The tunnel shaft, some two meters (6-1/2 feet) high, was accessed through an outdoor shaft in the hospital complex grounds, which were once crowded with tens of thousands of Palestinian civilians the army said had served as a human shield from war.

“That’s the way that they survive because they use the hospital as a human shield that protects them,” said Colonel Elad Tsuri, commander of an Israeli armoured brigade that found the tunnel. “And here they can stay for a long time. There is a room with air conditioning inside.”

Israel has long accused Hamas of using the Shifa hospital complex as a command and control center as part of a wider strategy that seeks to hide its forces among the civilian population.

Hamas and hospital officials have denied the accusation and the hospital site has been at the centre of accusations of war crimes on both sides, with Palestinians accusing Israel of targeting hospitals and Israel saying the sites were being used to shelter armed fighters.

Journalists were driven in Israeli military vehicles to the hospital complex in the northern Gaza Strip past a landscape of buildings destroyed or vacated during Israel’s nearly seven-week-old invasion of the Palestinian enclave.

Graced with arches, the tunnel was a well-built structure lined with stone and concrete. Army escorts used flashlights to illuminate the way in the dark and showed a small kitchen, a bathroom equipped with a toilet and sink behind a closed door, as well as a room large enough for meetings with two metal beds.

“We assume that there is another way out that they prepared. It’s not open yet and we are sure that there are ways to the city from here,” Tsuri said. He said the army knew the tunnel led to another opening in a Gaza kindergarten.

Israel has faced international criticism for its Gaza campaign, including its attacks on Shifa, the enclave’s largest hospital. Medical officials say Israel has killed around 13,000 people in the strip since Hamas’ Oct. 7 attack on Israel in which Israel says 1,200 people were killed and 240 taken hostage.

Outside on the ground, the army showed scores of guns, grenades and other explosives that military spokesperson Rear Admiral Daniel Hagari said had been collected in recent days inside the hospital, a motor home and nearby cars.

He said the body of one hostage, Noa Marciano, 19, had been recovered by the army outside a nearby medical clinic. Hamas earlier released a video saying she had died in an Israeli air strike. It was impossible to verify the claim.

In Washington, the White House has said its independent intelligence supported Israel’s claim that Hamas was using Gaza’s hospitals, including Shifa, to hide command posts.

Hamas responded at the time: “The White House and the Pentagon’s adoption of the false (Israeli) narrative, claiming that the resistance is using Al Shifa medical complex for military purposes, was a green light for the occupation (Israel) to commit more massacres against civilians.”

But Hagari, referring to Hamas’ use of a hideout beneath the hospital, said: “The world now should say what happened in Shifa, what happened in the hospitals, is a war crime.”

At one point a shelter for tens of thousands of Palestinian war refugees, Al Shifa Hospital has been evacuating patients and staff since Israeli troops swept in last week on what they called a mission to root out hidden Hamas facilities.

Israel is also searching for some 240 people Hamas kidnapped to Gaza after an Oct. 7 cross-border assault that sparked the war.

One of these was a 19-year-old Israeli army conscript, Noa Marciano, whose body was recovered near Shifa last week. Hamas said she died in an Israeli air strike and issued a video that appeared to show her corpse, unmarked except for a head wound.

The Israeli military said a forensic examination found she had sustained non-life-threatening injuries from such a strike.

“According to intelligence information – solid intelligence information – Noa was taken by Hamas terrorists inside the walls of Shifa hospital. There, she was murdered by a Hamas terrorist,” chief spokesperson Rear Admiral Daniel Hagari said.

He did not elaborate.

In his televised briefing, Hagari said Hamas gunmen had also brought a Nepalese and a Thai, among foreign workers seized in the Oct. 7 raid, to Shifa. He did not name the two hostages.

CCTV video aired by Hagari appeared to show a group of men frog-marching an individual into a hospital, to the surprise of medical staff. A second clip showed an injured man on a gurney. Another man nearby, in civilian clothes, had an assault rifle.

Hamas did not immediately comment on Hagari’s statements. The Palestinian Islamist group, which runs Gaza, has previously said it took some hostages to hospitals for treatment.

Separately on Sunday, the Israeli military published video of what it described as a tunnel, running 55 metres in length and dug by Palestinians 10 metres under the Shifa compound.

