Israeli forces raided Gaza's largest hospital on Wednesday morning, bringing to a head weeks of growing concern for the people trapped inside in horrific conditions as fuel and medical supplies run out.
After warnings from the United States and others that Al-Shifa must be protected, Israel said the raid was being executed based on "an operational necessity".
Israel claimed that it was targeting a Hamas command centre in tunnels beneath thousands of patients and civilians seeking refuge from intense combat in Gaza, which the Israeli military has indiscriminately bombarded non-stop for 40 days, killing over 11,400 people, mostly civilians.
Hamas has repeatedly denied concealing a base at the hospital.
Dozens of Israeli soldiers, some wearing face masks and shooting in the air, ordered young men to surrender, a journalist in contact with AFP said.
Youssef Abu Rish, an official from the Gaza health ministry who was in the hospital, told AFP he could see tanks inside the complex and "dozens of soldiers and commandos inside the emergency and reception buildings".
Witnesses have described conditions inside the hospital as horrific, with medical procedures taking place without anaesthetic, families with scant food or water living in corridors and the stench of decomposing corpses filling the air.