Crammed under makeshift canvas shelters in the car park, sleeping in corridors or on landings, passing the hours of the day in stairwells, hanging laundry on the roof - thousands of displaced Gazans are filling every space at Al-Shifa Hospital.
The main hospital in Gaza City has turned into a giant refuge for people whose homes have been bombarded, or who fear that they will be, in Israel's military assault on the Gaza Strip, which is entering its second month.
"We ran from our house because of the heavy air strikes," said Um Haitham Hejela, a woman sheltering with young children in an improvised tent fashioned from fabric, string and mats.
"The situation is getting worse day after day," she said. "There is no food, no water. When my son goes to pick up water, he queues for three or four hours in the line. They struck bakeries, we don't have bread."
Reuters journalists visiting the hospital on Tuesday saw people lying on both sides of corridors, leaving only a narrow space for anyone to walk, personal belongings stored in staircases and on window sills, and piles of refuse bags. The overwhelming impression was of extreme crowding.
The situation is not unique to Al-Shifa. The World Health Organization estimates 122,000 displaced Gazans are sheltering in hospitals, churches and other public buildings across the strip, with a further 827,000 in schools.
The war was triggered by an Oct. 7 attack on Israel by Hamas fighters who killed 1,400 people and took 240 others hostage. In response, Israel has mounted an air, sea and ground onslaught against Hamas which has killed more than 10,000 people in the densely populated coastal strip, according to officials in Gaza.
‘From fear into fear’
For hospitals, the displacement crisis is compounding an already catastrophic situation, with shortages of medical supplies and electricity as huge numbers of gravely injured patients arrive daily. Staff are resorting to desperate measures, such as performing surgery without anesthetics.
At Al-Shifa, displaced people said they had come seeking safety, but did not feel safe because of nearby air strikes and the approaching Israeli military. Israel has said its forces had surrounded Gaza City.
The Israeli military has accused Hamas of hiding tunnel entrances and operational centers inside Al-Shifa, which Hamas has denied.
"We have run from fear into fear," said Um Lama, a grieving mother sheltering in a corridor with several children and older relatives.
Her daughter Lama was among those killed by a strike on an ambulance just outside the hospital gate on Friday. The hospital director said 15 people had been killed and 60 injured.
Israel said it had targeted an ambulance carrying Hamas fighters. The Palestine Red Crescent Society said the ambulance had been one of a convoy of five attempting to evacuate severely wounded people.
"Look at our situation. Is this a life that we are living? We have no food, no electricity or water. We sleep in the corridors," said Um Lama.
Israel has told Gazans still living in the north of the strip to move to the south, which is also being bombarded though less intensively.
An Israeli military spokesman was asked at a media briefing on Tuesday about reports of flash bombs going off over Al-Shifa overnight.
"I'm aware that it happened. There was probably some operational requirement," he said.
"We're trying to get people to leave, that's all I can say about that. These are the sorts of messaging for people to try to get out of there."
But the women sheltering in the hospital said that despite the dire living conditions and the fear, they had no intention of leaving as they had nowhere to go, and nowhere was safe.
"We are strong. Whatever they do with us, we won't leave Al-Shifa. They cut the water, the electricity, no food, but we are strong. We can eat only biscuits and nuts. We can eat anything," said Hejela.
