Middle East Crisis: Israel Will Dispatch Team to Hear Biden Administration Worries on Rafah

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Displaced Palestinians transport their belongings through a street surrounded by the rubble of destroyed buildings in Khan Younis in the southern Gaza, last week.Credit…Agence France-Presse — Getty Images

At the request of President Biden, Israel’s prime minister, Benjamin Netanyahu, agreed on Monday to send a team of officials to Washington to discuss alternatives to a promised Israeli invasion of Rafah, the city that has become the last refuge for roughly half of Gaza’s population, according to Mr. Biden’s national security adviser, Jake Sullivan.

In a phone call on Monday, Mr. Biden told the Israeli leader that sending ground forces into Rafah, as Mr. Netanyahu has vowed repeatedly to do, could be disastrous when there are other options for defeating Hamas, Mr. Sullivan said.

“A major ground operation there would be a mistake,” Mr. Sullivan told reporters at the White House. “It would lead to more innocent civilian deaths, worsen the already dire humanitarian crisis, deepen the anarchy in Gaza and further isolate Israel internationally.”

Mr. Sullivan said Mr. Biden had asked Mr. Netanyahu to send a team of military, intelligence and humanitarian officials to Washington to hear U.S. concerns about Israel’s plans for Rafah, and to “lay out an alternative approach that would target key Hamas elements in Rafah and secure the Egypt-Gaza border without a major ground invasion.”

“The prime minister agreed that he would send a team,” he added. “Obviously he has his own point of view on a Rafah operation, but he agreed that he would send a team to Washington to have this discussion.”

During the call, Mr. Biden, who has been increasingly critical of Israel’s conduct of the war and the toll it has taken on civilians, expressed alarm that Israeli forces could repeat the pattern of destruction that has played out during major offensives in Gaza City and Khan Younis.

“More than a million people have taken refuge in Rafah,” Mr. Sullivan told reporters. “They went from Gaza City to Khan Younis and then to Rafah. They have nowhere else to go. Gaza’s other major cities have largely been destroyed.”

Mr. Sullivan said Israel has also not presented any plan for safely moving civilians out of harm’s way, or provide them with food, shelter and basic services like sanitation — a key request of the Biden administration for weeks.

In a statement posted on social media, Mr. Netanyahu said he and Mr. Biden had spoken about recent developments in the war. He said they also discussed Israel’s commitment to achieving all of its goals for the war: “Eliminating Hamas, freeing all of our hostages and ensuring that Gaza never gain constitutes a threat to Israel — while providing the necessary humanitarian aid that will assist in achieving these goals.”

Mr. Biden has publicly been resolute in what Mr. Sullivan described on Monday as a “bone-deep commitment to ensuring the long-term security of Israel.” But the president has engaged in an escalating critique of the Mr. Netanyahu as Palestinian casualties continue to mount from the military operation that Israel launched in response to the Oct. 7 attacks led by Hamas.

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President Biden told Prime Minister Benjamin Netanyahu of Israel that he was “deeply concerned” about the prospect of a major Israeli operation in Rafah during a phone call on Monday.Credit…Doug Mills/The New York Times

After Senator Chuck Schumer of New York, the majority leader, called for elections to replace Mr. Netanyahu, Mr. Biden praised his remarks as “a good speech” — without specifically endorsing any of Mr. Schumer’s criticisms of the prime minister.

And earlier this month, Mr. Biden could be heard in audio clips telling a member of Congress that he would have to have a “come to Jesus” meeting with Mr. Netanyahu about the bloodshed in Gaza.

Mr. Sullivan’ began his remarks on Monday by emphasizing the Israeli military’s success in routing Hamas and affirming the United States’ commitment to assisting with that effort. But his description of the chaos in Gaza was among the sharpest and most critical of the Israeli response to come from the White House over recent months.

“More innocent civilians have died in this conflict, in this military operation, than in all the wars in Gaza combined, including thousands of children,” he said. “A humanitarian crisis has descended across Gaza, and anarchy reigns in areas that Israel’s military has cleared but not stabilized.”

Zach Montague Reporting from Washington

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Outside Al-Shifa Hospital in Gaza City in December.Credit…Agence France-Presse — Getty Images

Israeli forces using tanks and bulldozers raided Al-Shifa Hospital in northern Gaza on Monday in an operation they said was aimed at senior Hamas officials who had regrouped at the medical facility, setting off an hourslong battle that both sides said had resulted in casualties.

The raid began before dawn, with the Israeli military’s chief spokesman, Rear Adm. Daniel Hagari, saying in a video statement that troops were operating in “limited areas” of the hospital complex. More than 12 hours later, Hamas’s military wing, the Qassam brigades, said that its forces were “engaged in fierce clashes with enemy forces” near the hospital.

