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In growing tide, civilians flee north Gaza or shelter at hospital as Israel, Hamas battle in city

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Israeli armed vehicles drive along the outskirts of Gaza City, as seen from southern Israel, Thursday Nov. 9, 2023.
Israeli armed vehicles drive along the outskirts of Gaza City, as seen from southern Israel, Thursday Nov. 9, 2023. (AP Photo/Leo Correa) Photo Gallery

DEIR AL-BALAH, Gaza Strip (AP) — Crowds of Palestinian families stretching as far as the eye could see walked out of Gaza City and surrounding areas toward the south Thursday to escape Israeli airstrikes and ground troops battling Hamas militants in dense urban neighborhoods. Others joined tens of thousands taking shelter at the city’s biggest hospital, not far from the fighting.

Gaza’s largest city is the focus of Israel’s campaign to crush Hamas following its deadly Oct. 7 incursion — and the Israeli military says Hamas’ main command center is located in and under the Shifa Hospital complex. The militant group and hospital staff deny that claim.

Growing numbers of people have been living in and around the hospital complex, hoping it will be safer than their homes or U.N. shelters in the north, several of which have been hit repeatedly. Israeli troops were around 3 kilometers (2 miles) from the hospital, according to its director.

The accelerating exodus to the south came as Israel agreed to put in place four-hour daily humanitarian pauses and to open a second route for people to flee the north, the White House said. The scope of the pauses was not immediately clear. The agreement came as Western and Arab officials gathered in Paris on Thursday to discuss ways of providing more aid to civilians in Gaza.

Separately, mediators worked on a possible deal for a three-day cease-fire in exchange for the release of around a dozen hostages held by Hamas, according to two Egyptian officials, a United Nations official and a Western diplomat.


Israeli ground forces battled near Gaza’s largest hospital, Shifa. Conditions are worsening for tens of thousands of people sheltering there, said three people who had left the hospital to go south in the past two days.

Families are sleeping in hospital rooms, even surgical theaters and the maternity ward, or on the streets outside. Daily food distributions helped a tiny number for a time, but there has been no bread for the past four days, they said. Water is scarce and usually polluted, and few people can bathe. Still more families are arriving, believing it is safer than fleeing to the south, where airstrikes also continue, the people said, speaking on condition of anonymity for fear of reprisals.

The Israeli military says the complex is a Hamas command center and that senior militant leaders are hiding there. Hamas and hospital staff say the military is creating a pretext to strike it.

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The hospital has been overwhelmed with daily waves of wounded from airstrikes, while medical supplies have been running low and electricity shut off in many wards. The U.N. delivered two truckloads of supplies Wednesday night, the second delivery since the war began — enough to last a few hours, the director said.

“The conditions here are disastrous in every sense of the word,” the director Mohammed Abu Selmia told The Associated Press on Thursday. “We’re short on medicine and equipment, and the doctors and nurses are exhausted. … We’re unable to do much for the patients.”

The U.S. humanitarian envoy for the war, David Satterfield, said Thursday that agreements being worked out would include a way to move wounded from the north.

International journalists who entered the north on a tour led by the Israeli military on Wednesday saw heavily damaged buildings, fields of rubble and toppled trees along the Mediterranean shoreline.

More than two-thirds of Gaza’s population of 2.3 million have fled their homes since the war began, with hundreds of thousands heeding Israeli orders to flee to the southern part of the enclave.

But the conditions there are also dire. Israel has continued to strike what it says are militant targets in the south, but often crushing homes with families inside.

Aid deliveries into Gaza from Egypt have reached an average of 100 trucks a day, Satterfield said. Relief workers say that is still far below what is needed.


The exodus from Gaza City and surrounding areas in the north has picked up in recent days. The U.N. said 50,000 people fled south on Gaza’s main highway Wednesday.

Similar-sized crowds streamed out on Thursday, according to an Associated Pres reporter on the scene as they arrived out of the northern zone. Shots rang out in the distance and smoke rose from blocks away as families made their way by food with only what they could carry. Others rode on horse-drawn carts.

“I’m carrying my house on my back,” said Kamal Nsew, a 28-year-old, pointing to the possession tied to his body. He had been walking three hours, he said. “We’ve been expelled, we’ve been put through a catastrophe. I don’t know where my people are and don’t know what is coming for us.”

His use of the Arabic word “nakba,” — which literally means “catastrophe” — is a reference to the expulsion or flight of some 700,000 Palestinians from their homes in what is now Israel during the 1948 war around Israel’s creation. More than half of Gaza‘s residents are refugees from that war, or their descendants.

The Hamas-run Interior Ministry, which has urged Palestinians to stay in their homes, has told media outlets not to circulate footage of people fleeing.

A month of relentless bombardment in Gaza since the Hamas attack has killed more than 10,800 Palestinians — nearly two-thirds of them women and minors, according to the Health Ministry in the Hamas-run territory. More than 2,300 others are believed to have been buried by strikes that in some cases have demolished entire city blocks.

Israeli officials say thousands of Palestinian militants have been killed, and blame civilian deaths on Hamas, accusing it of operating in residential areas and using Palestinian civilians as human shields. Gaza’s Health Ministry does not distinguish between civilians and combatants in its casualty reports.

More than 1,400 people have died in Israel since the start of the war, most of them civilians killed by Hamas militants during their initial incursion. Israel says 32 of its soldiers have been killed in Gaza since the ground offensive began.

Palestinian militants have continued to fire rockets into Israel, and some 250,000 Israelis have been forced to evacuate from communities near Gaza and along the northern border with Lebanon, where Israeli forces and Hezbollah militants have traded fire repeatedly.

A drone exploded in the yard of a house in Israel’s Red Sea city of Eilat, causing no injuries, and a long-range surface-to-surface missile — whose source was under investigation — was intercepted before entering Israeli airspace, the military said.

The occupied West Bank has also seen a surge in violence, with Israel carrying out frequent arrest raids that often spark gunbattles. At least 13 Palestinians were killed Thursday during a raid in Jenin, the Palestinian Health Ministry said. The Israeli military said more than 10 militants were killed in a raid in Jenin.