Thousands of people remained trapped in Gaza's largest hospital Monday, where evacuations have been hampered by fierce fighting between Israeli and Hamas forces.
Conditions are worsening for hundreds of patients and thousands of others sheltering around Al-Shifa hospital -- which has become the focus in the five-week-old war.
On Sunday, witnesses at the Gaza City hospital told AFP that "violent fighting" raged throughout the night.
As the clatter of small arms fire and aerial bombardments echoed across the sprawling complex, doctors reported two babies died when power to their incubators was cut.
Israel says that Hamas militants -- who killed 1,200 people during the October 7 attacks that sparked the war -- have deliberately based an operational headquarters at the facility and in an underground tunnel complex.
The World Health Organization (WHO) and other UN agencies warned that as many as 3,000 patients and staff are sheltering inside without adequate fuel, water or food.
"Regrettably, the hospital is not functioning as a hospital anymore," said WHO director Tedros Adhanom Ghebreyesus, after making contact with on-the-ground staff.
"It's been three days without electricity, without water," he said, describing the situation inside as "dire and perilous."
Youssef Abu Rish, deputy health minister in the Hamas government, on Sunday said three more premature babies had died along with six other patients who had been in critical condition.
"We fear the toll will rise further by morning," he said.
- 'Self-evacuation' -
Israel is facing intense international pressure to minimise civilian suffering amid a massive air and ground operation that Hamas authorities say has already killed 11,180 people, including 4,609 children.
Foreign officials like EU foreign policy chief Josep Borrell have urged Israel to show "maximum restraint", while condemning Hamas for using "hospitals and civilians as human shields."
Israel's military said it would observe a "self-evacuation corridor" Monday, allowing people to move from Al-Shifa southward, but admitted the area was still the scene of "intense battles."
The area of fighting "currently includes the area surrounding the Shifa hospital but not the hospital itself", a spokesperson for the Israel Defense Forces told AFP.
Tens of thousands of Gazans have already fled from the north of the territory under Israeli orders.
But it is unclear what, if any, provisions there would be for the sick and injured to be transported from Al-Shifa.
The Israeli army also said its ground soldiers had hand-delivered 300 litres of fuel to the hospital "for urgent medical purposes".
The military shared grainy night-time footage of combat troops hauling jerry cans, leaving a dozen or more outside a building.
AFP was unable to independently verify the footage, or Israel's claim that Hamas "forbade the hospital from taking it."
Only a handful of trucks carrying fuel had been let into Gaza since October 7, with Israel concerned fuel deliveries would be used by Hamas militants.
Al-Shifa director Mohammad Abu Salmiya told journalists the Israeli claims were "lies".
The 300 litres the army said had been delivered would power generators for "no more than quarter of an hour" anyway, Abu Salmiya said.
- Dwindling supplies -
Inside the hospital, AFP last week witnessed the sick and injured on gurneys that packed corridor walls.
The courtyard of the emergency ward was dotted with people and piles of rubbish lay uncollected.
Some of the thousands displaced by the fighting camped at the facility using make-shift kitchens and what few supplies they had.
Across Gaza City at the Al-Quds hospital the picture was also said to be dire, with the Palestinian Red Crescent warning it was now out of service due to a lack of generator fuel.
Twenty of Gaza's 36 hospitals are "no longer functioning", according to the UN's humanitarian agency.
Almost 1.6 million people -- about two-thirds of Gaza's population -- have been internally displaced since October 7, according to the UN agency for Palestinian refugees UNRWA.
Israel's Prime Minister Benjamin Netanyahu has ruled out calls for the ceasefire, saying Hamas must first release the estimated 240 hostages taken on October 7.
Israelis are still stunned by the worst attack in their country's history and preoccupied with the fate of those still missing.
A recent poll by the Israel Democracy Institute showed many Israelis back talks with Hamas to secure the release of hostages, but believe fighting should not be halted.
Netanyahu told US media that "there could be" a deal to free the hostages, but stopped short of providing any details.
"The less I say about it, the more I'll increase the chances that it materialises," he told NBC.
White House National Security Council spokesman John Kirby told MSNBC there has been "active negotiation" on a potential deal but kept mum on any details, while a Palestinian official in Gaza accused Israel of dragging its feet.
"Netanyahu is responsible for the delay and obstacles in reaching a preliminary agreement on the release of several prisoners," the official told AFP on condition of anonymity.
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