CNN
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Israel announced that it launched a “targeted” military operation against Hamas early Wednesday morning inside Al-Shifa Hospital, the largest hospital in Gaza, where thousands of Palestinians are believed to be taking shelter.

Conditions have changed inside the hospital, which has run out of fuel and is no longer considered operational It deteriorated quickly In recent days amid heavy fighting, doctors warned of a “catastrophic” situation for patients, staff and displaced people still inside.

In a statement posted online, the Israeli army said it had begun “a precise and directed operation against Hamas in a specific area in Al-Shifa Hospital.” It is still unknown how many troops entered the hospital, but Israeli tanks can be seen inside the facility’s compound, a journalist at Al-Shifa Hospital told CNN.

“We can see them pointing tank guns at the hospital. We are not sure if there were soldiers inside the hospital [buildings]“They are inside the compound with the tanks,” Khader Al-Zaanoun, a correspondent for the Palestinian News Agency (WAFA), told CNN.

He said there was an exchange of gunfire across the courtyard, and some of the windows of one of the buildings were open.

Doctors and journalists at the hospital described to CNN desperate efforts to keep premature babies alive, and limited procedures performed by candlelight.

In its statement on Wednesday, Israel again accused Hamas of continuing to use the large hospital complex for military purposes, which it said “endangers the hospital’s protected status under international law.”

Hamas and hospital officials have consistently rejected Israel’s claims that Hamas built a command center under the hospital.

A doctor inside Al-Shifa told CNN they received a 30-minute warning before the Israeli operation began.

“We were asked to stay away from windows and balconies. We can hear the armored vehicles, they are very close to the entrance to the complex,” Dr. Khaled Abu Samra said.

Hundreds of staff and patients remain inside Al-Shifa Hospital, according to the latest reports from the hospital, along with several thousand who are seeking shelter to escape the Israeli air and ground attack.

The Israeli statement said: “The Israeli army is conducting a ground operation in Gaza to defeat Hamas and rescue our hostages. “Israel is at war with Hamas, not with civilians in Gaza.”

A statement issued by Hamas blamed Israel and the United States for the Israeli army raid on the hospital. By supporting what she called Israel’s “false narrative” — that Hamas is using Shifa as a base for command and control — she said the United States gave Israel “the green light… to commit more massacres against civilians.”

On Tuesday, the White House and Pentagon said Hamas was as well Store weapons and operate the command center From the hospital.

The Pentagon said the United States recently declassified intelligence it claims shows that Hamas and Palestinian Islamic Jihad are using hospitals — including Al-Shifa Hospital — “as a means to conceal and support their military operations and hostage-taking.”

The Palestinian Minister of Health, Dr. Mai Alkaila, said that the Israeli army raid represents “a new crime against humanity, medical staff and patients,” and could have “catastrophic consequences” for patients and medical staff.

Israel declared war on Hamas, the Palestinian militant group that controls Gaza, and imposed a “total blockade” of the Strip following Hamas’ terrorist attacks on Israel on October 7. An estimated 1,200 people were killed in Hamas attacks, and about 240 others were captured. Hostages, most of whom are still being held in Gaza.

Since then, the Israeli response has killed at least 11,180 Palestinians — including 4,609 children and 3,100 women — according to the Palestinian Ministry of Health in Ramallah, which relies on medical sources in Gaza.

International pressure on the Israeli government has increased in recent days amid accounts of desperate conditions in Gaza’s fuel-starved hospitals, and severe food and water shortages.

On Tuesday, United Nations Secretary-General António Guterres renewed his call for a ceasefire in Gaza “in the name of humanity.”

Doctors and journalists described the catastrophic conditions inside Al-Shifa Hospital.

“There is no longer water, food, or milk for children and infants,” hospital director Muhammad Abu Salmiya told CNN on Monday. “The situation in the hospital is catastrophic.”

Journalist Al-Zaanoun said that people inside the hospital “are starving, there is no food or drinking water, and we barely get tap water for one hour a day.”

He added that dozens of bodies are scheduled to be buried in a mass grave in the courtyard of the hospital complex, as relatives cannot leave to bury their loved ones.

Al-Zaanoun told CNN: “The scene is horrific, the smell of the dead is unbearable, and most of the bodies are women and children.”

Abu Salamiya told Al Jazeera that there are plans to bury more than 150 bodies, but he expressed concern that the grave would not be large enough.

In recent days, 15 patients at Al-Shifa Hospital, including six newborns, died due to power outages and lack of medical supplies, according to the Palestinian Ministry of Health in Ramallah, which draws its numbers from Hamas-controlled territory.

Premature babies were removed from failed incubators and wrapped in aluminum foil on Monday in a desperate attempt to keep them alive after their oxygen supply ran out. The photos showed several newborn babies placed together on the bed.

Egyptian Health Minister Khaled Abdel Ghaffar said on Tuesday that they are working to bring 36 newborns from Al-Shifa to Egypt, although such a transfer would be dangerous.

Recorded by the World Health Organization At least 137 attacks On health facilities in Gaza, which it said led to the death of 521 people and the injury of 686 others.

Other protected sites, such as schools, civilian shelters and UN facilities, have already been damaged or destroyed during more than a month of Israeli air strikes. The United Nations Relief and Works Agency for Palestine Refugees announced Monday that more than 100 UN staff have been killed in Gaza since the fighting began — the highest death toll in UN history.

This story is broken and will be updated.