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.
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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0:59
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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3:24
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.
Image: 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.
Faces marked by terror and torment fill North Darfur’s displacement camps.
Their eyes fill with despair as they describe what they have survived during a 16-month siege on one of Sudan‘s oldest cities.
It has entrapped their loved ones and spread armed violence, leaving village after village burnt to the ground.
Extreme cases of torture, rape and forced starvation are shared again and again in horrifying detail.
Image: This elderly man told us he was blinded by the RSF when he tried to flee
Women collapse into sobs as they contemplate the future and the elderly raise their hands to the sky, trembling and empty, to pray for overdue relief.
In shelters which have seen little to no humanitarian aid, camp directors hand us lists showing requests for clean water, medical supplies and food. Even the trademark white United Nations tarp is scarce.
Some frayed tent material is used to close the gaps in the stick-lined walls that surround the traditional huts displaced families have built for themselves.
They use them as a temporary refuge from the battles that rage for control of the regional capital, Al Fashir.
Instead of fleeing into nearby Chad, they wait here for news that the siege has been lifted and they may finally be able to return.
But that news may never come.
The battle for Al Fashir – and Sudan
Al Fashir is being suffocated to death by the paramilitary Rapid Support Forces (RSF) as they push to claim full control of the Darfur region as a base for their parallel government, after the military recaptured the capital Khartoum and other key sites in central Sudan.
Close to a million people are facing famine in Al Fashir and surrounding camps as the RSF enforces a full blockade, launching armed attacks on volunteers and aid workers risking their lives to bring in food.
Inside the city, thousands are bombarded by almost daily shelling from surrounding RSF troops.
The RSF have physically reinforced their siege with a berm – a raised earth mound. First spotted by Yale Humanitarian Research Lab, the berm is visible from space.
The Sudan war started in April 2023, when long-simmering tensions between the Sudanese army and the RSF broke out in Khartoum.
UN agencies said in July that some 40,000 people have been killed and almost 13 million displaced.
Several mediation attempts have failed to secure a humanitarian access mechanism or any lulls in fighting.
‘We could hear some of them being killed’
As the bombs drop on Al Fashir, war-wounded civilians travel by road to the last functioning hospital in the state. But the beds in Tina Hospital are largely empty.
The facility cannot afford to provide free or subsidised treatment to the people that need it.
“It is so difficult. This hospital cannot care for a patient without money,” says Dr Usman Adam, standing over an emaciated teenager with a gunshot wound in his stomach.
“We need support.
“Either medication or money to the victims – by anyhow, we need support.”
Image: Maaz, 18, a victim of a gunshot wound, is treated in the last functioning hospital in North Darfur
In nearby camps, women are grieving brothers, fathers, and husbands killed, missing or still trapped inside Al Fashir. Many of them were forced to face Rapid Support Forces (RSF) torture as they tried to escape.
“If you don’t have money to pay ransom, they take you inside a room that looks like an office and say ‘if you don’t have anything we will kill you or worse’,” says 20-year-old mother Zahra, speaking to us at a girls’ school in Tine that is now a makeshift shelter.
“They beat the men, robbed them and whipped them. We could hear some of them being killed while we women were rounded up on a mat and threatened. We gave them money, but they took the other girls into a room, and we couldn’t tell if they were beaten or raped.”
Image: Zahra was threatened by the RSF and heard people being killed
The women around her on the mat echo Zahra’s anguish.
“They beat us, tortured us, humiliated us – everything you can imagine!” one yells out in tears.
A mother named Leila sits next to her four children and stares down at the ground. I ask her if she has hope of returning to Al Fashir, and she starts to say no as the women nearby shout: “Yes! We will return by the grace of God.”
Leila complies with weak affirmation, but her eyes have the haunting resignation of permanent loss. Her city, as she knows it, is gone.
Babies and young children silently stare out from their laps. Many of them wear the signs of physical shock. An older woman on the mat tells us her infant grandson was blinded by the extreme conditions of their escape and takes us to see him and his mother in their hut.
“We fled Al Fashir to Tawila camp while I was heavily pregnant,” says Nadeefa, as her son Mustafa cries on her lap, unable to focus his eyes.
Image: Mustafa was blinded as a newborn after his mother fled the RSF
“After I had given birth, we made the journey here. Mustafa was only 16 days old and could not handle the harsh conditions. As time went on, we realised he couldn’t see. We think he was blinded as a newborn on the road.”
Her mother and mother-in-law sit on the mat next to her and take turns trying to calm Mustafa down. Her mother-in-law Husna tells us that her own son, Mustafa’s father, is missing.
“We don’t know where my son is,” she says. “He disappeared as we fled.”
Image: Mustafa’s father went missing as the family fled the RSF
‘They killed my children’
An elderly woman, Hawa, approaches us in the same yard with her own story to tell.
“These people [the RSF] killed my children. They killed my in-laws. They orphaned my grandchildren. They killed two of my sons.
“One of my daughters gave birth on the road and I brought her with me to this camp. I don’t have anything,” she says, trembling as she stands.
“They raped my two younger daughters in front of me. There is nothing more than that. They fled from shame and humiliation. I haven’t seen them since.”
Image: The RSF raped Hawa’s daughters in front of her
Dr Afaf Ishaq, the camp director and emergency response room (EER) volunteer, is sobbing nearby.
“I have dealt with thousands and thousands of cases, I am on the verge of a mental breakdown,” she says.
“Sometimes in the morning, I have my tea and forget that I need to eat or how to function. I just sit listening to testimony after testimony in my head and feel like I am hallucinating.”
Everyone we speak to points to her as a source of relief and help, but Dr Ishaq is largely carrying the burden alone. When haphazard financial support for the ERR community kitchens ends, she says people flock to her complaining of hunger.