The Israeli military said that Hamas fighters had shot at its soldiers from within the complex and soldiers had returned fire. The Gazan Health Ministry said Israeli forces had launched missiles at the complex and fired into surgery rooms. Details of the fighting could not be independently verified.

The Israeli military said that it had launched the raid based on new intelligence that Hamas officials were operating from the hospital, four months after Israeli forces stormed the complex and found a tunnel shaft they said supported their contention that the armed group had used it to conceal military operations. Since then, Israel has withdrawn many troops from northern Gaza and shifted the focus of its invasion to the south.

During the operation on Monday, Israel said its forces had killed 20 militants. Among those killed, it said, was a senior Hamas official it identified as Faiq Mabhouh, the head of operations for the internal security forces of the Hamas government in Gaza, who was “armed and hiding in a compound” at the hospital. Hamas did not confirm his death or role in the organization and did not immediately respond to a request for comment.

The Israeli military also said one of its soldiers had been killed in the fighting at Al-Shifa.

Hamas, in the statement from its armed wing, claimed that it had caused “deaths and injuries” to Israeli forces, but did not provide evidence.

The hospital and the surrounding area house about 30,000 patients, medical workers and displaced civilians, and a number of people were killed and wounded in the raid, the Gazan Health Ministry said. It added that a fire had broken out at the gate of the complex, which caused some people to suffocate and made it difficult to reach those who were injured.

By midday, about 15 Israeli tanks and several bulldozers were inside the hospital grounds, said Alaa Abu al-Kaas, who was staying at the hospital to accompany her father who was being treated there.

“The fear and terror are really eating us alive,” she said in a phone call from a corridor of one of the hospital’s buildings where she was hiding. Her voice was barely audible amid loud booms and explosions.

Hedaya Al Tatar, who lives about a quarter-mile from the hospital, described hearing “intensive shooting and heavy shelling” starting at around 2 a.m., along with drone strikes.

Ms. al-Kaas, 19, said that around the same time, she heard shots and the sound of tanks before Israeli soldiers, using loudspeakers, ordered people in the complex to stay inside and close the windows. She said Israeli forces told people that they would be moved to the Al-Mawasi area in southern Gaza, although it was not immediately clear when or how they would be moved. Israel has sought to create a humanitarian “safe zone” in Al-Mawasi, although civilians have found little shelter there.

“We are just sitting here anxiously waiting for them to evacuate us out of here,” she said.

Ms. al-Kaas said that she had seen Israeli soldiers holding several people, their hands bound and clothes partially stripped off, in the courtyard of the hospital complex. She added that bodies of people who had apparently been shot were lying in the courtyard.

Israel has said that the hospital complex doubled as a secret Hamas military command center, calling it one of many examples of civilian facilities that Hamas uses to shield its activities. U.S. spy agencies have said that their own intelligence indicates that Hamas and another Palestinian group used Al-Shifa to command forces and hold some hostages.

Hamas has denied the accusations, and Israel came under criticism from health and humanitarian organizations after storming the hospital in November. Evidence examined by The New York Times suggests Hamas did use the hospital for cover and maintained a hardened tunnel beneath it that was supplied with water, power and air-conditioning. But the Israeli military has struggled to prove that Hamas maintained a command-and-control center under the facility.

“We know that senior Hamas terrorists have regrouped inside Al-Shifa Hospital and are using it to command attacks against Israel,” Mr. Hagari said on Monday. He added that there would be “no obligation” for staff and patients to evacuate, but said a passage would be provided for civilians to leave the hospital.

Myra Noveck and Abu Bakr Bashir contributed reporting.

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President Biden’s national security adviser, Jake Sullivan, at the White House on Monday.Credit…Andrew Harnik/Associated Press

Israeli forces have killed one of Hamas’s highest-ranking military leaders in the Gaza Strip, a senior White House official said on Monday.

Marwan Issa, the deputy commander of Hamas’s military wing, “was killed in an Israeli operation last week,” Jake Sullivan, President Biden’s national security adviser, told reporters at a White House briefing.

A senior Israeli official, speaking on the condition of anonymity because he was not authorized to speak to the news media, said Israel had not confirmed Mr. Issa’s death but that there were many indications he had been killed.

Israeli officials have said that Mr. Issa was targeted by an Israeli airstrike on the night of March 9-10. Though they have stopped short of saying whether Mr. Issa was killed in the attack, Israeli officials have hinted at his possible death — the Israeli military chief of staff said on Sunday that Hamas was trying to “hide” the fate of senior Hamas officials, without directly naming him.