While acknowledging that it has a network of hundreds of kilometres of secret tunnels, bunkers and access shafts throughout the Palestinian enclave, Hamas has denied that these are located in civilian infrastructure like hospitals.

The video showed a narrow passage with arched concrete roofing, ending at what the military, in a statement, described as a blast-proof door.

The statement did not say what might be beyond the door. The tunnel had been accessed through a shaft discovered in a shed within the Shifa compound that contained munitions, it said. A second video showed an outdoor shaft-opening in the compound.

Mounir El Barsh, the Gaza health ministry director, dismissed the Israeli statement on the tunnel as a “pure lie”.

“They have been at the hospital for eight days … and yet they haven’t found anything,” he told Al Jazeera television.

The WHO-led team, which included public health experts, logistics officers and security staff from various U.N. departments, was able to spend only an hour inside the hospital on Saturday due to security concerns, WHO said in a statement.

The team described the hospital as a “death zone” and said the situation was “desperate,” with the hospital basically not functioning as a medical facility due to scarcity of clean water, fuel, medicine and other essentials.

“Signs of shelling and gunfire were evident. The team saw a mass grave at the entrance of the hospital and were told more than 80 people were buried there,” the WHO statement said.

The hallways and hospital grounds were filled with medical and solid waste, and patients and health staff expressed fear for their health and safety, it said. There were 25 health workers and 291 patients, including 32 babies in critical condition, remaining in Al Shifa, WHO said.

“WHO and partners are urgently developing plans for the immediate evacuation of the remaining patients, staff and their families,” it said.

“Over the next 24–72 hours, pending guarantees of safe passage by parties to the conflict, additional missions are being arranged to urgently transport patients” to other hospitals in the south of Gaza.

The Israeli military did not immediately comment on the WHO statement or the visit.

The remaining 2,500 internally displaced people who had sought refuge on Al Shifa grounds were gone after the Israeli Defense Forces issued evacuation orders on Saturday, WHO said.

Israeli forces seized Al Shifa in their offensive across north Gaza last week, saying it concealed an underground Hamas command centre. The military said it found evidence of a Hamas base underground. Al Shifa staff say Israel has proven no such thing.

The visit was coordinated with the Israeli military to reduce risks but occurred in an active conflict zone, with heavy fighting close to the hospital, WHO said.

WHO repeated its call for an immediate ceasefire and sustained humanitarian assistance, saying options for medical care in the small coastal enclave were dwindling.

Doctor Ahmed El Mokhallalati told Reuters by telephone that despite the “difficult” conditions at the hospital, no babies had died there since Israeli troops entered it on Wednesday.

Israel says Hamas has a command centre underneath the hospital, an assertion the Palestinian militant group denies. Reuters has been unable to verify the situation at the hospital independently.

“It’s a totally terrifying situation, here the Israeli tanks and the Israeli troops have been moving within the hospital area, all over the hospital,” said Mokhallalati, a surgeon born in Ireland who trained in Cairo and practiced in London.

“The situation is totally difficult. They are shooting all the time, all the areas.”

The Israeli military said on Thursday it had uncovered a Hamas tunnel shaft and a vehicle with weapons at the Al Shifa hospital complex. It also made public videos and photographs to support its statement.

Speaking in English, Mokhallalati said: “They have found nothing. They have found no single resistance. No single gunshot, against them within the hospital area.”

The hospital, packed with patients and displaced people and struggling to keep operating, has become a focus of global concern.

Mokhallalati said the Israeli military had provided some supplies since entering the hospital but that it was insufficient.

“What happened is that the people, we run out of food, we ran out of drinking water,” Mokhallalati said. “And then, yesterday, they arranged some, just some food and water, which is very, very minimal, which doesn’t cover, maybe 40% of the number of people around here.”

Dr Mohamed Tabasha, head of the paediatric department at Al Shifa, said on Monday three newborn babies had died as problems mounted at the hospital, and that the 36 remaining newborns were at risk.

“As of yesterday they were 36, luckily no one has lost their lives,” he said on Friday.

“In the Shifa Hospital, IDF troops found an operational tunnel shaft and a vehicle containing a large number of weapons,” the military said, using the acronym for the Israel Defense Forces.

