Israeli troops and Palestinian fighters are locked in heavy, close quarters fighting in Gaza City, with the White House announcing that Tel Aviv has agreed to daily four-hour military pauses in northern Gaza but rejecting a full ceasefire.
Palestinian fighters armed with rocket-propelled grenade launchers and assault rifles were clashing on Thursday with Israeli soldiers backed by armored vehicles in the ruins of the besieged territory’s north.
Israeli airstrikes kept pounding Gaza City and other areas across the Palestinian enclave, with plumes of smoke rising from newly leveled homes and other civilian infrastructure.
Over a dozen Palestinians were killed after Israelis struck against the cities of Rafah and Deir al-Balah. At least 25 people were killed in fresh attacks on the Jabalia camp and in Khan Yunis.
Elsewhere, Israeli warplanes once again hit the vicinity of al-Shifa Hospital, Gaza’s largest medical complex. The regime’s jets also shelled al-Nasr Children's Hospital in Gaza City.
Tom Potokar, chief surgeon at the International Committee of the Red Cross, described the scene at the European hospital in Khan Yunis in southern Gaza as "catastrophic".
After more than a month of intense bombardment, hundreds of thousands of people remain trapped in a "dire humanitarian situation" in urban battle zones without enough food and water, the United Nations said.
The health ministry said the Palestinian death toll from Israeli attacks in the Gaza Strip has climbed to 10,812. The victims include 4,412 children, 2,918 women and 676 elders, while more than 26,000 people were injured, ministry spokesman Ashraf al-Qudra told a press conference in Gaza City.
He said 2,650 people, including 1,400 children, were also reported to be trapped under the rubble.
“The Israeli aggression has left 195 medics dead and 51 ambulances destroyed,” the spokesman added.
The climbing death toll in the territory meant that Palestinians were having to inter their dead in makeshift cemeteries.
"We bury the dead in football fields and other vacant lots because the proper burial grounds are full," said Shihteh Nasser, 48, who had helped in the burials.
Bodies have piled up outside hospitals, on roads and in parks, in refrigerated trucks and even in a repurposed ice-cream van.
UN rights chief Volker Turk condemned Israel over its bombardment and its orders for Gazans to flee.
"The collective punishment by Israel of Palestinian civilians amounts also to a war crime, as does the unlawful forcible evacuation of civilians," he told reporters at the Rafah border crossing with Egypt, the only route out of Gaza not controlled by Israel.
Israel's extremist prime minister Benjamin Netanyahu has repeatedly rejected a ceasefire. The United States has backed Israel's rejection of a ceasefire.
On Thursday, President Joe Biden said there was no chance of a full ceasefire as White House National Security Council spokesman John Kirby said Israel will begin to implement four-hour pauses in areas of northern Gaza each day.
International calls for a ceasefire have mounted, as have protests, including one at the weekend which targeted the White House. However, Biden ruled out a longer truce for now.
"None. No possibility," Biden told reporters as he left the White House for a trip to Illinois when asked about the chances of a ceasefire.
The United States has relentlessly stood by Israel, saying that Hamas cannot be allowed to remain in control of Gaza.
Israel has pressed on with its invasion and encircled northern Gaza in recent days. On Thursday, the army said 50,000 people had fled their homes in the main battle zone of northern Gaza, adding to the more than 1.5 million people already seeking safety in the south of the coastal strip.
UN aid chief Martin Griffiths said the world body must not help push Palestinians out of their homes.
“The United Nations cannot be part of a unilateral proposal to push Palestinians into so-called safe zones," Griffiths said.
Doctors Without Borders chief Isabelle Defourny called southern Gaza safe zones “fake zones", and said about 30% of those killed in Gaza were in the south.
Palestine’s Government Media Office announced that Israel is carrying out a "war of extermination and ethnic cleansing" in a statement on Thursday, and said that people in Gaza have reached the final stages before all services completely collapse.
“The next few hours are crucial in terms of the medical system stopping completely; all will cease to work. People will have no water or place to remove waste. We appeal to people around the world, those who still have humanity left in them, to take urgent and immediate action to save Gaza,” it added.
A spokesperson for the health ministry said many hospitals and intensive care units have already stopped working due to the full siege imposed by Israel on October 9.
“The Kamal Adwan Hospital and Indonesian hospital will also stop working in 24 hours,” he said.
He also denounced Israel’s targeting of hospitals, ambulances and medical staff.
Fares, a medical student who is volunteering in Gaza’s al-Aqsa Hospital, said the situation is “horrific and unspeakable” right now.
“Two days ago, a bag of body parts was brought to the hospital. A man identified his niece from her hand and another relative from a leg. He was unable to identify other relatives by the other body parts,” he said.
Fares said roads to hospitals have been bombed, houses leveled, with hundreds trapped under the rubble.
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