In the attack, Israeli warplanes struck an underground space in the Nuseirat neighborhood of central Gaza that had been used by Mr. Issa and another senior Hamas military official responsible for the group’s weapons, a spokesman for the Israeli military, Rear Adm. Daniel Hagari, said a week ago.

Hamas — which has announced the deaths of just a few of its members since the war began — did not immediately comment on Mr. Sullivan’s remarks. The Israeli military declined to comment on the remarks on Monday.

The death of Mr. Issa, a key figure in its Qassam Brigades, would represent a victory for Israel, whose leaders have vowed to wipe out the Hamas leadership in Gaza — although the group has swiftly replaced such leaders in the past, and many of Hamas’s top political leaders live outside the enclave.

One of the most senior Hamas officials to have been confirmed dead since the start of the war is Saleh al-Arouri, a founder of the group’s armed wing. Hamas said he was killed in an Israeli attack in Lebanon on Jan. 2.

But despite an Israeli military campaign that has battered Hamas over the last five months, the group’s leader in Gaza and the presumed mastermind of the Oct. 7 attack, Yahya Sinwar, has eluded Israeli forces. Mohammed Deif, the top commander of the Qassam Brigades, is also believed to be alive.

Admiral Hagari has said that Mr. Issa helped plan the Hamas-led Oct. 7 attack and last week called him a part of “the main triangle of terror” in Gaza, alongside Mr. Sinwar and Mr. Deif.

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There are few photos of Marwan Issa, the senior-most Hamas leader killed by Israel since the start of the war. An official in the group’s military wing, he kept a low profile.Credit…Emrah Gurel/Associated Press

Marwan Issa, the deputy commander of Hamas’s military wing in Gaza and a presumed mastermind of the Oct. 7 assault on southern Israel, was confirmed dead on Monday by a senior U.S. official after an Israeli airstrike more than a week ago.

Jake Sullivan, the U.S. national security adviser, told reporters that Mr. Issa, one if the highest-ranking officials in Hamas, had been killed. Rear Adm. Daniel Hagari said on March 11 that Israeli military warplanes had targeted Mr. Issa and another senior Hamas official in an underground compound in central Gaza.

With his death, Mr. Issa, who had been among Israel’s most wanted men, became the senior-most Hamas leader to be killed in Gaza since the start of the war. Israeli officials have characterized the strike as a breakthrough in their campaign to wipe out the Hamas leadership in Gaza.

But experts cautioned that his death would not have a devastating effect on Hamas’s leadership structure. Israel has killed Hamas’s political and military leaders in the past, only to see them quickly replaced.

Here is a closer look at Mr. Issa and what his death means for Hamas and its leadership.

Mr. Issa, who was 58 or 59 at the time of his death, had served since 2012 as a deputy to Mohammed Deif, the elusive leader of the Qassam Brigades, Hamas’s military wing. Mr. Issa assumed the role after the assassination of another top commander, Ahmed al-Jabari.

Mr. Issa served both on Hamas’s military council and in its Gaza political office, overseen by Yahya Sinwar, the group’s highest-ranking official in the enclave. Mr. Issa was described by Palestinian analysts and former Israeli security officials as an important strategist who played a key role as a liaison between Hamas’s military and political leaders.

Salah al-Din al-Awawdeh, a Palestinian analyst close to Hamas, described Mr. Issa’s position in the group as “part of the front rank of the military wing’s leadership.”

Maj. Gen. Tamir Hayman, the former Israeli military intelligence chief, said Mr. Issa was simultaneously Hamas’s “defense minister,” its deputy military commander and its “strategic mind.”

Experts described Mr. Issa as an important associate of Mr. Deif and Mr. Sinwar, though they said his death did not represent a threat to the group’s survival.

“There’s always a replacement,” Mr. Awawdeh said. “I don’t think the assassination of any member of the military wing will have an effect on its activities.”

Michael Milshtein, a former Israeli military intelligence officer and an expert on Palestinian affairs, said Mr. Issa’s death was a significant blow to the Qassam Brigades, though he conceded it wasn’t “the end of the world” for Hamas.

“He had a lot of experience,” Mr. Milshtein said. “His death is a big loss for Hamas, but it isn’t a loss that will lead to its collapse and it won’t affect it for a long time. In a week or two, they’ll overcome it.”

Mr. Milshtein added that even though Mr. Issa’s opinion was valued at the highest levels of Hamas, the fact he did not directly command fighters meant his death did not leave a gaping hole in Hamas’s operations.

Mr. Issa was a lesser-known member of Hamas’s top brass, maintaining a low profile and rarely appearing in public.

