Israeli soldiers pushed into the heart of the largest city in the southern Gaza Strip on Tuesday, Israel and Hamas said, amid some of the most intense bombing and ground combat of the war, and growing concerns that there is almost nowhere left for desperate civilians to flee.
The Israeli offensive drove deep into the southern Gazan city of Khan Younis — “Hamas’s military capital,” the Israeli military said — which was home to more than 200,000 people before the war, but swelled during the conflict with people who heeded an earlier Israeli order to evacuate all of the northern enclave.
Heavy bombardment was heard on Tuesday from inside Nasser Hospital, the city’s largest, where many Palestinians had sought shelter and were sleeping in hallways. Video from the hospital showed that it was packed with people, including crying children and a young girl who was carried inside and bandaged on the floor.
The Israeli military said its soldiers were also still fighting Hamas in the north, in the Shajaiya neighborhood of Gaza City, and Jabaliya, a densely populated neighborhood north of Gaza City that was heavily bombed by Israeli warplanes in October.
“We are in the most intense day since the beginning of the ground operation — in terms of terrorists killed, the number of firefights and the use of firepower from the land and air,” the chief of Israel’s southern military command, Maj. Gen. Yaron Finkelman, said in a statement. “We intend to continue to strike and secure our accomplishments.”
Lt. Gen. Herzi Halevi, the chief of the Israeli general staff, told reporters on Tuesday evening that Israeli troops were often battling house to house, and that Hamas fighters were sometimes wearing civilian clothes. “Our forces find weapons in nearly every building and house, and in many houses terrorists, and engage them in combat,” he said.
Hamas, which controls Gaza, said that its fighters had killed 10 Israeli soldiers in close-quarters combat in Khan Younis, had shot at least six more with snipers and had totally or partly destroyed 24 military vehicles in the city.
It was not possible to independently confirm either side’s account of the fighting, but the intensity was clear. The World Health Organization warned that the humanitarian crisis for Gazans was “getting worse by the hour,” after some of “the heaviest Israeli shelling in the enclave” since Oct. 7, when Hamas led a cross-border attack that Israeli officials said had killed 1,200 people in the southern part of the country.
The Gazan health authorities say the war has claimed more than 15,500 lives, mostly women and children.
In recent days, the Biden administration has urged Israel to do more to limit harm to civilians than it did in the war’s early stages, like using smaller bombs to collapse Hamas’s tunnel network. Administration officials have said that Israel’s military appeared to be heeding that advice, but some experts say they see no evidence that the military has moderated its tactics.
“I don’t have the sense that the renewed Israeli operations are significantly different than the earlier operations in terms of seeking to minimize the risk of harm to civilians,” said Brian Finucane, a former legal adviser at the State Department and now a senior adviser for the U.S. program at the International Crisis Group.
An Israeli military spokesman, Lt. Col. Peter Lerner, when asked whether the United States had put pressure on Israel to use smaller munitions, told reporters on Tuesday that he was “not aware of any limitations on the ability to utilize our firepower.”
In October, Israel directed civilians to evacuate northern Gaza, home to about half of the territory’s estimated 2.2 million people, and most complied, crowding into southern Gaza, where homes and shelters are full to overflowing and many people are living in the streets. The United Nations relief agency for Palestinians says a single shelter in Khan Younis holds 22,000 people, 10 times its designed capacity.
In the past few days, the Israeli military has ordered the evacuation of neighborhoods in and around Khan Younis that U.N. officials say are home to about 600,000 people, posting on social media instructions for zones to evacuate and those to go to. But Palestinians and humanitarian groups say many people, without electricity or internet service, have no access to those instructions and no place to take shelter, and that in any case the areas labeled safer have not been immune to bombing and carnage.
“As long as so many people remain, I am staying here,” Khalil Ahmed, 53, a chemistry teacher in Nuseirat, just south of Gaza City, said in an interview on Tuesday. His community, a former U.N. refugee camp that has been built up over decades, was nearly destroyed, he said, and the windows of his house were smashed. But he could see no safer alternative.
“They are bombing everywhere, and where we are seems to be less dangerous than in Khan Younis and Deir al-Balah,” he said, naming cities farther south. “They are hitting there very hard.”
Dr. Rick Peeperkorn, a W.H.O. official who was in Rafah, the southernmost large city in Gaza where the Israeli military has urged civilians to seek refuge, told reporters that even there, there was “intensified bombing going on all around.”
Some specialists in the laws of war say that even though the Israeli military has warned civilians to move out of harm’s way, the scope of its campaign called into question whether that was possible.
“There is no reliably safe way to go and no reliably safe place in Gaza, period,” said Omar Shakir, the Israel and Palestine director at Human Rights Watch. “So even if they tell you this area is relatively safe, the airstrikes continue to hit virtually all parts of Gaza.”
Matthew Miller, a State Department spokesman, said on Monday that while it was too early to make definitive assessments, the United States saw signs that Israel was making changes to limit civilian casualties, including reducing mass displacement.
He pointed to the more detailed evacuation map published by the Israeli military, saying it represented “a much more targeted request” and “an improvement on what’s happened before.”
But the civilian toll has still been heavy. Since the collapse of Israel’s weeklong truce with Hamas on Friday, more than 300 people have been killed each day, according to Gaza’s health officials. Nearly 1.9 million people, or more than 85 percent of all Gazans, have been displaced by the war, according to the United Nations.
Israeli leaders blame Hamas for endangering the civilian population, saying its fighters operate out of underground tunnels and densely populated urban neighborhoods, using men, women and children as human shields.
President Biden on Tuesday blamed the collapse of the cease-fire on Hamas’s refusal to release the women it still holds hostage, referring to “accounts of unimaginable cruelty” by Hamas against women, including rape and mutilation committed during the Oct. 7 assault. He stopped short of suggesting, as a State Department spokesman did on Monday, that Hamas was holding the remaining women because it did not want their experience of abuse to be made public.
Israel does not have an official tally of the number of Hamas fighters killed, according to Colonel Lerner, the military spokesman. But the military estimates it is “several thousands,” he said, based on extrapolations from “information that we’re receiving from the field and from our after-action review.”
Human rights groups have warned that, as the battlefield expands, beleaguered civilians are being pushed into a patchwork of smaller and smaller areas that lack adequate food, shelter and medical care.
With shelters in Rafah already well beyond capacity, new arrivals were erecting tents and fashioning shelters in the streets or whatever empty spaces they can find, according to the United Nations’ office for humanitarian affairs.
“The conditions required to deliver aid to the people of Gaza do not exist,” Lynn Hastings, the U.N. aid coordinator for the Palestinian territories, said in a statement. “If possible, an even more hellish scenario is about to unfold, one in which humanitarian operations may not be able to respond.”
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