcia has ties to the MS-13 gang.

Mr Garcia’s lawyers have argued there is no evidence of this.

Speaking about Mr Van Hollen’s trip to El Salvador, White House spokesperson Karoline Leavitt said the Democrats “still refuse to accept the will of the American people”.

She alleged Mr Garcia was an “illegal alien MS-13 terrorist” and claimed his wife petitioned for court protection against him after alleged incidents of domestic violence.

White House press secretary Karoline Leavitt.
Pic: AP/Jose Luis Magana
Image:
White House press secretary Karoline Leavitt.
Pic: AP/Jose Luis Magana

After outlining the allegations against Mr Garcia, she went on: “All of that is not enough to stop the Democrat Party from their lies.

“The number one issue they are focused on right now is bringing back this illegal alien terrorist to America.

“It’s appalling and sad that Senator Van Hollen and the Democrats are plotting his trip to El Salvador today, are incapable of having any shred of common sense or empathy for their own constituents and our citizens.”

After making a statement, Ms Leavitt introduced Patty Morin, who described graphic details of her daughter’s murder by an immigrant from El Salvador.

Rachel Morin was raped and murdered by Victor Martinez-Hernandez along a popular hiking trail northeast of Baltimore.

Afterwards, Ms Leavitt left without taking any questions from reporters.

Kilmar Abrego Garcia. Pic: CASA / AP
Image:
Kilmar Abrego Garcia. Pic: CASA/AP

Senator travels to El Salvador

Mr Van Hollen met with the El Salvador vice president during his trip to the Central American country.

But he did not meet with President Nayib Bukele, who publicly met with Donald Trump in the Oval Office this week, nor did he meet Mr Garcia himself.

US senator Chris Van Hollen speaking to the media in El Salvador. 
Pic: Reuters/Jose Cabezas
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US senator Chris Van Hollen has been in El Salvador.
Pic: Reuters/Jose Cabezas

In a post on X, he said he would continue to fight for Mr Garcia’s return.

During Mr Bukele’s trip to the White House earlier this week, he said he would not return Mr Garcia, likening it to smuggling “a terrorist into the United States”.

Along with Mr Garcia, the Trump administration has deported hundreds of people, mostly Venezuelans, who it claims are gang members without presenting evidence and without a trial.

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‘I’m talking about violent people’

Judge’s contempt warning

It comes hours after a US federal judge warned that he could hold the Trump administration in criminal contempt for violating his orders to turn around planes carrying deportees to El Salvador.

The comments are an escalation in a row which began last month when US district judge James E Boasberg issued an order temporarily blocking the deportations.

However, lawyers told him there were already two planes with immigrants in the air – one headed for El Salvador, the other for Honduras.

Mr Boasberg verbally ordered the planes to be turned around, but the directive was not included in his written order. The Trump administration then denied refusing to comply.

Charges could be brought forward by the Justice Department, NBC News, Sky’s US partner network, reported.

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However, that could create an uncomfortable situation for the department, which is headed by the attorney general – a position appointed by the president.

If the executive-led Justice Department refused to prosecute the matter, Judge Boasberg said he would appoint another attorney to prosecute the contempt.

The judge wrote: “The Constitution does not tolerate wilful disobedience of judicial orders – especially by officials of a coordinate branch who have sworn an oath to uphold it.”

He gave the government a 23 April deadline.

White House director of communications Steven Cheung said the administration would seek “immediate appellate relief” – a review of a decision within a lower court before the case has been resolved.

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Israeli troops will remain in ‘security zones’ in Gaza, Lebanon and Syria indefinitely, minister says

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Israeli troops will remain in 'security zones' in Gaza, Lebanon and Syria indefinitely, minister says

Israel’s troops will remain in “security zones” in Gaza, Lebanon and Syria indefinitely, according to the country’s defence minister.

Israeli forces have taken over more than half of the Gaza Strip in recent weeks in a renewed campaign to pressure the territory’s rulers Hamas to free hostages after a ceasefire ended last month.

Israel has also refused to withdraw from some areas in Lebanon following a truce with Hezbollah last year, and it seized a buffer zone in southern Syria after President Assad’s regime was overthrown last December.

Israeli defence minister Israel Katz said his forces “will remain in the security zones as a buffer between the enemy and [Israeli] communities in any temporary or permanent situation in Gaza – as in Lebanon and Syria”.

He said that “unlike in the past” the military was “not evacuating areas that have been cleared and seized”.

His comments could further complicate talks with Hamas over a ceasefire and the release of hostages.

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Gazans struggle to find bodies under rubble

On Wednesday, health officials said Israeli strikes in Gaza killed 22 people, including a girl who was less than a year old.

Fifty-nine hostages are still inside Gaza, 24 of whom are believed to be alive, after dozens of others were previously released in ceasefire agreements or other deals.

Israeli defence minister Israel Katz. Pic: AP
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Israeli defence minister Israel Katz. Pic: AP

Meanwhile, Lebanese President Joseph Aoun said Israel’s continued presence in some areas in Lebanon was “hindering” the Lebanese army’s full deployment as required by the ceasefire negotiated with Israel.

The war left over 4,000 people dead, many of them civilians.

