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Workers and onlookers at the site of a strike on the Al-Najjar family’s home, east of Khan Younis, in the southern Gaza Strip on Sunday, Nov. 12, 2023.

Workers and onlookers at the site of a strike on the Al-Najjar family’s home, east of Khan Younis, in the southern Gaza Strip on Sunday, Nov. 12, 2023. (Loay Ayyoub for The Washington Post)

JERUSALEM — Israeli Prime Minister Benjamin Netanyahu defended his military’s assault on northern Gaza on Sunday as the United States signaled its displeasure at hospitals coming under attack and international criticism mounted over the rising civilian death toll.

Israeli forces were “proceeding as quickly as we can but also as carefully as we can because we want to minimize civilian casualties and we want to minimize casualties on our side,” Netanyahu told NBC News on Sunday.

“We have no battle with patients or civilians at all.”

But Gaza’s largest hospital, al-Shifa, has become a battle zone in recent days. The fighting has driven tens of thousands of civilians to embark on a perilous, hours-long march to the south, in scenes reminiscent of the mass displacement of Palestinians during the 1948 Arab-Israel war — known as the Nakba, or “catastrophe.”

Around 10,000 displaced people and 1,500 patients were still trapped at Shifa hospital on Sunday, according to Munir al-Bursh, director general of the Gaza Health Ministry, who said the hospital is “besieged” by Israeli forces “from all sides.”

“The coming hours are very dangerous,” Bursh said.

More than 11,000 Palestinians have been killed in just over a month of war, according to the Gaza Health Ministry, many of them in Israeli airstrikes. Israel has vowed to destroy Hamas after militants overran large parts of southern Israel on Oct. 7, killing some 1,200 people and taking more than 230 hostage.

The ground offensive Israel launched late last month, which has seen tanks push deep into Gaza City, “is actually reducing the amount of civilian casualties because the civilian population is heeding our call to vacate,” Netanyahu said.

The Israel Defense Forces said its soldiers “opened and secured a passage” for civilians to leave from the Shifa, Rantisi and al-Nasr hospitals in Gaza City on Sunday.

Rantisi and Nasr, both pediatric hospitals, are now empty. The last holdouts in Rantisi left on Sunday, a day after the staff at Nasr evacuated patients and displaced people “under the threat of [Israeli] weapons and tanks,” Nasr’s director, Bakr Qaoud, told The Washington Post from Khan Younis, where he had relocated.

The Post could not independently verify his or the IDF’s account.

While Israel has agreed to daily pauses in the fighting to allow for evacuations, it has rejected calls for a cease-fire. As fighting between Israeli forces and Hamas militants raged in Gaza City on Sunday, civilians trapped in their homes were running out of food and water.

A father of three in the neighborhood of Tel al-Hawa broke down on the phone Sunday when The Post asked him to describe what his 10-year-old son was like. The boy was killed after a missile struck the kitchen of their home on Saturday afternoon. His body was still with the family, the father said, because they had no safe way to bury him.

The father, who spoke on the condition of anonymity to protect his security, said he and his wife were injured in the attack, but could not access medical care.

Aid groups and medical workers at the few remaining hospitals in northern Gaza said they too were penned in by fighting and out of power.

Gaza City’s al-Quds Hospital is no longer operational, the Palestine Red Crescent Society, which operates it, said Sunday. “The cessation of services is due to the depletion of available fuel and power outage,” the organization said.

At Shifa, Bursh said Israeli strikes have hit electrical generators, water wells, part of the intensive care unit, a floor of the maternity hospital and an oxygen station. Three of the hospital’s 38 premature babies have died since Saturday, he said. “The rest have severe complications from vomiting, diarrhea and colds,” he said.

The IDF has denied striking the hospital or targeting civilians. It said it is battling militants around Shifa, and that the hospital sits atop a Hamas military headquarters.

The Post cannot independently verify the IDF’s claims about Shifa or confirm the source of the attacks on the facility.

Netanyahu said Sunday that Gazan authorities had refused Israel’s offer Saturday night to provide Shifa with “enough fuel to operate the hospital, operate the incubators and so on.”

Bursh confirmed that health authorities had turned down the offer, saying it was only a fraction of the 10,000 liters of fuel the hospital needs per day.

Dozens of bodies lie in front of the hospital, Bursh said, since staff cannot safely collect them. Others were rotting in the morgue, which is no longer refrigerated.