Gerhard Conrad, a former German intelligence officer who met Mr. Issa more than a decade ago, described him as a “decisive and quiet” person lacking charisma. “He was not very eloquent, but he knew what to say, and he was straight to the point,” Mr. Conrad said in an interview.

Mr. Conrad said he met Mr. Issa, Mr. al-Jabari and Mahmoud al-Zahar, another senior Hamas official, about ten times between 2009 and 2011 in Gaza City. The men met as part of an effort to broker a prisoner swap between Israel and Hamas.

“He was the master of the data on the prisoners,” Mr. Conrad said of Mr. Issa. “He had all the names to be negotiated on.”

Mr. Conrad, however, said it was apparent at the time that Mr. Issa was a subordinate to Mr. al-Jabari. “He was a kind of chief of staff,” he said.

It was only after Mr. al-Jabari’s assassination that Mr. Issa’s prominence grew, but he still was keen to stay out of view. Few images of Mr. Issa are in the public domain.

Mr. Awawdeh, the analyst, called Mr. Issa a man who liked to “remain in the shadows” and who seldom granted interviews to the media.

In one of those rare interviews, Mr. Issa spoke in 2021 about his role in the indirect talks that resulted in Israel exchanging more than 1,000 Palestinian prisoners for a single Israeli soldier, Sgt. First Class Gilad Shalit, and his hopes for a future conflict with Israel.

“Even if the resistance in Palestine is monitored by the enemy at all hours, it will surprise the enemy,” he told Al Jazeera at the time.

In a separate interview with a Hamas publication in 2005, Mr. Issa lauded militants who raided Israeli settlements and military bases, calling the actions “heroic” and an “advanced activity.”

Mr. Issa was born in the Bureij area of central Gaza in 1965, but his family hails from what is now the Ashkelon area in Israel.

A Hamas member for decades, he was involved with the militant group involved pursuing Palestinians who were believed to have collaborated with Israel, according to Mr. Awawdeh.

Mr. Issa spent time in prisons operated by both Israel and the Palestinian Authority.

Admiral Hagari has said that Mr. Issa helped plan the Hamas-led Oct. 7 attack. Mr. Issa is also thought to have planned operations aimed at infiltrating Israeli settlements during the second intifada in the 2000s, Mr. Milshtein said.

A correction was made on 

March 18, 2024

An earlier version of this article misstated the name of a former Israeli military intelligence chief. He is Maj. Gen. Tamir Hayman, not Heyman.

How we handle corrections

Adam Rasgon reporting from Jerusalem

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Palestinian children waiting in line for food provided by donors in Deir al Balah, Gaza, in February.Credit…Mohammed Saber/EPA, via Shutterstock

Experts project that northern Gaza will face famine conditions as soon as this month, and that half of the enclave’s population will suffer deadly levels of hunger, according to a new report from the global authority that has classified food security crises for decades.

The report, released Monday by the Integrated Food Security Phase Classification global initiative, projected that famine is “imminent” for the 300,000 Palestinian civilians in northern Gaza, where such conditions will develop by the end of May. And by mid-July, as many as 1.1 million people in Gaza could face what the group characterized as the worst stage of hunger: an “extreme lack of food,” and severe levels of starvation, death, destitution and acute malnutrition.

Bar chart shows the proportion of Gaza’s northern governorates and southern governorates that are facing different levels of food insecurity, ranging from stressed (level 2) to famine (level 5).

Food insecurity levels by region

Emergency

Stressed

Crisis

Catastrophe

North Gaza and Gaza

20%

25%

55%

Deir al-Balah and Khan Younis

20%

45%

30%

Rafah

30%

40%

25%

Food insecurity levels by region

Crisis

Stressed

Emergency

Catastrophe

North Gaza and Gaza

20%

25%

55%

Deir al-Balah and Khan Younis

5%

20%

45%

30%

Rafah

5%

30%

40%

25%

The group — set up in 2004 by U.N. agencies and international relief groups, and known as the I.P.C. — has classified a famine only twice: in 2011, in parts of Somalia, and in 2017, in parts of South Sudan. In those countries, relatively small proportions of the population met the group’s criteria for famine conditions. In Gaza, the residents of the critically threatened north make up more than 13 percent of the population.

According to the I.P.C., a famine occurs when three conditions are met: at least 20 percent of households have an extreme lack of food; at least 30 percent of children suffer from acute malnutrition; and at least two adults, or four children, for every 10,000 people die daily from starvation or from disease linked to malnutrition. (Although I.P.C. experts conduct and review the analysis necessary to classify a famine, only government and top U.N. officials can officially make an official declaration.)

