GAZA STRIP - Hundreds of people stranded in Gaza's biggest hospital were enduring "inhuman" conditions on Monday while heavy fighting raged around them, a doctor inside said, as US President Joe Biden urged Israel to "protect" the facility.
Witnesses reported intense air strikes, with tanks and armoured vehicles just meters from the gate of Al-Shifa hospital, under which Israel argues Hamas has buried its military headquarters -- a charge denied by Hamas.
"The situation is very bad, it is inhuman," a surgeon with Doctors Without Borders (MSF), the medical charity group, wrote on social media.
"We don't have electricity. There's no water in the hospital," added the doctor, who was not named.
Biden added to rising international pressure on Israel, urging the United States ally to use "less intrusive action relative to the hospital".
"The hospital must be protected," Biden told reporters in the Oval Office when asked if he had expressed concerns to Israel on the issue.
The Israeli army has pushed on with its campaign, determined to destroy the Hamas movement.
Israel said 44 of its troops have been killed in the Gaza ground operation begun.
"Hamas has lost control of Gaza," the territory it has ruled since 2007, Israeli Defence Minister Yoav Gallant said in a statement broadcast on Israel's main TV stations.
"Terrorists are fleeing southward. Civilians are looting Hamas bases," Gallant said on Israeli television without providing evidence.
But Israel is facing intense international calls to minimise civilian suffering during its massive air and ground operations that the Health ministry in Hamas-run Gaza say have killed 11,240 people, including 4,630 children.
Israel's top diplomat, as quoted by his spokesman, said the nation has "two or three weeks until international pressure really steps up."
Foreign Minister Eli Cohen added that Israel is working to "broaden the window of legitimacy, and the fighting will carry on for as long as necessary."
- Fear of regional conflict -
The Hamas-run health ministry said there were dozens of bodies on the streets of northern Gaza, where the heaviest fighting raged, and ambulances were coming under Israeli fire when they tried to retrieve them.
The Hamas government's deputy health minister Youssef Abu Rish said the death toll inside Al-Shifa rose to 27 adult intensive care patients and seven babies since the weekend as the facility suffered fuel shortages.
Gaza has been reliant on generators for more than a month after Israel cut off power supplies following the October 7 Hamas attack, and the besieged territory's only power plant ran out of fuel.
A lack of fuel is also hitting the UN agency for Palestinian refugees UNRWA. The agency's Gaza chief Thomas White said operations "will grind to a halt in the next 48 hours as no fuel is allowed to enter" the territory.
The World Health Organization in the Palestinian territories said early Monday that at least 2,300 people -- patients, health workers and people fleeing fighting -- were inside the crippled Al-Shifa facility.
The Israel Defense Forces on Monday reported more heavy fighting and again stressed its claim that Hamas was hiding in civilian infrastructure.
Israeli forces had "found signs" that Hamas militants had held hostages at a children's hospital in Gaza City, army spokesman Daniel Hagari said, showing footage of a baby bottle and a rope near a chair.
Teams of Israeli troops ran between jagged ruins in Gaza while air strikes shown on grainy military-released video shattered buildings.
Israelis are stunned by the October 7 attack and worried for the fate of the hostages. Demonstrators rallied on Monday outside the United Nations in Jerusalem to call for the world body's help in freeing the captives.
A possible deal for the "release of prisoners" was the subject of ongoing negotiations being mediated by Qatar, according to Biden.
The war in Gaza has also spurred concerns of a wider regional conflict.
At least eight pro-Iran fighters were killed in US strikes on eastern Syria, a war monitor said, in response to attacks on American forces.
It was the third time in less than three weeks that the US military has targeted locations in Syria. Attacks on American forces in the Middle East have spiked since the Israel-Hamas war began.
- International concern -
International attention has focused on the plight of Palestinians, and protests have been held worldwide in solidarity with the 2.4 million under bombardment and near-total siege for more than five weeks.
About 980 trucks carrying humanitarian aid have been let into Gaza since October 21, according to the UN humanitarian agency.
Before the war, 500 trucks entered every day, it claimed.
Palestinian prime minister Mohammad Shtayyeh called on the European Union and the United Nations to "parachute aid" into Gaza.
Fuel is in critical need, especially for hospital generators, but Israel has been concerned that any fuel deliveries could be diverted to Hamas militants.
Almost 1.6 million people -- about two-thirds of Gaza's population -- have been internally displaced since October 7, according to UNRWA.
Some people were being allowed to leave the besieged territory via the Egypt-controlled Rafah crossing and on Monday more than 550 foreigners passport holders and nine wounded Palestinians wounded and companions crossed.
Israel's military said it would observe a "self-evacuation corridor" Monday, allowing people to move from Al-Shifa southward, but admitted the area was still the scene of "intense battles".
The area of fighting "currently includes the area surrounding the Al-Shifa hospital but not the hospital itself", an IDF spokesperson told AFP.
The Israeli army also said its ground soldiers had hand-delivered 300 litres (80 gallons) of fuel near the hospital "for urgent medical purposes".
Al-Shifa director Abu Salmiya said he told Israeli authorities he needed far more -- at least 8,000 litres to run the main generators and "save hundreds of patients and wounded, but they refused".