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Battle of Khan Younis threatens biggest hospital still working in Gaza

Patients and displaced people at Nasser Hospital flee in panic as Israeli forces pound areas near the hospital

Israeli forces advancing into the southern Gaza Strip's main city pounded areas near the biggest hospital still functioning in the enclave on Thursday, sending patients and residents fleeing a battle they feared would lay the city to waste.

The heaviest battle of the year so far was under way in Khan Younis, sheltering hundreds of thousands of people who fled the north earlier in the war, now in its fourth month.

Residents described heavy fighting and intense bombardment in the north and east of the city and, for the first time, in the west, where they said tanks had advanced to carry out a raid before withdrawing.

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The Israeli military said a brigade in Khan Younis, now operating further south than troops had ventured before, had "eliminated dozens of terrorists in close-quarters combat and with the assistance of tank fire and air support". It said it had killed 60 fighters in the previous 24 hours, including 40 in Khan Younis. The figures were impossible to verify.

The charity Medecins Sans Frontieres, which has doctors at the city's Nasser Hospital, said patients and displaced people sheltering there were fleeing in panic.

In Rafah, further south, where more than half of Gaza's 2.3 million people are now crammed into a small city by the Egyptian border, 16 bodies were laid out on the bloodstained cobbles outside a morgue, most in white shrouds, a few in body bags.

A branch of the Zameli family had been wiped out in a strike that destroyed their home overnight. Half the bundles were tiny, holding the bodies of small children. A grey-haired man howled in sorrow as he clung to one of the bodies, burying his face in the face of the shrouded corpse. A woman in a pink headscarf keened and stroked one of the shrouds.

At the scene of the bombing, a tattered schoolbag lay in the rubble. Tears rolled down the cheeks of 10-year-old cousin Mahmoud Al Zameli, who lived next door and had escaped.

"Yesterday, I was playing with the children over there. They have all died," he sobbed. "I'm the only one still alive."

Gaza health authorities said on Thursday the war's death toll had risen to 24,620 with many more feared buried under the rubble. More than 170 were killed in the past 24 hours.

Israel has said it is planning to wind down its ground operations and shift to smaller-scale tactics.

But before doing so, it appears determined to capture all of Khan Younis, which it says is now the principal base for the Hamas fighters.

An Israeli official, speaking on condition of anonymity, told Reuters that, while Israel had already shifted to smaller scale operations in Gaza's north, the fierce battle for Khan Younis was likely to rage on for up to two months.

In central Gaza, the Israeli military said it had located and destroyed facilities that were the "heart of Hamas' weapons manufacturing industry". Reuters could not independently verify the assertion.

Khan Younis residents said on Thursday the fighting had come within a whisker of Nasser Hospital, the biggest hospital still working in the enclave, which has been receiving hundreds of wounded patients a day, crammed into wards and treated on the floors since the fighting shifted to the south last month.

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"What is happening in Khan Younis now is complete madness: the occupation bombards the city in all directions, from the air and the ground too," said Abu El-Abed, 45, now living in Khan Younis after being displaced several times with his family of seven since leaving Gaza City in the north earlier in the war.

Israeli officials have accused Hamas fighters of operating from Nasser Hospital, which staff deny.

In a statement on Thursday Hamas also denied claims aired by released Israeli hostage Sharon Aloni in an interview on CNN that she and a number of other prisoners had been detained in rooms in the hospital.

The group "considers this to be in line with the lies of Israel and its old and new incitement against hospitals to justify its destruction of them".

Israel stormed Al Shifa hospital in northern Gaza in November and showed what it said were Hamas weapons and equipment found on the premises.

Two-thirds of Gaza's hospitals, including all medical facilities in the northern half of the enclave, have now ceased functioning, and the rest are only partly operational. Losing Nasser would curtail the limited trauma care still available.

In a video that included footage of dark smoke rising above central Khan Younis, MSF Head of Mission for Palestine Leo Cans, who reached the hospital, said fighting had come "very close".

"The wounded people that we take care of, many of them lost their legs, lost their arms. There are really complex wounds that require a lot of surgery. And we don't have the capacity to do this now."

Israelis marked the first birthday of the youngest hostage, baby Kfir Bibas, who was not among scores of women and children freed during a truce in November. Hamas says it is no longer holding children, and that Kfir, his 4-year-old brother and their mother were killed in an Israeli air strike, though it has released no images confirming their deaths.

"His whereabouts are unknown," Israeli President Isaac Herzog said at the World Economic Forum in Davos, sitting next to a photograph of the baby. "I call upon the entire universe to work endlessly to free Kfir and all the hostages."