Gaza City, November 14 (RHC)-- Medics have warned of mounting casualties among patients, including newborn babies, and concern of spreading disease is growing, as Israeli forces approach the gates of al-Shifa, Gaza City’s main hospital.

Besieged for days by Israel’s military, doctors inside the hospital reiterated on Monday that the lack of fuel for electricity generators is leaving them unable to save patients. Israel has refused to back down, claiming that the hospital hides a Hamas base.

Fighting has been concentrated in a tightening circle around the Gaza Strip’s largest hospital, where thousands of civilians have sought shelter.  The Israeli military, whose ground forces entered the Strip in late October and quickly encircled the north’s main settlement Gaza City, has said that al-Shifa is the primary target in its battle to seize control of the northern half of the enclave.

Israel says that Hamas fighters have an underground headquarters in tunnels beneath the hospital and are deliberately using its patients as a shield, a claim that Hamas denies.  Reports on Monday suggested that thousands of people have fled the hospital.  But huge numbers also remain trapped within the medical facility.

At least 650 patients remain, as well as staff, said Gaza’s Ministry of Health spokesperson Ashraf al-Qudra, who was inside al-Shifa Hospital in Gaza City, adding that an Israel tank was stationed at the hospital gate.

“The tank is outside the gate of the outpatient clinic department, this is how the situation looks this morning,” al-Qudra told the Reuters news agency by phone.   Israeli snipers and drones were firing into the hospital, making it impossible for medics and patients to move around, he added.

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

The official said that 32 patients had died in the past three days, including three newborn babies, as a result of the siege of the hospital and the cut-off of its power.

It was unclear where they would go. Several hospitals and clinics in Gaza have been forced to shut down, while others are already working at full capacity with dwindling supplies.  Meanwhile, Israeli forces have surrounded the facility.

Israel also claimed that it attempted to evacuate babies from al-Shifa’s neonatal ward and left 300 litres (79 gallons) of fuel to power emergency generators at the hospital entrance, but that Hamas blocked the offer and prevented the hospital from using the fuel.

The Health Ministry spokesperson denied rejecting the fuel, adding that 300 litres would power the hospital for just half an hour.  Al-Shifa needed 8,000-10,000 litres (2,113-2,641 gallons) of fuel per day, which must be delivered by the Red Cross or an international aid agency, he told Reuters.

Medical Aid for Palestinians, a UK-based charity that has supported al-Shifa’s neonatal intensive care unit, said transferring critically ill infants is complex.

“With ambulances unable to reach the hospital … and no hospital with capacity to receive them, there is no indication of how this can be done safely,” CEO Melanie Ward said. She said the only option was to pause the fighting and allow in fuel.

The Gaza Health Ministry said that of 45 babies in incubators at al-Shifa, six had died as of Monday. Al-Qudra had no immediate update.

World Health Organization chief Tedros Adhanom Ghebreyesus said in a post on X that al-Shifa was “not functioning as a hospital anymore.”

“Tragically, the number of patient fatalities has increased significantly,” he said. “The world cannot stand silent while hospitals, which should be safe havens, are transformed into scenes of death, devastation, and despair.”