Middle East Crisis: Battle at Hospital Points to Power Vacuum in Northern Gaza

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People fleeing the area around Al-Shifa Hospital on Monday.Credit…Agence France-Presse — Getty Images

Since the start of the war in Gaza, Prime Minister Benjamin Netanyahu of Israel has repeatedly spoken of the need to topple Hamas but has done little to address the power vacuum left behind by withdrawing Israeli forces.

Nowhere is that more apparent than in northern Gaza, where an Israeli military raid on a major hospital complex entered a third day on Wednesday, as Israel said the re-emergence of Hamas fighters had forced it to return to a site they first stormed in November.

Since Monday, the Israeli military said, troops have engaged in deadly gun battles with militants at the complex, Al-Shifa, leaving displaced people, medical teams and nearby residents caught in the crossfire. On Wednesday, the army said that it had killed dozens of militants in the operation and questioned or arrested hundreds of people. Its account of the operation could not be independently confirmed.

Israeli military analysts say that a coherent plan for governing Gaza could take months or years to put in place, and that troops would likely have had to return to Al-Shifa in the interim. But critics of Mr. Netanyahu say that he has failed to advance even an initial realistic proposal, leaving Palestinian civilians to bear the highest cost of the disorder.

“Lives have been transformed into hell,” said Talal Okal, a political analyst from Gaza City who fled northern Gaza in October and is now in the United Arab Emirates.

“Netanyahu and his partners don’t want to answer the question of the day after the war,” he said. “Complete chaos has taken hold and the people are paying the price. But what can they do? All they can do is raise their hands and pray to God.”

Following the Hamas-led attack on southern Israel on Oct. 7, the Israeli forces launched a wide-scale invasion of northern Gaza, killing Hamas militants and causing immense civilian death and devastation. Its soldiers first raided Al-Shifa Hospital in November after accusing Hamas of using the hospital for military purposes.

That raid on Shifa revealed a stone-and-concrete tunnel shaft below the hospital. At the time, the Gaza Health Ministry said the incursion had put the hospital out of service.

Soldiers withdrew from the hospital in mid-November, but returned to the surrounding area in late January and pulled back again in February.


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Emmy Shaheen, a resident of Gaza City, filmed clashes around Al-Shifa Hospital, where the the Israeli military carried out an operation.CreditCredit…Emmy Shaheen

As Israeli forces have shifted the focus of their invasion to southern Gaza — and Mr. Netanyahu says they will soon invade the southernmost city of Rafah — the north of the enclave has been all but cut off from humanitarian aid. Lawlessness, damaged roads and attacks on convoys have led aid groups to suspend deliveries there, and the United Nations has said many of its relief missions have been blocked by Israel. Israeli officials say there are no limits on how much aid can enter Gaza.

Palestinians in the north are struggling to obtain basic services and food.

“We’re living but we’re dead,” said Rajab Tafish, 37, a resident of Gaza City. “We’re exhausted from all of this misery.”

Mr. Tafish, a telephone repairman, said he and his family could hear “terrifying” explosions and gunfire emanating from the Shifa Hospital area, where a family member had been receiving treatment but was no longer reachable.

He said his family had sent his brother to nearby schools on Wednesday in hopes of acquiring flour.


Shortages of staff and supplies have crippled Al-Shifa Hospital in Gaza City, where a person awaited medical care on Friday.Credit…Agence France-Presse — Getty Images

The U.N.-backed Integrated Food Security Phase Classification initiative said this week that 1.1 million people, half the population of Gaza, would most likely face catastrophic food insecurity and predicted an imminent rise in hunger-related deaths. In the northern areas, it said, 300,000 people faced “imminent” famine.

Twice in the past month, attempts to distribute food ended in bloodshed as Palestinians seeking aid were killed.

More than 100 people were killed in Gaza City on Feb. 29, according to local health authorities, who said Israeli troops had opened fire on a crowd that massed around aid trucks. The Israeli military acknowledged opening fire, but said most of the deaths had occurred when people stampeded or were run over by truck drivers.