The report noted that the first condition had already been met, and the second most likely has been reached. Collecting data on the third, malnutrition-linked deaths, is immensely difficult in a war zone, the group has said. The death rate among children appeared higher than for adults, it added, but said it was “impossible to ascertain.”

At least 27 people, including 23 children, have died of malnutrition, dehydration and lack of baby formula, according to the Gazan Health Ministry.

Shimon Freedman, a spokesman for the Israeli agency that oversees policy for the Palestinian territories, COGAT, reiterated on Monday Israel’s position that it “places no limit on the aid that can enter the Gaza Strip.”

And Eylon Levy, an Israeli government spokesman, called the report an “out-of-date picture” that “does not take into account the latest developments on the ground,” including major humanitarian initiatives last week. He also said Israel is taking “proactive measures” to expand aid delivery in northern Gaza.

Last week, Israel allowed a small World Food Program convoy to deliver food to northern Gaza for the first time since Feb. 20. After the report was released, the organization’s chief economist, Arif Husain, warned that “time is running out” for many Gazans. “This is why children are dying,” he said. “If we don’t get in there they won’t be dying in 20 or 30s, they will be dying in hundreds and thousands.”

Alex de Waal, an expert on humanitarian crises who has written a book about mass starvation, said the situation in Gaza was “unprecedented.”

“None of us who’ve worked in this field have ever seen anything like this,” he said. “It is absolutely shocking.”

The I.P.C. classifies acute food insecurity in five phases, ranging from minimal to catastrophic.

All of Gaza’s 2.2 million people are in at least the third, or crisis, level of food insecurity, meaning that they are not eating enough and are malnourished. Nearly 40 percent are in the fourth, or emergency, phase, facing extreme food shortages and bearing an increased risk of hunger-related death. And 30 percent are in the most severe stage, indicating they have almost no food and are facing critical levels of starvation and death.

In December, the group warned that famine could occur within six months unless fighting stopped immediately and more humanitarian supplies made it into the territory. “Since then, the conditions necessary to prevent famine have not been met,” the latest report said.

The Famine Review Committee, a group within the I.P.C. which studied the report’s nutrition analysis, said famine could be prevented by “an immediate political decision for a cease-fire together with a significant and immediate increase in humanitarian and commercial access to the entire population of Gaza.”

The U.N. secretary general, António Guterres, called the report “an appalling indictment of conditions on the ground for civilians.” The hunger crisis, he said, “is an entirely man-made disaster — and the report makes clear that it can be halted.”

More than five months after Israel’s campaign against Hamas began, hunger experts estimate that nearly the entire population of Gaza relies on food aid. Israel has eased the restrictions on humanitarian deliveries it established immediately after the Hamas-led attacks of Oct. 7, but aid groups say that the aid reaching Gaza is not sufficient.

UNRWA, the U.N. agency that supports Palestinians, said Gaza is receiving only a fraction of what is necessary to prevent conditions from continuing to deteriorate. Much of that aid does not make it much farther than where it crosses the border.

Josep Borrell Fontelles, the European Union’s top diplomat, urged Israel to allow “free, unimpeded, safe humanitarian access.”

“Hunger can’t be used as a weapon of war,” he said in a statement.

Israel’s foreign minister, Israel Katz, rejected Mr. Borrell’s criticism, saying that the country allows extensive aid in by air, land and sea.

Amy Schoenfeld Walker, Elena Shao and Farnaz Fassihi contributed reporting.

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In Tel Aviv this month, people held photos of a hostage believed to have been taken during the Hamas-led attacks on Israel on Oct. 7. Some Israelis say their government is not doing enough to secure the captives’ release.Credit…Amir Levy/Getty Images

Israeli negotiators arrived in Qatar on Monday to participate in a new round of in-person talks aimed at achieving a cease-fire in the Gaza Strip and the release of hostages held by Palestinian militants, a senior Israeli official said.

The trip to the Qatari captial, Doha, by a delegation headed up by the head of Mossad, Israel’s foreign intelligence agency, comes after Israel and Hamas failed to reach an agreement ahead of the Muslim holy month of Ramadan, which began last week.

Two senior Israeli officials said the government had initially given its negotiating team an amorphous mandate. The team has now been authorized to go deeper into details during the talks, they said, but wasn’t given the full latitude it had requested. The officials spoke on the condition of anonymity because they were not authorized to communicate with the news media.

A meeting was scheduled to take place on Monday involving the Israelis, Egyptian officials and Prime Minister Mohammed bin Abdulrahman Al Thani of Qatar, according to a person with knowledge of the talks, who requested anonymity because he wasn’t authorized to speak publicly. Qatar and Egypt have acted as intermediaries, in part because negotiators for Israel and Hamas do not talk directly with each other.