Dr Ishaq lives in the camp by herself after fleeing her home in Khartoum at the start of the war in April 2023. She says she quickly escaped after her husband joined the RSF.
Image: Dr Afaf Ishaq has seen thousands of cases of violence and sexual violence
Since then, she has been constantly reminded of the atrocities committed by her husband’s ranks in Khartoum, her hometown Al Fashir and the ethnic violence they are carrying out across the region.
“The RSF focuses on ethnicity,” she says. “If you are from the Zaghawa, Massalit, Fur – from Darfuri tribes – you should be killed, you should be raped.
“If they find that your mother or father are from another tribe like Rizeigat or Mahamid – they won’t rape you, they won’t touch you.”
Image: The RSF has besieged Al Fashir for 16 months. File pic: Reuters
A message for the West
In January, the Biden administration determined that the RSF are carrying out genocide in Darfur, 20 years after former US secretary of state Colin Powell made the declaration in 2004.
But the designation has done little to quell the violence.
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Sudan’s government has accused the United Arab Emirates (UAE) of supplying arms and logistical support to the RSF. The UAE denies these claims but many on the ground in Darfur say its role in this war is accepted as fact.
The silence from the UAE’s allies in the West, including the UK and US, is felt loudly here – punctuated by gunfire and daily bombs.
Image: Dr Ishaq fled her home in Khartoum at the start of the war after her husband joined the RSF
Dr Ishaq’s distress ratches up when I ask her about neglect from the international community.
“I direct my blame to the international community. How can they speak of human rights and ignore what is happening here?
The prime suspect in the disappearance of Madeleine McCann has refused to be interviewed by the Metropolitan Police.
German drifter Christian B, as he is known under privacy laws, became a leading person of interest following the three-year-old British girl’sdisappearance from a holiday resort in Portugal in 2007.
He is expected to be released from a jail in Germany as soon as Wednesday, at the end of a sentence for raping an elderly woman in Praia da Luz in 2005.
The Met said it sent an “international letter of request” to the 49-year-old for him to speak with them – but he rejected it.
Madeleine vanished shortly after she was left sleeping by her parents, Kate and Gerry McCann, who went for dinner in a nearby restaurant in Praia da Luz.
Image: The search for the British toddler has gone on for 18 years
The Met said Christian B remains a suspect in its own investigation – with Portuguese and German authorities also probing Madeleine’s disappearance.
He has previously denied any involvement.
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Detective Chief Inspector Mark Cranwell, a senior investigating officer, said the force will “continue to pursue any viable lines of inquiry” in the absence of an interview with Christian B.
He said: “For a number of years we have worked closely with our policing colleagues in Germany and Portugal to investigate the disappearance of Madeleine McCann and support Madeleine’s family to understand what happened…
“We have requested an interview with this German suspect but, for legal reasons, this can only be done via an International Letter of Request which has been submitted.
“It was subsequently refused by the suspect. In the absence of an interview, we will nevertheless continue to pursue any viable lines of inquiry.”
Image: Madeleine was taken from her family’s apartment while her parents dined in a nearby restaurant
Buther mother, Kate, has long dismissed the suggestion her daughter managed to get out of the apartment alone.
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13:29
Sky’s Martin Brunt investigates the hit-and-run theory in the case of Madeleine McCann
A number of searches have been carried out by German, Portuguese and British authorities since her disappearance – with the latest taking place near the Portuguese municipality of Lagos in June.
In 2023, investigators carried out searches near the Barragem do Arade reservoir, about 30 miles from Praia da Luz.
Christian B spent time in the area between 2000 and 2017 and had photographs and videos of himself near the reservoir.
In October last year, the suspect was cleared by a German court of unrelated sexual offences, alleged to have taken place in Portugal between 2000 and 2017.
The total funding given to the Met’s investigation, titled Operation Grange, has been more than £13.2m since 2011 after a further £108,000 was secured from the government in April.
It has deployed tanks, battleships and supersonic bombers for military drills with Belarus that are happening on land, at sea and in the air.
‘Zapad-2025′ are the allies’ first joint exercises since the invasion of Ukraine, and on Sunday involved the launch of a hypersonic missile in the Barents Sea.
“There are several strategic goals here that [Russia and Belarus] want to achieve,” Hanna Liubakova, an independent Belarusian journalist, told Sky News.
“Scare, show that they are capable, show that they can threaten… and of course, they’re also checking what the reaction and response could be.”
The reaction so far has been frosty, to say the least.
Image: A Russian nuclear submarine sets out to sea during the practice run. Pic: AP.
Image: Russia launches a Zircon hypersonic missile at a target during the Zapad joint strategic exercise. Pic: Reuters
Ahead of the drills, Poland closed its border with Belarus and deployed more than 30,000 troops as part of its own military exercises.
Lithuania is also holding drills and said it would bolster defences along its frontiers with Russia and Belarus.
The authorities in Minsk, and in Moscow, insist the drills are defensive and not aimed at any other country.
Image: A Russian nuclear submarine sets out to sea during the practice run. Pic: AP.
On Friday, the Kremlin even described Europe’s concerns as “emotional overload”.
But the last time these drills happened four years ago, it led to a massive build-up of Russian troops in Belarus, which Moscow then used for part of its invasion of Ukraine a few months later.
And the drills aren’t the only thing Europe is worried about.
The show of strength comes at a time of heightened tension after recent Russian drone incursions into NATO airspace – first in Poland and then Romania.
There’s a feeling in the West that the drones and drills are a test of NATO’s defences and Western resolve.
But you’re unlikely to find that opinion on the streets of the Belarusian capital, Minsk.
“There is no aggression,” Mikhail told Sky News. “Exercises are normal, especially planned ones. So I think it’s fine.”
Image: Pic: AP
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