Last week, at least 20 people were killed while awaiting aid at a traffic circle in northern Gaza. Gazan officials said Israeli forces had “targeted” the crowds, a claim that Israel’s military has denied.

Adam Rasgon reporting from Jerusalem


Smoke rising above Gaza City, in the northern Gaza Strip, on Friday.Credit…Mohammed Saber/EPA, via Shutterstock

Former Israeli security officials are split on how to address growing anarchy in the northern Gaza Strip, but many agree that Prime Minister Benjamin Netanyahu’s lack of a workable plan for how the enclave will be governed makes it impossible to chart a path toward a more stable future.

Mr. Netanyahu has brought forward a vague plan that calls for Israeli security control over Gaza after the war. He has also outright rejected U.S. calls for an overhauled Palestinian Authority — which now has limited governing powers in the West Bank — to govern the enclave.

But there are no simple options. Many Palestinians see the Palestinian Authority as tainted by corruption and mismanagement, and it is mistrusted by many in Mr. Netanyahu’s government. Some politicians and retired Israeli military officials have called for Israel to occupy Gaza — at least temporarily — but that is widely opposed by the international community and would put enormous limits on Palestinian freedoms. How Hamas and other factions confront an occupation would also pose a significant challenge.

Some former Israeli officials say that Mr. Netanyahu must introduce a governing body now in areas where the army has pulled out in order to block Hamas from reconstituting itself and to prevent chaos from proliferating. They argue that Israel will likely have to continue returning to parts of Gaza that it has left to fight resurgent Hamas militants in the near term, but they said that without a more comprehensive plan Israeli soldiers would be left fighting a protracted war of attrition.

“It’s a huge mistake” not to have a governing plan now, said Gen. Gadi Shamni, a retired commander of the army’s Gaza division. “It might take months or even years to create a successful alternative, but we need to start moving things in that direction.”

“We will continue doing these back and forth operations much longer than necessary,” he said.

In February, Mr. Netanyahu called for Israeli military control over Gaza and for the “administration of civilian affairs and the enforcement of public order” to be based on “local stakeholders with managerial experience.” Many experts interpreted the plan as an effort to procrastinate on serious action.

General Shamni said that Mr. Netanyahu’s stance reflected his unwillingness to let the Palestinian Authority take over governance in Gaza. His government depends on hard-line coalition partners who are opposed to the authority’s aspirations for Palestinian statehood.

“What’s most important to him is his political survival,” General Shamni said.


Israeli soldiers in the central Gaza Strip, during a tour for journalists escorted by the Israeli military last month.Credit…Sergey Ponomarev for The New York Times

Other retired Israeli officials have argued that the Palestinian Authority is too weak to govern Gaza but have agreed that the status quo of leaving areas ungoverned is untenable.

Instead, Israel should fully occupy Gaza first and then try to introduce an alternative governing body, they argue. Michael Milshtein, a former Israeli military intelligence officer, said that a new Israeli military raid on Al Shifa this week, a hospital complex Israel had first stormed in November, showed the need for a bigger Israeli security presence in the north.

“People are asking: Didn’t we already clean Shifa? We very much didn’t,” Mr. Milshtein said. “If you don’t remain there, within five minutes, they come back,” he said, referring to Hamas.

The Gazan Health Ministry has condemned the Israeli raid as a “crime against health institutions,” and humanitarian organizations expressed alarm over the situation at the complex, which, along with the surrounding area, had been sheltering 30,000 patients, medical workers and displaced civilians. Witnesses described a terrifying scene during the raid.

Israel said it had detained scores of people and killed dozens of militants, while Hamas has claimed that it caused “deaths and injuries” to Israeli forces.

Fully occupying Gaza would require Israel to increase its forces in Gaza and dedicate more resources to providing services to Palestinians. It would also defy international calls on Israel, including by President Biden, not to take such action.