The military also made public videos and photographs of the tunnel shaft and weapons.

The United States is confident in an assessment from its own intelligence agencies on Hamas activities in the Gaza facility, Kirby said. He has refused to elaborate or provide details over the past several days.

The Biden administration has not declassified the sources of the U.S. intelligence “because some of those same channels are being used to monitor the status of hostages,” a knowledgeable source said.

The intelligence “is definitive,” said the source, and includes communications intercepts of Hamas fighters. The intercepts were first reported on Wednesday by the Wall Street Journal.

Israeli troops entered Al Shifa hospital on Wednesday after an aerial bombardment and ground operation targeting Hamas militants whom Israeli officials say killed 1,200 people in a cross-border attack from Gaza on Oct. 7.

About 11,500 people have been killed in Israel’s retaliatory bombardments, according to health officials in Hamas-controlled Gaza.

Asked whether Israelis have shared any new intelligence since the raid on the hospital began, Kirby said, “I’m not going to talk about specific intelligence that may pass between the two of us.”

“That’s really for them to speak to, but as I said the other day, we’re confident in our own intelligence assessment about how Hamas was using that hospital,” Kirby said in a briefing.

Hamas militants were sheltering themselves in the hospital and using the facility as a shield against military action, placing patients and medical staff at risk, he said.

“We have our own intelligence that convinces us that Hamas was using al Shifa as a command and control node, and most likely as well as a storage facility.

“We are still convinced of the soundness of that intelligence.”

The army released a video it said showed a tunnel entrance in an outdoor area of Al Shifa, Gaza’s biggest hospital.

The video, which Reuters could not immediately verify, showed a deep hole in the ground, littered with and surrounded by concrete and wood rubble and sand. It appeared the area had been excavated; a bulldozer appeared in the background.

The army said its troops also found a vehicle in the hospital containing a large number of weapons.

Hamas said in a statement late on Thursday that claims by the Pentagon and U.S. State Department that the group uses Al Shifa for military purposes “is a repetition of a blatantly false narrative, demonstrated by the weak and ridiculous performances of the occupation army spokesman.”

The United States is confident in an assessment from its own intelligence agencies on Hamas activities in Al Shifa hospital and will neither share nor elaborate on it, White House spokesperson John Kirby said on Thursday.

The two telecoms companies in Gaza said all energy sources supplying the network had run out and therefore all services in the territory were down. Israel refuses fuel imports, saying Hamas could use them for military purposes.

With communications out and in the absence of fuel, the U.N. agency for Palestinian refugees, UNRWA, said it was impossible to coordinate humanitarian aid truck convoys.

“If the fuel does not come in, people will start to die because of the lack of fuel. Exactly as from when, I don’t know. But it will be sooner rather than later,” said UNRWA Commissioner-General Philippe Lazzarini.

As of late Thursday night, there was no further word from the companies, Paltel and Jawwal, whose internet, mobile phone and landline networks remained inoperable.

Palestinian civilians have borne the brunt of Israel’s weeks-long military campaign in retaliation for an Oct. 7 attack by Hamas that Israel says killed 1,200 people, mostly civilians.

Gaza health authorities deemed reliable by the United Nations say at least 11,500 people have been confirmed killed in an Israeli bombardment and ground invasion – more than 4,700 of them children.

The Israeli military’s chief of staff said Israel was close to destroying Hamas’ military system in the northern Gaza Strip and there were signs the army was taking its campaign to other parts of the enclave of 2.3 million people.

Israel distributed pamphlets telling civilians to leave four towns in southern Gaza, areas Gazans had been previously told would be safe.

Gaza Hospitals At Crux Of Global Debate

Israeli officials said Hamas held some of the 240 hostages taken by gunmen on Oct. 7 in the hospital complex. The body of a woman hostage was recovered by troops in a building near Al Shifa on Thursday, the army said.

Military equipment including Kalashnikov rifles and rocket-propelled grenades were also found in the building, it said.

Human Rights Watch said hospitals have special protections under international humanitarian law.

“Hospitals only lose those protections if it can be shown that harmful acts have been carried out from the premises,” the watchdog’s U.N. Director Louis Charbonneau said.