Two Israeli drone strikes in southern Lebanon on Wednesday killed two people, the health ministry said. The United Nations said Israeli strikes in Lebanon have killed more than 70 civilians since the ceasefire took effect in November.

Read more:
Lack of rescue equipment leaves Gazans dying under rubble
A timeline of events since the 7 October attacks

Israel has said it must keep control of some areas to prevent a repeat of the Hamas attack that triggered the latest conflict in Gaza.

The war began when militants attacked southern Israel on 7 October 2023, killing 1,200 people, mostly civilians, and kidnapping about 250.

Israel’s retaliatory offensive has killed more than 51,000 people, according to Gaza’s health ministry.

The figure includes more than 1,600 people killed since a ceasefire ended and Israel resumed its offensive last month to pressure Hamas to accept changes to the agreement.

The health ministry does not distinguish between civilians and combatants in its total count but said that more than half of the fatalities are women and children.

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Lack of heavy rescue equipment into Gaza leaves hundreds to die slow deaths under rubble

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Lack of heavy rescue equipment into Gaza leaves hundreds to die slow deaths under rubble

It was in the evening that the bombing started to intensify.

Salah Jundia, his father and brothers huddled together in their home in Shujaiyya, just east of Gaza City, trying to work out what to do.

It was too risky for them to leave at night. There were a lot of them too. Extended family living across four storeys. They decided they would wait until after dawn prayers.

The explosion tore through the building just before 5am, collapsing one storey on to the next.

The remains of where the family lived - where loved ones were trapped beneath the rubble
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The aftermath of Israel’s bombing campaign in Shujaiyya, just east of Gaza City

Salah Jundia
Image:
Salah Jundia

Jundia says he survived because pieces of bedroom furniture fell on top of him.

Then he looked for his father and brothers.

“I found one of them calling for help. I removed the rubble covering him with my hands. Then I saw another brother covered in rubble but he was dead,” he told Sky News.

Jundia added: “My father was also dead. My other brother was also dead. We got them out and that is when I saw that the whole building had collapsed.”

Over the next few hours, they scrambled to rescue who they could.

An aunt and uncle and one of their children, Shaimaa. Uncle Imad and his son Mohammad. The bodies of Montasir and Mustaf.

One of the child victims of the attack on the home in Gaza City
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One of the child victims of the attack on the home near the Gaza City

One of the child victims of the attack
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Another one of child victims of the attack

Jundia says he could hear cries for help, but they were coming from deep in the rubble and were impossible to reach.

The rescue teams on site – civil defence they are called – did not have the kit to clear through three floors of 500 square metres, 30cm slabs of concrete.

Palestinians drilling to try and reach the people trapped below the rubble
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Rescuers drilling to try and reach the people trapped below the rubble

Efforts to free those trapped beneath the rubble in Gaza City
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Efforts to free those trapped beneath the rubble near the Gaza City

In the afternoon, Jundia says Israel’s Defence Forces (IDF) told rescue teams to leave as they would be resuming their bombardment.

Jundia buried the bodies he had managed to pull out but he knew 15 of his family members, 12 of them children, were still somewhere inside the rubble, still crying for help.

He made a desperate video appeal, begging the Red Cross and Arab countries to pressure Israel to grant access to the site. It was picked up on a few social media accounts.

Israel won’t allow heavy equipment into Gaza. No diggers or bulldozers, nor the fuel or generators to run them.

They say it will fall into Hamas’s hands.

It was a major sticking point during the ceasefire and it is a major issue now as the bombardment continues, given the fact that hundreds if not thousands of civilians might survive if there were the equipment to extract them.

Members of Salah Jundia's family left alive after the attack
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Members of Salah Jundia’s family left alive after the attack

Salah Jundia and his family
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Salah Jundia and his surviving family

Civil defence trying to get to the Jundia family home over the next few days were halted because the IDF were in the vicinity. A family friend tried himself and was killed.

The footage that our camera teams have shot in Shujaiyya over the past two weeks shows how civil defence teams struggle to save those who are trapped and injured with the most rudimentary of equipment – plastering trowels, sledgehammers, ropes and small drills.

“The tight siege stops civil defence equipment from getting in,” says one.

They added: “So we are taking much longer to respond to these events. Time is a factor in getting these people out. So we call immediately for the necessary equipment to be allowed in for the civil defence to use.”

The IDF say they are investigating the circumstances around the Jundia family as a result of our enquiries.

In relation to the access of heavy equipment into Gaza, they say they work closely with international aid organisations to enable the delivery of humanitarian activities in accordance with international law.

The last contact Jundia had from beneath the rubble was a phone call from his uncle Ziad, three days after the strike.

“The line was open for 25 seconds then it went dead. We don’t know what happened. We tried to call, but there was no answer,” he says.

He and his family were displaced several times before they returned home to Shujaiyya – to Rafah in the south, then Khan Younis and Deir al-Balah.

Along the way, Jundia lost one brother and a nephew to Israeli bombs.

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“We were happy and all the family came back. We went back to our house. It was damaged, but we improvised and we lived in it. We have nothing to do with the resistance. We are not interested in wars. But we have been gravely harmed,” he says.

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