An Israeli airstrike destroyed a school-turned-shelter in southern Gaza on Tuesday, resulting in the deaths of at least 25 Palestinians.

Simultaneously, intense bombardment in northern Gaza led to the closure of medical facilities in Gaza City, forcing thousands to seek increasingly scarce safe-havens.

In Gaza’s largest city, Israel’s recent ground assault targeted Hamas members allegedly regrouping in previously cleared zones.

After nine months of conflict, substantial portions of Gaza City and its surrounding urban areas lie in ruins, creating a devastated landscape.

While many fled earlier in the war, several hundred thousand Palestinians still remain in the north.

“The fighting has been intense,” said Hakeem Abdel-Bar, who fled Gaza City’s Tuffah district to the home of relatives in another part of the city.

He reported that Israeli warplanes and drones were “striking anything moving,” with tanks moving into central districts.

The strike at the school entrance killed at least 25 people, according to an Associated Press (AP) reporter who counted the bodies at Nasser Hospital in Khan Younis.

Hospital spokesperson Weam Fares said the dead included at least seven women and children, and the death toll was expected to rise.

Earlier airstrikes in central Gaza killed at least 14 people, including a woman and four children, according to two hospitals that received the bodies.

Israel has repeatedly targeted what it says are Hamas sites across Gaza since the conflict began nine months ago.

The Israeli army stated that the airstrike near the school and reports of civilian casualties were under review, claiming the strike targeted a Hamas member involved in the Oct. 7 incursion on Israel.

There was no immediate information available on casualties in Gaza City.

Families of those wounded or trapped were calling for ambulances.

Still, first responders could not access most affected districts due to ongoing Israeli operations, said Nebal Farsakh, a spokesperson for the Palestinian Red Crescent.

“It’s a dangerous area,” she said.

Medical facilities closure

After Israel issued evacuation orders for eastern and central Gaza City on Monday, staff at two hospitals – Al-Ahli and the Patients Friends Association Hospital – rushed to relocate patients and shut down, according to the United Nations (U.N.).

Farsakh reported that all three Red Crescent medical facilities in Gaza City were closed.

Many patients were transferred to the Indonesian Hospital in northern Gaza, which itself had been the site of heavy fighting earlier in the war. “We do not know where to go. There is no treatment and no necessities for life,” said Mohammad Abu Naser, a patient there. “We are slowly dying.”

The Israeli military stated on Tuesday that it had informed hospitals and other medical facilities in Gaza City that evacuation was unnecessary.

However, hospitals in Gaza often close and relocate patients at any sign of potential Israeli military action, fearing airstrikes.

The Episcopal Church in the Middle East, which operates Al-Ahli, stated that the hospital was “forced to close by the Israeli army” following evacuation orders and a series of nearby drone strikes on Sunday.

Over the past nine months, Israeli forces have occupied at least eight hospitals, resulting in deaths among patients and medical personnel, as well as significant damage to facilities and equipment.

Israel claims that Hamas uses hospitals for military purposes, but has provided limited evidence.

According to the United Nations humanitarian office, only 13 of Gaza’s 36 hospitals are operational, and even those are functioning only partially.

Israel’s offensive in Gaza, triggered by Hamas’ Oct. 7 attack, has resulted in the deaths or injuries of more than 5% of Gaza’s 2.3 million Palestinians, according to the territory’s Health Ministry.

Nearly the entire population has been displaced from their homes, with many forced to flee multiple times.

Hundreds of thousands are now crowded into sweltering tent camps.

The U.N. humanitarian office described the exodus in Gaza City as “dangerously chaotic,” with people instructed to flee through neighborhoods where fighting was ongoing.

“People have been seen fleeing in multiple directions, unsure of the safest route,” the agency said in a statement, noting that the largest U.N. bakery in the city had been forced to close, and that aid groups were unable to access warehouses due to the fighting.

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