The Israeli officials said the broad proposal being discussed includes a 42-day pause in the fighting in exchange for the release of 40 of more than 100 hostages taken from Israel and held in Gaza by Hamas or its allies. But they emphasized that they expected reaching an agreement to take a long time.

A senior official in Hamas’s political office did not respond to a request for comment.

On Thursday, Hamas presented a new proposal that omitted a previous demand that Israel immediately agree to a permanent cease-fire in return for beginning an exchange of hostages and Palestinian prisoners held in Israeli jails, according to people familiar with the negotiations.

The Israeli officials said Hamas’s new proposal included details that were unacceptable to Israel.

For months, Hamas leaders have been publicly calling for a comprehensive cease-fire and complete Israeli withdrawal from Gaza. Israeli officials have repeatedly rejected the demands and indicated that they would be open to only a temporary pause.

Hamas officials have also called for the return of displaced Palestinians to their homes and for more aid to reach the territory.

Palestinians grappling with displacement and hunger have grown frustrated that Israel and Hamas still have not reached a deal, and the families of hostages have raised concerns about the fate of their relatives months into captivity.

Adam Rasgon and Vivian Nereim reporting from Jerusalem and Riyadh, Saudi Arabia

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Shortages of staff and supplies have crippled Al-Shifa hospital in Gaza City, where a youth lay on a dirty floor awaiting medical attention on Friday.Credit…Agence France-Presse — Getty Images

The largest hospital in Gaza’s shattered health system, Al-Shifa, was only “minimally functional” before Israeli forces raided it again on Monday, according to the World Health Organization.

Before the war began in October, Al-Shifa, which is in Gaza City, was part of a system of 36 hospitals serving more than two million people. The Gaza Strip had health outcomes comparable to elsewhere in the Middle East in terms of infant mortality and life expectancy, according to the Gaza and West Bank representative of the United Nations’ World Health Organization.

But 23 of the hospitals no longer operate and the others are overcrowded and can only provide limited services despite an escalation of medical needs, not least the tens of thousands of people who the health authorities in Gaza say have been wounded during the conflict between Israel and Hamas. Hospitals are grappling with physical damage and shortages of staff, medicines, electricity, equipment and cleaning supplies.

Early in the conflict, thousands of people fled to Al-Shifa, seeking safety on its grounds from Israeli bombardment and later from fighting as Israeli forces invaded northern Gaza.

The Israeli government, however, made the hospital a key target, arguing that Hamas had built tunnels beneath it that it used as a military headquarters, weapons store and troop shelter, using the hospital’s medical function as a shield.

The Israeli military raided the hospital after a siege in November and detained its director, Mohammed Abu Salmiya.

It was unclear on Monday whether he remained in detention, and the Israeli military did not immediately respond to questions about his status. But Leo Cans, a senior official with medical charity Doctors Without Borders, who visited Al-Shifa a week ago, said the hospital had a new interim director.

Mr. Cans said that Al-Shifa was trying to get back on its feet but lacked surgeons, and its staff were exhausted and many had not been paid. Vital machines for providing X-rays and other services can only work sporadically because of a lack of generator fuel, he said. At the same time, he said he saw evidence of military damage at the hospital, including in the intensive care unit.

“There were patients inside, but most of the hospital remains largely empty,” he said.

After the Israeli seizure of Al-Shifa in November, The New York Times examined evidence indicating that Hamas had used the hospital to store weapons and had maintained a tunnel network. But it was less clear that Hamas had operated a command-and-control center under the facility.

The Israeli military pulled back from the hospital as part of a weeklong cease-fire in late November. It also reduced its forces in northern Gaza as the focus of its invasion moved to central and southern Gaza. On Monday it launched a new raid on Al-Shifa, claiming that senior Hamas officials had regrouped there.

As Israeli forces have since raided other Gazan hospitals, a debate has arisen over the legitimacy of targeting civilian facilities in pursuit of military objectives — and the price paid by Gaza’s population. Although hospitals are protected under international law, they can be legitimate targets if used in ways that are “harmful to the enemy,” but experts say that any military action must take into account the expected harm to civilians.

International health officials say that Israel has, in effect, destroyed the health system in northern Gaza, worsening a humanitarian crisis.