For Palestinians, it would mean that the Israeli military would remain in full control of Gaza’s cities and entry and exit points.

Hamas would likely suffer under such a scenario with less room to maneuver because Israeli soldiers would be able to clamp down on the group more easily, but it is likely Hamas would mount an insurgency.

Mr. Milshtein argued that extending full Israeli control over Gaza was the only way to set the stage for another entity to take over.

“We don’t need more and more limited operations in Gaza, we need to occupy the whole area, and only after that, we can build a new arrangement,” he said.

Adam Rasgon reporting from Jerusalem


Antony J. Blinken, the U.S. secretary of state, arriving in Jeddah, Saudi Arabia, on Wednesday.Credit…Evelyn Hockstein/Reuters

Secretary of State Antony J. Blinken arrived in Saudi Arabia on Wednesday, the first stop of a Mideast trip amid efforts to broker a deal between Israel and Hamas for a pause in Israel’s offensive in Gaza, the release of Israeli hostages and a flow of more humanitarian aid into the Palestinian territory.

The visit to the city of Jeddah came as the Biden administration was hoping it could convince Saudi Arabia to establish diplomatic relations with Israel, a long-term objective that the United States considers important to stabilizing the broader Middle East.

The State Department said that Mr. Blinken would be in Saudi Arabia on Wednesday and Egypt on Thursday to meet with each country’s “leadership.” It did not name specific officials.

The department said separately that Mr. Blinken would be traveling to Israel, as well, for talks with the country’s “leadership” about efforts to secure the release of hostages held in Gaza and to “dramatically increase” humanitarian aid deliveries to the enclave. It is Mr. Blinken’s sixth trip to the region since the Hamas-led Oct. 7 attack on Israel set off the war in Gaza.

There was no immediate confirmation from the Israeli government. Nor were there details on whom Mr. Blinken would meet with.

Mr. Blinken told reporters in Manila on Tuesday that his discussions in the Middle East would include postwar plans for Gaza and the wider region.

He also said he would address “the right architecture for lasting regional peace,” an apparent reference to diplomacy among the United States, Israel and Saudi Arabia to broker a joint agreement.

Such a pact would likely require Israel to make concessions to the Palestinians in return for its first-ever formal diplomatic relations with Saudi Arabia. In turn, the Saudis want the United States and Israel to support the creation of a civil nuclear program on Saudi soil, as well as greater military support from Washington.

After a period of deeply strained relations, Saudi Arabia’s crown prince, Mohammed bin Salman, and President Biden found common ground earlier this year over exploring a potential deal in which Saudi Arabia would recognize Israel and establish diplomatic ties.

Many Arab governments, including Saudi Arabia, have long refused to establish a diplomatic link with Israel before the creation of a Palestinian state. Over the past decade, though, that calculus has shifted as the region’s authoritarian leaders have weighed negative public opinion toward a relationship with Israel against the economic and security benefits it could offer — and what they might obtain from the United States in return.

Framing the prospect of building ties with Israel as a way to obtain greater rights for the Palestinians could allow Prince Mohammed to limit popular backlash in his own country, where hostility toward Israel and support for the Palestinians is widespread.

Mr. Blinken’s trip comes as negotiators from Israel have joined officials from Egypt and Qatar to hold meetings in the Qatari capital, Doha, aimed at achieving a temporary cease-fire in the Gaza Strip and the release of hostages held by Palestinian militants.

The visit to Israel by Mr. Blinken will come as American and Israeli leaders are increasingly at odds over Israel’s approach to the war. Prime Minister Benjamin Netanyahu of Israel has brushed aside President Biden’s opposition to a planned ground invasion of Rafah, in southern Gaza, saying on Tuesday that his government would press ahead despite pleas for restraint from the United States and other allies.

In a phone call with Mr. Netanyahu this week, Mr. Biden argued that a ground invasion could be disastrous for those sheltering in Rafah, and that Israel had other ways of achieving its objective of defeating Hamas.