EU foreign policy chief Josep Borrell, on his first visit to Israel since the Oct. 7 Hamas attack, called on Israel to do more to protect civilians in Gaza.

“I understand your rage but let me ask you not to be consumed by rage,” Borrell said. Israeli Foreign Minister Eli Cohen said Hamas was to blame not only for the Oct. 7 attack but also for the current plight of Palestinians in Gaza.

The army simultaneously released a video that it said showed some of the material recovered from an undisclosed building within the large hospital complex, including automatic weapons, grenades, ammunition and flak jackets.

Hamas, which is battling Israeli forces within the Gaza, dismissed the announcement as “lies and cheap propaganda”.

Israel invaded the Palestinian enclave last month and has vowed to destroy Hamas after the Islamist group launched a surprise cross-border assault on southern Israel on Oct. 7.

The military has focused its operations on hospitals across northern Gaza after long accusing Hamas of setting up major command and control centres beneath medical facilities in an effort to avoid air strikes.

Israeli troops forced their way into Al Shifa overnight and have spent the day scouring specific locations within Gaza’s largest hospital.

“These assets in Shifa hospital, just like in Rantissi, prove that hospitals have been used for military purposes for terror, in direct opposition to international law,” Hagari said.

Israeli soldiers entered the Rantissi paediatric hospital on Monday, later releasing a video showing what it said were weapons stored by Hamas in the building’s basement.

The military made no mention on Wednesday of finding any tunnel entrances in Al Shifa. It has previously said that Hamas had built a network of tunnels under the hospital.

Both Hamas and hospital staff have denied this.

Hagari said the search would continue “in a precise way and in accordance with intelligence … in order to gather more details and to discover more assets”.

Hamas accused Israel of fabricating evidence, saying it was “trying to justify its genocidal crimes destroying the health sector in Gaza”.

Speaking earlier on CNN, military spokesman Lieutenant Colonel Richard Hecht said Israelis forces had entered a specific area inside the hospital, adding: “There wasn’t an all-out attack.”

He said fire was exchanged before the Israeli soldiers moved into the hospital, but there was “no engagement whatsoever” once they entered.

Israeli officials have previously suggested that some of the 240 captives seized by Hamas militants in Israel on Oct. 7 might be located underneath Gazan hospitals. However, Hecht said the raid at Al Shifa was not focused on hostages.

“We were focused on bringing intelligence and dismantling certain capabilities that we had intelligence on,” he said.

Israel says 1,200 people were killed in the Hamas attack on Israel on Oct. 7. Gaza health officials say more than 11,100 Palestinians are confirmed killed in Israeli’s military offensive since then.

Gaza health ministry spokesperson Ashraf Al-Qidra, who was inside Al Shifa hospital, said 32 patients had died in the past three days, including three newborn babies, as a result of the siege of the hospital and lack of power.

At least 650 patients were still inside, desperate to be evacuated to another medical facility by the Red Cross or some other neutral agency. Israel says the hospital sits atop tunnels housing a headquarters for Hamas fighters using patients as shields, which Hamas denies.

“The tanks are in front of the hospital. We are under full blockade. It’s a totally civilian area. Only hospital facility, hospital patients, doctors and other civilians staying in the hospital. Someone should stop this,” a surgeon at the hospital, Dr Ahmed El Mokhallalati, said by telephone.

“They bombed the (water) tanks, they bombed the water wells, they bombed the oxygen pump as well. They bombed everything in the hospital. So we are hardly surviving. We tell everyone, the hospital is no more a safe place for treating patients. We are harming patients by keeping them here.”

There was also fresh concern that the war could spread beyond Gaza, with an upsurge of clashes on Israel’s northern border with Lebanon, and the United States launching air strikes on Iran-linked militia targets in neighbouring Syria.

King Abdullah in neighbouring Jordan was quoted by state media on Monday as saying the root cause of the crisis was Israel’s denial of Palestinians’ “legitimate rights” and that there could be no military solution.

Israel launched its campaign last month to annihilate Hamas, the militant group which runs the Gaza Strip, after Hamas fighters rampaged through southern Israel killing civilians. Around 1,200 people died and 240 were dragged to Gaza as hostages according to Israel’s tally, in the deadliest day in its 75-year history.

