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Battle rages at Gaza hospital as UN reports 'catastrophic' hunger

Palestinians flee bombardment in Gaza City, where intense battles rage more than five months into the Israel-Hamas war
— Gaza Strip (Palestinian Territories) (AFP)

Fighting raged Monday in and around the besieged Gaza Strip's largest hospital complex where Israel said its forces killed and arrested Hamas militants, as Palestinians fled by foot under heavy bombardment.

The United States separately said Israel had killed the deputy leader of Hamas's armed wing, making him the most senior militant killed inside the territory during the war.

While the raid at Gaza City's Al-Shifa hospital was underway, Israel sent its spy chief to Qatar for renewed truce talks and top ally the United States urged an "alternative" to a looming ground invasion of the southern city of Rafah.

The devastating war since Hamas's October 7 attack on Israel has left roughly half of Gazans -- around 1.1 million people -- experiencing "catastrophic" hunger, a UN-backed food security assessment warned.

The expert report is "exhibit A for the need for an immediate humanitarian ceasefire", said United Nations Secretary-General Antonio Guterres, decrying an "entirely man-made disaster".

An AFP journalist witnessed air strikes on the area around Gaza City's Al-Shifa hospital, with hundreds of Palestinians fleeing their homes

Gaza's soaring civilian death toll and large-scale destruction have hardened global opposition to Israel's military operation and siege, including accusations of deliberate starvation of Palestinian civilians.

Israeli Prime Minister Benjamin Netanyahu, however, has not softened his war objectives.

In a phone call with United States President Joe Biden, Netanyahu reiterated a commitment "to achieving all of the war's objectives" -- eliminating Hamas, freeing all hostages and "ensuring that Gaza will never present a threat to Israel", his office said.

European Union foreign policy chief Josep Borrell said Israel's military campaign had turned Gaza into the world's biggest "open-air graveyard", and that Israel was using famine as a "weapon of war".

Foreign Minister Israel Katz countered that "Israel allows extensive humanitarian aid into Gaza" and accused Borrell of "attacking Israel".

With tensions rising between Israel and the United States over the war's impact on civilians, Biden and Netanyahu spoke for the first time in over a month.

The White House said the two leaders discussed "efforts to surge humanitarian assistance to Gaza" and "the situation in Rafah", where about 1.5 million Palestinians are sheltering in crowded conditions near the Egyptian border.

Israel has repeatedly threatened to send ground troops into the city in its war against Hamas militants and said civilians would be evacuated, but offered few details.

Netanyahu agreed to Biden's request to send a delegation to Washington to discuss the Israeli plans for Rafah and a possible "alternative approach", US National Security Advisor Jake Sullivan said.

"Hamas should not be allowed a safe haven in Rafah or anywhere else, but a major ground operation there would be a mistake" and exacerbate the humanitarian crisis, Sullivan told reporters.

- Hospital raided again -

During its raid on Al-Shifa more than 20 militants were killed inside the hospital complex, the army said, and another 20 were killed in the surrounding area. Troops also arrested more than 200 suspects, it said.

Displaced Palestinians, fleeing the area of Gaza City's al-Shifa hospital, arrive at the Nuseirat refugee camp

Witnesses reported air strikes and tanks near the complex crowded with thousands of Palestinian patients and displaced people.

AFP images showed black smoke engulfing parts of the city, with Palestinians fleeing by foot along rubble-strewn roads as others treated the wounded in the street.

The Israeli army identified one of the fatalities as Hamas internal security official Fayq al-Mabhouh. A Gaza police source confirmed his death and said he was a brigadier general in the force.

Israeli troops previously raided Al-Shifa in November, sparking an international outcry.

In Washington, Sullivan reported the death of senior Hamas official Marwan Issa. Israel had on March 11 said an air strike on an underground compound in central Gaza targeted Issa, whom it called the deputy head of Hamas's armed wing. At that time it was unclear if he had been killed.

In January, Israel said it had "completed the dismantling" of Hamas's command structure in northern Gaza, but on Monday military spokesman Daniel Hagari said Palestinian militants and commanders have since returned to Al-Shifa "and turned it into a command centre".

Food crisis in the Gaza Strip

Israel has repeatedly said the complex housed an underground Hamas control base, which the militants have denied.

World Health Organization chief Tedros Adhanom Ghebreyesus said the renewed fighting around Al-Shifa was "endangering health workers, patients and civilians".

The bloodiest ever Gaza war broke out after Hamas launched an unprecedented attack on October 7 that resulted in about 1,160 deaths in Israel, mostly civilians, according to an AFP tally based on official Israeli figures.

Militants also seized about 250 hostages, of whom Israel believes 130 remain in Gaza, including 33 who are presumed dead.

Israel has carried out a relentless bombing campaign and ground offensive that Gaza's health ministry says has killed at least 31,726 people, most of them women and children.

- 'Nothing to eat' -

As fighting flared around Al-Shifa, elsewhere in Gaza City a massive crowd gathered at a UN food distribution centre to collect bags of flour.

Children in Gaza's Rafah, where Israel has repeatedly threatened to invade, carry water to a displacement camp

"There's nothing to eat or drink. Children are dying," said resident Umm Omar al-Masharwai.

The UN agency for Palestinian refugees, UNRWA, which operates the facility and coordinates nearly all aid to Gaza, has faced funding cuts since Israel accused several of its employees of involvement in the October 7 attack.

UNRWA chief Philippe Lazzarini said Monday he intended to visit Gaza but had been denied entry. Israeli authorities said he had failed to follow "the necessary coordination processes".

Mediators who had helped secure a week-long ceasefire and hostage release in November continued their efforts toward another halt in fighting.

A Palestinian man receives a bag of flour at a Gaza City distribution centre

Israel's Mossad spy chief, David Barnea, was to meet on Monday in Doha with Qatari Prime Minister Mohammed bin Abdulrahman Al-Thani and Egyptian officials, a source close to the talks said.

The meeting follows the latest proposal from Hamas for a six-week truce, vastly more aid into Gaza and the initial release of about 42 hostages in exchange for Palestinian prisoners held by Israel.

During the proposed truce, Israeli forces would withdraw from "all cities and populated areas" in Gaza, according to a Hamas official.