Ground battles rage in Gaza as concern grows for hospitals

Israel's intensifying land and air campaign since Hamas's October 7 attacks has heightened fears for the 2.4 million civilians trapped inside besieged Gaza, where the Hamas-ruled health ministry says more than 8,000 have died.

Dozens of Israeli tanks rolled into the fringes of Gaza City, eyewitnesses said, after a night of heavy clashes in nearby areas where the army said it had killed dozens of "terrorists" and Hamas also reported fierce fighting.

The Israeli land forces are supported by heavy fire from fighter jets, drones and artillery that the army said had struck more than 600 targets within 24 hours, up sharply from 450 a day earlier.

Concern has surged about the widening humanitarian disaster, with fears centred on Gaza hospitals inside Israeli-mandated evacuation zones where medics warn that many patients cannot be moved.

The army said troops overnight "killed dozens of terrorists who barricaded themselves in buildings and tunnels and attempted to attack" while an aircraft struck a building "with over 20 Hamas terrorist operatives inside".

Columns of Israeli tanks and armoured bulldozers were seen churning through the sand, and Israeli snipers took positions inside emptied residential buildings, in footage released by the army.

Israeli tanks were later spotted on the edges of Gaza City, usually the most densely populated urban area but now emptied of many residents following repeated Israeli evacuation orders.

A witness told AFP the Israeli tanks blocked the strip's major north-south road and had been "firing at any vehicle that tries to go along it".

AFP journalists are not inside Gaza City, following Israeli warnings that the territory's northern areas must be considered a war zone.

- 'The ground shook' -

It is now more than three weeks since Hamas gunmen launched a wave of bloody cross-border raids against homes, communities, farms and security posts in Israel that shocked and infuriated the nation.

An estimated 1,400 people, mostly civilians, were killed and 239 people were taken hostage, according to the latest Israeli tallies.

Israel has vowed to free the hostages, track down those responsible and "eradicate" Hamas, the Islamist movement that has governed Gaza since 2007.

After weeks of ferocious air strikes, Israeli Prime Minister Benjamin Netanyahu has declared a new "stage" in a "long and difficult" war.

Israel has for weeks warned Palestinians civilians to flee the northern half of the Gaza Strip, while also cutting off normal supplies of water, food, fuel and other essentials to the long-blockaded territory.

The United Nations reported Sunday that civil order was starting to break down after "thousands of people" had ransacked its warehouses looking for tinned food, flour, oil and hygiene supplies.

According to the UN, all 10 hospitals in northern Gaza have received evacuation orders -- despite sheltering thousands of patients and about 117,000 of the displaced.

Among those being treated are intensive care patients, infants and elderly people on life support systems.

The head of the World Health Organization said calls to evacuate Al-Quds hospital in Gaza City were "deeply concerning".

"We reiterate -- it's impossible to evacuate hospitals full of patients without endangering their lives," Tedros Adhanom Ghebreyesus wrote on X.

Mohamed al-Talmas, who has taken shelter in Gaza's biggest hospital Al-Shifa, said "the ground shook" there with intense Israeli raids.

Israel describes Al-Shifa hospital as a de facto Hamas "command centre" and headquarters.

- 'Collective punishment' -

UN chief Antonio Guterres has warned the situation was getting "more desperate by the hour" and warned against the "collective punishment" of Palestinians.

US President Joe Biden stressed in a call with Netanyahu that, while Israel has the right to defend itself, it must do so "in a manner consistent with international humanitarian law that prioritises the protection of civilians".

Britain's Prime Minister Rishi Sunak and French President Emmanuel Macron earlier "stressed the importance of getting urgent humanitarian support" into Gaza.

And the International Criminal Court lead prosecutor Karim Khan warned Israel on Sunday that preventing access to humanitarian aid could be a "crime".

Limited aid has entered Gaza from Egypt under a US-brokered deal, but its volume has fallen far short of the hundreds of trucks a day aid agencies say are needed.

The UN reported that 33 trucks carrying water, food and medical supplies had entered Gaza on Sunday -- bringing to 117 the total that have entered through the Rafah crossing since the resumption of aid on October 21.

With increasingly fierce urban war now feared in Gaza, Israeli army spokesman Daniel Hagari again urged Palestinian civilians to go "to a safer area" in the south, where many families now live in cars, tents or in the open.

"We are gradually expanding the ground activity and the scope of our forces in the Gaza Strip," he said.

- Fears for hostages -

Inside Israel, where shocked residents still face daily rocket attacks, much of the focus is on the hostages abducted by Hamas.

Hamas has released four and offered to free more as part of a swap for Palestinians detained in Israel.

It has also claimed "almost 50" hostages were killed by Israeli strikes -- a claim that was impossible to verify but has caused anguish to those praying for their loved ones to return.

"We demanded that no action be taken that endangers the fate of our family members," said Meirav Leshem Gonen, the mother of hostage Romi Gonen.

Israel's Defence Minister Yoav Gallant accused Hamas of playing "psychological games" and charged that "Hamas is cynically using those who are dear to us -- they understand the pain and the pressure".

Anti-Israel anger has flared across the tense region.

Washington has expressed deep concern about the war spilling over, as Israel's enemies -- in particular Iran-allied "axis of resistance" groups -- step up actions across the Middle East.

Iran's President Ebrahim Raisi has warned Israel's "crimes have crossed the red lines, which may force everyone to take action".

The Israeli army said Monday it had "struck military infrastructure in Syrian territory" in response to launches "toward Israeli territory".

Skirmishes have intensified on the Israeli-Lebanese border with Iran-backed Hezbollah.

Israel's military said Monday that 31-year-old sergeant Yinon Fleishman, a reservist, was killed in northern Israel when his tank overturned.