Since then thousands of Gazans have been killed and two thirds of the population made homeless by a relentless Israeli military campaign. Israel has ordered the total evacuation of the northern half of Gaza. Gaza medical authorities say more than 11,000 people have been confirmed killed, around 40% of them children.

Since Israeli ground forces entered Gaza in late October and quickly surrounded Gaza City, fighting has been concentrated in a tightening circle around Al Shifa, the enclave’s biggest hospital.

Gaza health ministry spokesperson Qidra said an Israel tank was now stationed at the hospital gate. Israeli snipers and drones were firing into the hospital, making it impossible for medics and patients to move around.

“We are besieged and are inside a circle of death,” he said.

Israel has told civilians to leave and medics to send patients elsewhere. It says it has attempted to evacuate babies from the neo-natal ward and left 300 litres of fuel to power emergency generators at the hospital entrance, but the offers were blocked by Hamas.

Qidra said the 300 litres would power the hospital for just half an hour, and Shifa needed 8,000-10,000 litres of fuel per day delivered by the Red Cross or an international agency. An Israeli official who requested anonymity said 300 litres could last several hours because only the emergency room was running.

Dr El Mokhallalati, the surgeon, said premature babies that would normally be in individual incubators were being lined up eight to a bed, kept warm with whatever power was left.

After three died there were 36 alive in the neo-natal unit, he said. “We are expecting to lose more of them day by day.”

Gunbattle At Second Hospital

Fighting also took place at a second major hospital in northern Gaza, al-Quds, which has also stopped functioning. The Palestinian Red Crescent said the hospital was surrounded by heavy gunfire, and a convoy sent to evacuate patients and staff had been unable to reach it.

Israel said it had killed “approximately 21 terrorists” at al-Quds in return fire after fighters shot from the hospital entrance. It released footage purporting to show a group of men at the hospital gate, one of whom appeared to be carrying a rocket-propelled grenade launcher.

U.N. agencies observed a minute’s silence on Monday for 101 staff members killed so far in Gaza.

U.N. agency UNRWA is now housing around 800,000 people in Gaza, or half of those made homeless by the fighting. It said on Monday its emergency fuel depot for the enclave had finally run dry and it would soon be unable to run ambulances, resupply hospitals, provide drinking water or pump sewage.

The more than month-long conflict has polarised the world, with many countries saying that even the shocking brutality of the Hamas attacks did not justify an Israeli response that has killed so many civilians.

Israel says it must destroy Hamas, and the blame for harm to civilians falls on fighters hiding among them. It has rejected demands for a ceasefire, which it says would only prolong the suffering by letting Hamas regroup. Washington backs that position though it says it is pressing its ally to protect civilians.

Hundreds of thousands of residents are believed to remain in the northern part of Gaza, despite Israel’s order to leave. Israel has also regularly bombed the south.

The conflict has raised fears of a broader conflagration. Lebanon-based Hezbollah, which like Hamas is backed by Iran, has traded missile attacks with Israel.

U.S. and international forces based in northeastern Syria were targeted at least four times in less than 24 hours with drones and rockets, a U.S. military official said on Monday, adding there had been no casualties.

“As a result, one newborn baby died inside the incubator, where there are 45 babies,” Ashraf Al-Qidra, the spokesman for the Health Ministry in Hamas-controlled Gaza told Reuters.

Israel’s military, which residents said had been fighting Hamas gunmen all night in and around Gaza City where the hospital is located, did not immediately respond to a request for comment.

“The situation is worse than anyone can imagine. We are besieged inside the Al Shifa Medical Complex, and the occupation has targeted most of the buildings inside,” Qidra said by telephone.

The Israeli military has said that Hamas militants who rampaged through southern Israel last month have placed command centres under Shifa hospital and others in Gaza, making them vulnerable to being considered military targets.

Hamas has denied using civilians as human shields and health officials say growing numbers of Israeli strikes on or near hospitals put at risk patients, medical staff and thousands of evacuees who have taken shelter in and near their buildings.

“The occupation forces are firing on people moving inside the complex, which is limiting our ability to move from one department to another. Some people tried to leave the hospital and they were fired at,” Qidra said, adding that there was no electricity and no internet.