“We are terribly worried about the situation at Al-Shifa Hospital in northern Gaza, which is endangering health workers, patients and civilians,” Dr. Tedros Adhanom Ghebreyesus, the W.H.O. chief, said in a statement posted on social media on Monday. “The hospital has only recently restored minimal health services. Any hostilities or militarization of the facility jeopardize health services, access for ambulances and delivery of life-saving supplies.“

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Trucks carrying humanitarian aid bound for Gaza, at the inspection area at the Kerem Shalom border crossing in Israel, on Thursday.Credit…Amir Levy/Getty Images

Trucks carrying lifesaving humanitarian relief for the Gaza Strip idle for days or weeks in Egypt waiting for Israeli inspectors to let them enter, and some are rejected despite having vital medical supplies, the chief of Saudi Arabia’s state agency said on Monday.

“The biggest solution is to open as many corridors as you can,” said Dr. Abdullah Al Rabeeah, a Saudi royal court adviser and head of the King Salman Humanitarian Aid and Relief Center.

The aid agency has raised nearly $180 million through a donation campaign for humanitarian relief in Gaza. But it has struggled to deliver relief to the people who need it most because of Israeli restrictions on the movement of aid into and within the Palestinian territory, Dr. Al Rabeeah said in an interview in Riyadh. Nearly all aid that has reached Gaza since October has entered through two border crossings, and more openings are needed, he said.

“These corridors mean life and death for those in need,” he said. “We should not block aid and see death for innocent civilian people who are not part of the conflict.”

Across Gaza, people are facing severe shortages of food and other basic goods amid Israel’s bombardment and invasion that have killed more than 30,000 Palestinians, according to local health authorities. Experts anticipate a steep rise in malnutrition-related deaths among children, and in northern Gaza, famine is imminent, according to a recent report.

Aid groups contend that Israel, which insists on inspecting every delivery, is making it impossible to supply enough aid to ensure the survival of Gazans. On Monday, Josep Borrell Fontelles, a top European Union diplomat, accused Israel of using starvation as “a weapon of war.”

Israeli officials deny that they are deliberating limiting aid. The obstacles, they say, are disorganization by the United Nations and aid groups, and interference and theft of supplies by Hamas, the armed group that has governed Gaza and led the Oct. 7 attacks on Israel.

“Israel allows extensive humanitarian aid into Gaza by land, air, and sea for anyone willing to help,” Israel Katz, the country’s foreign minister, wrote on the social media platform X, responding to Mr. Borrell’s comments. He blamed Hamas for “violently disrupting aid convoys.”

So far, the Saudi aid agency has managed to send 488 truckloads into Gaza. But many more are waiting on the Egyptian side of the Rafah border crossing for Israeli inspections, Dr. Rabeeah said.

“What makes it difficult is that it’s not consistent, so one day you may have more trucks than the other day, some days maybe no trucks are allowed,” Dr. Al Rabeeah said. “When I visited Rafah, I spoke to the truck drivers myself, and those drivers are actually tired — exhausted — because they wait days, sometimes weeks, to get approval.”

Given the shortages that have built up inside Gaza, at least 500 to 600 trucks of aid a day are needed now to meet people’s needs, Dr. Al Rabeeah estimated. Instead, an average of 150 trucks a day have been entering, according to U.N. data.

Even after trucks cross into Gaza, some of them run into internal Israeli checkpoints and are turned back from their ultimate destinations, Dr. Al Rabeeah said.

Another major challenge is that Israeli authorities are refusing to allow certain medical items to enter Gaza — including incubators for premature babies and certain medical diagnostic machines, he said — even though local aid partners say they are desperately needed. Israeli authorities claim they could also be used for military applications, said Dr. Rabeeah, who is a physician.

“They say they may have ‘dual usage,’ but again, incubators are incubators,” he said. “You cannot have a newborn premature child and not put them in an incubator; we know as doctors that they may not be able to survive.”

Saudi Arabia is not interested in pursuing airdrops — which the United States, Jordan and the United Arab Emirates have undertaken — because they provide only a “very tiny” amount of aid compared to the need, Dr. Rabeeah said. The kingdom is potentially interested in joining a project to deliver aid by sea that is being put together by the United States, but officials are awaiting further details from their American counterparts, he added.

Vivian Nereim reporting from Riyadh, Saudi Arabia

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Senator Jack Reed of Rhode Island at the Capitol in January. Credit…Valerie Plesch for The New York Times

Senator Jack Reed, the chairman of the Armed Services Committee, said on Monday that Prime Minister Benjamin Netanyahu of Israel was in a compromised position and had competing personal agendas that complicate his handling of the war in Gaza.

Mr. Reed, a senior Democrat from Rhode Island, said he strongly agreed with comments last week by Senator Chuck Schumer, Democrat of New York and the majority leader. In a blistering speech on the Senate floor, Mr. Schumer criticized Mr. Netanyahu as a major obstacle to peace in the Middle East and called for new leadership in Israel after five months of war.

