GAZA CITY – The fighting has stretched into its third horrific day at Al-Shifa Hospital in northern Gaza. What was once a sanctuary for the sick has devolved into a bloody battleground between Israeli troops and militant fighters, leaving civilians trapped in the crossfire of a broader power struggle.
As the conflict rages on, a devastating portrait has emerged of the dire situation in northern Gaza amid a power vacuum left in the wake of Israel’s military invasion of the territory. With the Palestinian government forces of Hamas severely weakened, civilians are bearing the brunt of the lawlessness, violence and deprivation.
The Israeli military’s re-entry into the Al-Shifa hospital complex this week points to the tenuous control over this region. Prime Minister Benjamin Netanyahu has repeatedly called for toppling Hamas, the militant faction that governs Gaza. However, his forces have struggled to establish order and provide basic security in the areas they have re-taken from Hamas.
“Complete chaos has taken hold and the people are paying the price,” said Talal Okal, a political analyst who fled Gaza City for the UAE. “Netanyahu and his partners don’t want to answer the question of the day after the war.”
Since Israel’s ground invasion began on October 27th in response to a Hamas attack, northern Gaza has descended into a nightmarish existence cutoff from aid and basic services. The once-crowded streets lie in ruin. Food is scarce. Medical care is nearly non-existent. Families have been torn apart, fleeing one bombardment only to seek refuge in areas soon targeted themselves.
“We’re living but we’re dead,” said Rajab Tafish, a 37-year-old phone repairman from Gaza City, his voice heavy with despair. “We’re exhausted from all of this misery.”
Just blocks from his home, Tafish said he could hear the terrifying sounds of the raging battle at Al-Shifa Hospital, where Israeli forces engaged in deadly gunfights with militants they claim had made a foothold there. The UN has estimated over 300,000 people in northern Gaza now face famine due to the deprivation and difficulty in delivering humanitarian aid to the cut-off region.
Israel had initially raided the hospital in November after accusing Hamas of using it as a base. They pulled back after uncovering a tunnel network beneath the complex, only to return again in late January amid reports of Hamas regrouping at the site.
Now over 70 hours of fighting has left the hospital at least temporarily crippled and displaced many of the patients and staff. The toll has been staggeringly high – Israel claims it has killed dozens of militants while arresting hundreds more in the operation. But as usual in this conflict, the cost has fallen heaviest on civilians trapped in the crossfire.
“Lives have been transformed into hell,” said Okal. With Hamas fighters still holding ground and Israeli forces seeming unable to pacify the zones they have re-taken, northern Gaza has fallen into a spiral of violence and deprivation from which there seems no escape for the beleaguered population.
Bastion of Hamas Faces Existential Threat
While northern Gaza has slipped into pandemonium, the remaining holdout for Hamas militants – and an estimated 1.5 million displaced civilians – is the southern city of Rafah near the Egyptian border. And it is here that the climactic battle of the conflict may be looming.
Netanyahu has made clear his intention to soon order forces into Rafah to uproot the Hamas fighters still controlling the city. But it is an invasion not without controversy, nor ease.
The Biden Administration has warned the Israeli leader that sending troops into the densely populated city, which has become overwhelmed with refugees fleeing the fighting elsewhere, could result in a humanitarian catastrophe.
“Our view is that there are ways for Israel to prevail in this conflict… and not smash into Rafah,” National Security Advisor Jake Sullivan said this week. He added the White House would present alternatives when Israeli officials arrive in Washington for urgent talks expected in the coming days.
Yet Netanyahu has remained resolute, saying an invasion is necessary to achieve the original goal of degrading Hamas’ capabilities to carry out attacks. Rafah represents one of the last bastions of the group’s control in Gaza.
What is clear is that any further escalation in Rafah could compound the suffering among Gaza’s civilians, who have already endured wave after wave of violence and displacement just to stay alive. More than a million Gazans have been forced to flee their homes at various points since the conflict escalated in October.
A Repeated Cycle of Evacuation and Displacement
When Israeli airstrikes first began pounding Gaza in early October in response to the Hamas attack, the military wasted no time in warning over 1 million civilians to evacuate the northern part of the territory. While impractical for many, the orders still prompted a massive exodus south as families lugging what few belongings they could grabbed hold of sought safety.