The White House is expected to host an Israeli delegation early next week to discuss Israel’s plans for the invasion, and the issue will also be on Mr. Blinken’s agenda when he is in Israel.

The State Department said that on his visit Mr. Blinken would “discuss the need to ensure the defeat of Hamas, including in Rafah, in a way that protects the civilian population, does not hinder the delivery of humanitarian assistance, and advances Israel’s overall security.”


A vigil in 2014 near where the bodies of three Israelis were found. Mahmoud Qawasmeh was accused of helping plan and finance the kidnappings of the three teenagers.Credit…Abir Sultan/European Pressphoto Agency

The Israeli military said Wednesday that it had detained a senior Hamas leader in Gaza who it says was involved in the 2014 kidnapping and killing of three Israeli teens, a case that convulsed the nation and set off a wave of violence that led to a 50-day war.

On Wednesday, the Israeli military said that its forces had arrested Mahmoud Qawasmeh, the senior Hamas leader, during a raid on the Al-Shifa Hospital in Gaza City and transferred him to Israel for interrogation.

The Israeli military’s claims about Mr. Qawasmeh’s arrest could not be independently verified, and there was no immediate comment from Hamas.

The kidnapped Israelis — Eyal Yifrach, 19, and Gilad Shaar and Naftali Fraenkel, both 16 — became national symbols when they disappeared near Gush Etzion in the occupied West Bank. After their bodies were discovered, a Palestinian teenager was kidnapped and killed in an apparent revenge attack, according to the Israeli authorities. Violent Palestinian protests and rocket attacks on Israel by militants in Gaza followed, all of which led to a war that killed nearly 2,200 people in the Gaza Strip and more than 70 in Israel.

Mr. Qawasmeh’s brother was sentenced to three life terms for his role as logistics commander in the abductions. Sentencing documents from the time accused Mr. Qawasmeh of helping transmit the funds for the abductions and killings. Mr. Qawasmeh, confined to Gaza, was not arrested.

A former Israeli prisoner, he had been sent back to Gaza in 2011 as part of a mass prisoner swap for the release of Gilad Shalit, an Israeli soldier held captive by Hamas.

The Israeli military’s statement about Mr. Qawasmeh’s arrest comes amid a diplomatic push to broker a cease-fire along with the release of hostages held by Hamas and other armed groups in the enclave. Those negotiations involve proposals for a pause in the fighting and the exchange of hostages and Palestinian prisoners held in Israeli jails.


Palestinians gathering to receive aid outside an UNRWA warehouse in Gaza City on Monday. Gaza residents face crisis levels of hunger amid the ongoing conflict between Israel and Hamas.Credit…Mahmoud Issa/Reuters

The United States would cut off funding for the main U.N. agency that provides aid to Palestinians in Gaza under a spending agreement on track to soon become law, according to two people familiar with the plan.

The ban, part of a massive spending bill negotiated by lawmakers and the White House that is expected to clear Congress by this weekend, would create a shortfall of hundreds of millions of dollars for the agency, known as UNRWA. That could have disastrous consequences for Gazans, who are facing an acute hunger crisis and displacement in crowded shelters and tent encampments.

The suspension is planned through March 2025 and extends a pause in funding that the White House and lawmakers from both major U.S. parties supported after Israel accused at least 12 UNRWA employees in January of participating in the Oct. 7 attack on southern Israel led by Hamas.


Palestinians leaving Gaza City for the south of the Gaza Strip in November.Credit…Samar Abu Elouf for The New York Times

For many civilians in Gaza, fleeing from Israeli attacks has become a grim cycle. Israeli evacuation orders have prompted more than a million people to move from one destination to another since October, each time packing belongings and seeking transport — by vehicle, cart or foot — to escape airstrikes and ground fighting between Israel and Hamas.