Mr. Reed called the remarks by Mr. Schumer, the highest-ranking Jewish elected official in the United States, “courageous.”

“Prime Minister Netanyahu is in a very compromised position,” Mr. Reed told the Defense Writers Group. “There are indications that he tolerated Hamas as a way to disrupt the Palestinian Authority.”

Mr. Reed added: “He knows that if there’s an election, he’ll lose. He also is fearful that unless the courts are reformed, quote-unquote, he could very well be put in jail. So he’s operating not as someone whose sole interest, I believe, is the state of Israel. He has so many competing personal agendas on that I think Chuck’s advice is well taken.”

Mr. Netanyahu has faced prosecution on corruption charges since long before the war began. In January, Israel’s Supreme Court struck down a plan by Mr. Netanyahu’s government to limit the courts’ powers, part of a broader overhaul of the judiciary that his opponents say is meant partly to rid him of his legal troubles.

Mr. Reed, a former 82nd Airborne Division officer in the U.S. Army, urged the Israeli military to use more precise targeting if it proceeds with a ground offensive in the southern Gaza city of Rafah. Mr. Netanyahu said over the weekend that Israel’s military would move ahead with an offensive in the city despite warnings from allies that such a move would imperil more than one million Palestinians sheltering there.

More important, however, is the urgent need for Israel to allow humanitarian aid into Gaza, Mr. Reed said.

“They have to deal with the humanitarian crisis in Gaza,” he said. “They have to allow food to come in. And I don’t think it would detract from their operation against Hamas.”

Mr. Reed also made it clear that he opposed putting conditions on military assistance to Israel to try to influence its military operations in Gaza.

“We are Israel’s ally,” he said. “They are our allies.”

Eric Schmitt reporting from Washington

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World Central Kitchen is the only aid group that has successfully delivered aid directly to Gaza by sea.Credit…Yiannis Kourtoglou/Reuters

As a second ship towing desperately needed aid prepared to depart for Gaza on Sunday, José Andrés, the founder of the food charity sending the vessels, called for a cease-fire and said that Israel should be doing more to prevent hunger in Gaza.

“At the very least,” Mr. Andrés, the celebrity chef, said on NBC’s “Meet the Press,” Israel should “make sure that nobody’s hungry and that nobody’s without food and water.”

“This is something that should be happening overnight,” he added. “But for political reasons, I guess it’s not happening there.”

Mr. Andrés said he hoped his group, World Central Kitchen, would be able to scale up its nascent effort and eventually bring “huge quantities of food daily into the shores of Gaza,” where United Nations officials have said 2.2 million people are on the brink of famine.

Though the Open Arms, the first ship dispatched by the group, attracted global attention in recent days, the maritime route is so far delivering just a tiny fraction of the aid that the United Nations says is needed to stave off famine. The Open Arms towed a barge to a makeshift jetty off Gaza on Friday with the equivalent of about 10 truckloads of food — far less than the 500 trucks a day aid groups say are needed.

Aid groups — including World Central Kitchen, which has sent more than 1,400 aid trucks into Gaza — have pleaded for Israel to allow more trucks in through more land crossings, saying that only a fast stream of trucks can sustain Gaza’s population.

But only about 150 trucks have been entering Gaza through the two open land crossings each day, according to U.N. data, because of several factors, including lengthy Israeli inspections to enforce stringent restrictions on what can enter Gaza.

The limitations at those entry points have set off a scramble for creative solutions among donors such as the European Union, which helped set up a maritime route from Cyprus to Gaza, and the United States, which has been airdropping aid and is leading an effort to build a temporary pier off Gaza’s coast to accommodate more deliveries by ship. John Kirby, the spokesman for White House National Security Council, told ABC’s “This Week” on Sunday that it would take six to eight weeks to complete construction.

So far, only World Central Kitchen, which Mr. Andrés founded after the 2010 Haiti earthquake, has successfully delivered aid directly to Gaza by ship. The first delivery consisted of about 200 tons of rice, flour and lentils, and canned tuna, chicken and beef.

The second, which was still anchored in the Cypriot port of Larnaca on Sunday night, is set to bring food and equipment to help with future maritime deliveries.

Mr. Andrés on Sunday wondered aloud why Israel’s military was bombing buildings in Gaza that might house the hostages Israel says it wishes to see returned to safety. He also issued a plea for peace, saying he had seen great humanity on both sides of the conflict.

“The time I’ve spent in Israel, the time I’ve been spending in Gaza, seems everybody loves falafel and everybody loves hummus with equal intensity,” said Mr. Andrés, whose group has opened more than 60 community kitchens within Gaza to serve hot meals. “It makes you wonder how people that loves the same foods, they can be at odds with each other.”

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