In an interview Sunday with CNN, U.N. Secretary General António Guterres said Netanyahu’s assertions that Israel is obeying international laws for conflict were “simply not true,” and that the humanitarian principle of protection of civilians “is not happening.”

Though the Biden administration has been full-throated in its support for the Israeli war effort, officials have also urged the country to reduce civilian deaths.

“The bottom line for the United States is that we do not want to see firefights in a hospital,” White House national security adviser Jake Sullivan told CNN on Sunday.

“We do not want to see innocent patients who are sick or wounded or be injured or killed in the crossfire,” he said. “So that is how we look at this issue, and that is how we are communicating with our Israeli counterparts.”

Netanyahu affirmed his resolve Sunday to press on with the war. Asked whether Israel could succeed without global support, he told NBC, “We will win this war. We have no other choice.”

He spoke of an “an alliance for peace” that “includes Israel, the United States, the moderate Arab states and the rest of the civilized world.”

But Arab leaders have condemned Israel’s war on Gaza and are calling for an urgent cease-fire.

“Israel crossed every legal, ethical & humanitarian red line in its barbaric war on Gazans,” Jordanian Foreign Minister Ayman Safadi wrote on the social media platform X, formerly Twitter, on Sunday.

Iran-aligned militants in the region, meanwhile, have continued to launch attacks on U.S. and Israeli targets. On Sunday, the Lebanese militant group Hezbollah claimed an antitank missile attack on the northern Israeli border village of Dovev that wounded several Israelis. Separately, mortar fire from Lebanon injured seven Israeli soldiers, Daniel Hagari, the IDF spokesman, wrote on X.

Israeli fighter jets struck “a number of Hezbollah terror targets in Lebanon” in response, the IDF said.

The IDF also announced a “tactical pause of military operation for humanitarian purposes” in the Jabalya refugee camp and Ezbet Mallin for four hours on Sunday, during which Gazans could evacuate south.

Video footage showed men, women and children making the trek, on foot and on horse-drawn carts, many waving white flags and carrying little more than a backpack full of essential items. Explosions could be heard nearby.

“We are now rolling out the Gaza Nakba,” Avi Dichter, Israel’s agriculture minister, said in an interview Saturday, fueling fears among Gazans that their displacement will be a permanent one.

Communications and internet networks in Gaza will go “completely” out of service later this week, the Palestinian communications minister in Ramallah, Ishaq Sider, warned Sunday.

The “widespread demolition, destruction and bombardment” has taken out 65 percent of the communications networks in the Gaza Strip, Abdel Majeed Melhem, chief executive of Palestinian telecom company Jawwal, said at a news conference. An executive from another provider, Ooredoo , said 70 percent of the company’s network was out of service.

As it becomes harder and harder to reach people in Gaza, the humanitarian situation grows more desperate by the day. No bottled water has been distributed to displaced people living in shelters for more than a week, the U.N. Office for the Coordination of Humanitarian Affairs (OCHA) said Saturday.

Fifty-three trucks carrying aid entered Gaza as of Saturday evening, OCHA said, bringing to 914 the number of trucks that have crossed the Egyptian border since Oct. 21.

Those numbers are “far below the quantities needed to meet the needs of over 2 million people besieged in Gaza,” the agency said.

Hospitals in the south, already overcrowded and stretched for resources, are ill-equipped to receive any more people. Only two hospitals in the area have the capacity to treat complex injuries, and they are already struggling to treat the injured in central and southern Gaza, Fikr Shalltoot, Gaza program manager for the nonprofit Medical Aid for Palestinians, told The Post.

At Abu Youssef El-Najar Hospital, a small medical facility in the southern city of Rafah, there are limited supplies of electricity, gas, medicine or water, a doctor told The Post, speaking on the condition of anonymity since he is not authorized to talk to the press. The hospital has just 18 dialysis machines to serve more than 200 patients, he said.

“The numbers of the wounded are increasing and the services decreasing,” he said. “I am truly consumed. The situation is hopeless.”

Harb reported from London and Mahfouz from Cairo. Hazem Balousha in Amman, Sarah Dadouch in Beirut, Jennifer Hassan and Leo Sands in London, Kelly Kasulis Cho in Seoul and Mariana Alfaro in Washington contributed to this report.

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