Hours before families in Gaza lined up on Thursday to start the second phase of an emergency polio vaccination campaign, a deadly Israeli airstrike hit near a hospital in an area where a previous round of inoculations had just concluded.
Health officials have heralded the vaccination program, which began on Sunday and is built around a deal by Israel and Hamas for brief pauses in hostilities, as an unexpected success in the early going. The World Health Organization said the first phase, in the central Gaza Strip, finished on Wednesday and the second, in southern Gaza, began Thursday.
But the limited nature of those pauses was highlighted by the strike overnight, which killed four people and wounded a number of others, including women and children, according to Wafa, the Palestinian Authority’s official news agency. Witnesses said it landed in the courtyard of Al-Aqsa Martyrs Hospital in the central Gaza city of Deir al-Balah, where displaced civilians had taken shelter.
Photos and video taken by the Reuters news agency showed flattened tents and makeshift shelters at the site, with tarps, clothes and other belongings strewed on the ground outside the hospital, one of Gaza’s largest.
“We sought refuge in a safe place, in the courtyard of Al-Aqsa Hospital, displaced and sleeping peacefully, we found nothing but the airstrikes hitting us,” one woman, Iqbal Al-Zeidi, told Reuters.
The Israeli military confirmed the strike, which it said was carried out with attack helicopters, but not the death toll or the proximity to the hospital. It said it had struck a Hamas command center to “remove an immediate threat,” which was “embedded” within a humanitarian area in Deir al-Balah.
“Numerous steps were taken to mitigate the risk of harming civilians, including the use of precise munitions” and aerial surveillance, the statement said, echoing words often employed by the military after airstrikes in Gaza.
The charitable group Doctors Without Borders said it was the fifth time since March that the hospital or its surroundings had been hit.
Israel agreed to the brief, staggered pauses in its military offensive in Gaza to allow health officials to carry out the urgent drive to vaccinate hundreds of thousands of children and avert a deadly polio outbreak. The first polio case in Gaza in 25 years was confirmed last month in a boy less than a year old.
Mediators from the Biden administration, Egypt and Qatar have sought for months to reach a deal on a lasting cease-fire, but the talks have been stalled by multiple disagreements between Israel and Hamas.
For weeks, the talks have snagged on the question of an Israeli postwar military presence in Gaza. But American officials say that another issue has also emerged as a key sticking point: the release of hostages held in Gaza and Palestinians held in Israeli prisons.
U.S. officials say that the two sides have not agreed on how many people each side would set free, nor on who they would be, in the first, six-week phase of a truce.
“The negotiations go into the most difficult issues, some of which are not the ones that stand out in the public discussion,” Jack Lew, the American ambassador to Israel, said on Thursday at the Institute for National Security Studies, an independent research center in Tel Aviv.
Prime Minister Benjamin Netanyahu of Israel has said his country’s forces must keep control of a strip of Gaza along the border with Egypt, to prevent Hamas from smuggling weapons into Gaza. The strip, known as the Philadelphi Corridor, would remain under Israeli military control during the six-week first phase of a proposed cease-fire, but Mr. Netanyahu said on Wednesday that its control would probably go on much longer.
Hamas says a full Israeli withdrawal from Gaza is central to any cease-fire deal. Egypt says an Israeli military presence in the corridor would violate the two countries’ security agreement.
But Mr. Netanyahu pushed back on the idea that the Philadelphi Corridor was the chief obstacle, accusing Hamas of intransigence.
“In fact, while we agreed in May and July and in August to a deal, and to an American proposal, Hamas has consistently said no to every one of them,” Mr. Netanyahu said in an interview with “Fox and Friends” that aired on Thursday. “They don’t agree to anything, not to the Philadelphi Corridor, not to the keys of exchanging hostages for jailed terrorists, not to anything, so that’s just a false narrative.”
Complicating the delicate issue further is the killing of six hostages whose bodies Israeli forces retrieved from Gaza over the weekend, an episode that prompted a public furor in Israel and added more pressure on Mr. Netanyahu to make a deal. The Israeli military said the hostages were killed by Hamas.
On Wednesday, Hamas released video of two hostages, Carmel Gat, 40, and Alexander Lobanov, 32, recorded before their deaths. Hamas had released videos of two other hostages this week. The latest release ensures that the fate of the dozens of remaining captives, which has inflamed divisions in Israel, remains in the public eye.
President Biden this week signaled that Mr. Netanyahu was not doing enough to bring the hostages home, and American officials have said both sides had thrown up roadblocks to a deal.
But in public, U.S. officials have focused blame primarily on Hamas for holding up the negotiations. At the White House on Wednesday, a senior U.S. official who briefed reporters on condition of anonymity said that the killings of the hostages had not only injected “a sense of urgency” into the talks but also “called into question Hamas’s readiness to do a deal of any kind.”
The negotiations come as Israel is fighting on at least two other fronts, with Hezbollah militants in the border region with Lebanon and in raids into the Israeli-occupied West Bank, which on Thursday stretched into a ninth day.
Israeli airstrikes killed five Palestinians in the area of Tubas, a small city in the northern West Bank. The Israeli raids have left at least 39 people dead and 145 others injured, according to the Palestinian Health Ministry, as well as damaging homes, roads, and power, water and internet lines.
Israel describes the raids as an effort to crack down on Palestinian armed groups and combat rising attacks against Israelis. The Israeli military said Thursday’s strikes near Tubas targeted armed fighters who hurled explosives and shot at security forces.
Violence has flared in the West Bank since Hamas’s surprise Oct. 7 attack on Israel, which killed about 1,200 people, and the devastating Israeli bombing campaign and invasion that followed. More than 600 Palestinians have been killed in that time in the West Bank, according to the United Nations, as Israel has ramped up military raids there and violence by extremist Jewish settlers has increased.
U.S. officials hope that a cease-fire in Gaza could calm tensions across the region, including the West Bank and southern Lebanon.
Israel is deeply divided between people who want a cease-fire to free the hostages, and those who want the military to continue to pursue and kill Hamas. Even the short pauses in fighting for the vaccination campaign have faced some pushback in Israel.
In the first phase of the vaccination campaign, the W.H.O. inoculated more than 187,000 children in central Gaza over three days. The second phase, which began on Thursday in southern Gaza, is scheduled to last three days. A third and final phase is planned for northern Gaza.
The effort aims to vaccinate a total of about 640,000 children under 10 against the disease. The plan is to give a second dose to each child next month.
Health officials say the war has created the conditions for a resurgence of polio, which spreads by contact with fecal matter. The vast majority of Gaza’s population has been displaced in the war and countless families are living in cramped tents with little access to sewage or clean water.
The World Health Organization says the vaccination program exceeded its target for the first phase by 30,000 children, as more than 2,180 workers fanned out across hospitals, temporary schools and camps for displaced people, visiting tents and areas destroyed by nearly 11 months of fighting.
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