The latest example is Rafah, in southern Gaza, a city swollen to more than 1.4 million people by forced displacement. Prime Minister Benjamin Netanyahu of Israel said on Tuesday that his military would invade the city to root out Hamas but that it would provide humanitarian aid and “facilitate an orderly exit of the population.”

Jake Sullivan, the U.S. national security adviser, has said that a major ground invasion in Rafah would be a mistake, not least because it would further imperil humanitarian access. Displacement has contributed to a hunger crisis sweeping the territory, and the United Nations has said that an invasion could mean that an already catastrophic situation slides “deeper into the abyss.”

Some civilians say they have fled time and again. As many people face the prospect of being displaced again, here is a look at what happened on a few occasions when Israel has told civilians to evacuate.


Walking south on Salah al-Din Road, toward the southern Gaza Strip, in November.Credit…Samar Abu Elouf for The New York Times

Israel began telling more than one million civilians to evacuate northern Gaza about two weeks ahead of its ground invasion on Oct. 27, though the area was pummeled by Israeli airstrikes soon after the Hamas-led attack in Israel on Oct. 7.

“Hamas is using you as a human shield,” Rear Adm. Daniel Hagari, an Israeli military spokesman, said on Oct. 22, calling on civilians still in northern Gaza to move south.

The Israeli military also dropped Arabic-language leaflets over the area, warning that anyone who did not move south “may be considered as a partner in a terrorist organization.”

The United Nations said that the evacuation order was impractical, and the U.S. asked Israel to delay its invasion to give civilians more time. Even so, hundreds of thousands of people obeyed the order and moved to southern Gaza, carrying a few possessions away from an area that had already been shattered by airstrikes before the full-scale invasion began.

The south proved to be no escape from peril. An investigation by The New York Times in December found that Israel had used some of the largest and most destructive bombs in its arsenal in southern Gaza, posing a pervasive threat to civilians.

Mr. Netanyahu says that Israel intends to minimize civilian casualties while fighting Hamas, and Israeli officials said that Hamas fighters had set up checkpoints to prevent people from complying with the orders to move.


People arriving in Rafah after fleeing Khan Younis in January.Credit…Fatima Shbair/Associated Press

In early December, after a one-week cease-fire, Israel launched a major military operation in Khan Younis, southern Gaza’s largest city. Many civilians there had fled to the city from northern Gaza.

The Israeli military again warned civilians to leave parts of Khan Younis for Rafah and other places farther south, though residents said that they sometimes had mere hours of notice. Israel also dropped leaflets over Khan Younis and broadcast information about which parts of the city were safe at any given moment.

Several Palestinians said, however, that the orders to leave Khan Younis, or to move within it, were confusing, not least because they appeared to shift over time and left little opportunity to gather possessions. In addition, obeying the orders meant carting relatives — many of whom had been displaced several times previously — to a new place where the prospects for shelter and basic essentials were uncertain.

Civilians also said that when they fled as instructed, they sometimes found themselves at locations engulfed in fighting or subject to airstrikes.


A makeshift tent camp with displaced people in Rafah last week.Credit…Bassam Masoud/Reuters

The most recent designated large scale safe zone is Rafah, which lies against the closed Egyptian border and has been immensely swollen by displacement. Without sufficient accommodations, many of its new residents have pitched makeshift tents.

Rafah has been subject to airstrikes and fighting in recent weeks. In one example, the health authorities in Gaza said on Feb. 12 that at least 67 people had been killed overnight in airstrikes in the city. Israel’s military had launched an operation to rescue two people held hostage in Gaza since the Oct. 7 attack.


Displaced Palestinians in Al-Mawasi, Gaza, last month.Credit…Mohammed Abed/Agence France-Presse — Getty Images

The Israeli authorities have asked people at least twice to head to Al-Mawasi, a coastal village in southern Gaza that could be a destination for people asked to leave Rafah. Aid officials have said that the village lacks shelter, humanitarian aid and basic infrastructure.

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