“Hamas is using you as human shields,” an Israeli admiral warned at the time, as the military dropped leaflets urging people to leave for their own well-being ahead of the eventual invasion.
But the south, where Israel had made clear the intensity of its bombardment, proved anything but a safe haven. An investigation by the New York Times revealed the Israeli military used some of its largest conventional weapons in crowded civilian areas there, causing massive damage and casualties.
After a brief ceasefire in early December, fighting flared again, this time in the southern city of Khan Younis. Once more, confusing Israeli orders prompted many civilians who had already fled north to uproot again on short notice and head farther south to Rafah.
Rafah, which hugs the Egyptian border, then became the latest designated safe zone. But with over 1.5 million displaced people crammed into its streets and makeshift camps, it has proven no refuge either as violence has followed them there as well.
On February 12th, Gaza’s health authorities said over 60 civilians perished in a single night of airstrikes in Rafah as Israel launched a hostage rescue operation against Hamas. Earlier this month, at least 20 more died while waiting for humanitarian aid at a traffic circle in the city.
No Permanent Place of Safety
For many Gazans, stories of being forced to flee at a moment’s notice have become all too common and familiar. Parents grab children, hauling nothing but the clothes on their backs. The sick and elderly are loaded into rickety carts pulled by donkeys or jammed into vehicles overflowing with belongings strapped to every inch.
“We really have no permanent place anymore,” said Jamal abu Sultan, a father of six, after fleeing Khan Younis last month following vague evacuation warnings from Israel. “Home is simply where the bombs aren’t falling at any given time.”
In December, abu Sultan described scenes of pandemonium, as throngs of civilians carrying meager possessions choked the roads heading south under bombardment. Just ahead was the village of Al-Mawasi, one of the latest areas Israel had deemed temporarily “safe” despite its lack of shelters and infrastructure.
After arriving at the coast and pitching tents in the sand amid the swelling crowds, the bombing soon followed. So the cycle started anew – racing to flee Al-Mawasi and head farther south to what was supposed to be the real safe zone, Rafah.
But not even Rafah has proven safe from the conflict’s reach. In addition to the recent deadly airstrikes, surging food and water shortages now have aid workers warning that mass starvation and hunger-related fatalities are imminent in the overcrowded city.
The UN has estimated that a staggering 1.1 million Gazans are now facing catastrophic food insecurity, with the situation most dire among the displaced populations crammed into places like Rafah. The collapse of basic services makes securing sustenance a daily brutal struggle.
On multiple occasions, deadly violence has erupted as crowds gathered for aid distribution due to both the desperation and militia activity in such areas. Just two weeks ago, at least 20 people were killed at a traffic circle while awaiting food after the Israeli military acknowledged opening fire on the masses.
A Way Forward Remains Elusive
With a potential escalation looming in Rafah, the scenes of displacement and human suffering appear poised to reach new, unfathomable levels. The UN has cautioned that a major Israeli offensive in the city risks plunging Gaza’s already dire humanitarian crisis “deeper into the abyss.”
Faced with that prospect, the United States aims to present alternatives to Netanyahu during the upcoming talks in Washington. While welcoming an end to Hamas’ hostilities, Biden is urging Israel to consider “other ways” of achieving that beyond sending troops into Rafah.
What those options entail remains unclear. Israel may seek guarantees to prevent Hamas rearming or to enable its forces to jointly patrol and secure areas of Gaza. Washington may propose a multinational peacekeeping force.
Progress could hinge on parallel negotiations to release Israeli hostages held by Hamas and securing a lasting ceasefire. Those talks too have proved turbulent, with the Palestinian side accusing Israel’s hardline government of making uncompromising demands.
The Biden Administration hopes injecting American muscle into the discussions and bringing both sides together for face-to-face talks could provide a breakthrough. What is certain is that bold action is essential before already-unconscionable levels of death and displacement in Gaza precipitate into an even greater humanitarian catastrophe from which recovery may prove impossible.
While pockets of militants remain dug-in, most of Gaza’s over 2 million residents want only to see the bombing cease and to be able to return home – or what’s left of it. The utter exhaustion is palpable in the weary eyes of the displaced.
“Please make this stop. I want to live,” said Aisha Sabah, a mother of five, wandering the streets of Rafah clutching her children and few remaining possessions. “Is that too much to ask?”
