Live updates | Biden says Gaza's largest hospital 'must be protected' as thousands flee the fighting

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Palestinians line up for food during the ongoing Israeli bombardment of the Gaza Strip in Rafah on Monday, November 13, 2023. (AP Photo/Hatem Ali)

Fighting between Israeli forces and Palestinian militants outside Gaza's largest hospital has prompted thousands of people to flee from the sprawling medical facility, but hundreds of patients and others displaced by the war remained inside, health officials said Monday.

U.S. President Joe Biden said Shifa hospital “ must be protected ” and called for “less intrusive action” by Israeli forces.

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Shifa has been without electricity and water for three days and “is not functioning as a hospital anymore,” said World Health Organization Director-General Tedros Adhanom Ghebreyesus on Sunday. He said there has been gunfire and bombings outside the compound.

Patients there include dozens of babies at risk of dying because of a lack of electricity, health officials at the facility said.

More than two-thirds of Gaza’s population of 2.3 million have fled their homes since the war began.

Gaza City, the largest urban area in the territory, is the focus of Israel’s campaign to crush Hamas following the militant group's deadly Oct. 7 incursion into southern Israel that set off the war.

More than 11,000 Palestinians, two-thirds of them women and minors, have been killed since the war began, according to the Health Ministry in Gaza, which does not differentiate between civilian and militant deaths. About 2,700 people have been reported missing.

More than 1,200 people in Israel died, most of them in the Hamas attack, and about 240 hostages were taken from Israel into Gaza by Palestinian militants.


Thousands flee Gaza's main hospital but hundreds, including babies, still trapped by fighting

Is Hamas hiding in Gaza's main hospital? Israel's claim is now a focal point in a dayslong stalemate

EU nations condemn Hamas for what they describe as use of hospitals, civilians as ‘human shields’

Biden's initial confidence on Israel gives way to the complexities and casualties of a brutal war

Detroit-area doctor grieves the loss of 20 relatives killed during Israel's war against Hamas

— Find more of AP’s coverage at

Here’s what's happening in the latest Israel-Hamas war:


UNITED NATIONS — China, many Arab nations and Iran condemned an Israeli minister’s statement that an option in Israel’s war against Hamas could be to drop a nuclear bomb on the Gaza Strip.

At Monday’s opening of a U.N. conference whose goal is to establish a nuclear-free zone in the Middle East, speaker after speaker said the Israeli statement posed a threat to the region and the wider international community.

The condemnations and criticisms were in response to comments by Israel’s Heritage Minister Amihai Eliyahu on the possible use of nuclear weapons in Gaza in a radio interview on Sunday. His remarks were quickly disavowed by Prime Minister Benjamin Netanyahu, who suspended Eliyahu from cabinet meetings.

Israel has neither confirmed nor denied its nuclear capability. It is widely believed to possess nuclear weapons, and a former employee at its nuclear reactor served 18 years in Israeli prison for leaking details and pictures of Israel’s alleged nuclear weapons program to a British newspaper in 1986.

China’s deputy U.N. ambassador Geng Shuang said Beijing was “shocked” at what “Israeli officials said about the use of nuclear weapons in the Gaza Strip,” calling the statements “extremely irresponsible and disturbing” and saying they should be universally condemned.

He stressed that the statements run “counter to the international consensus that a nuclear war cannot be won and must not be fought.” And he urged Israeli officials to retract the statement and become a party to the Nuclear Nonproliferation Treaty, considered the cornerstone of nuclear disarmament, as a non-nuclear weapon state “as soon as possible.”


KHAN YOUNIS, Gaza Strip — Sitting in a tent next to Nasr Hospital in southern Gaza, 10 members of the al-Tarabish family survive on what little they have: Pieces of days-old flatbread and dried herbs kept in a plastic sandwich bag.

Nermin Abu al-Tarabish says she feels lucky to be alive, having escaped heavy bombardment around Shifa hospital in Gaza City.

“Some were cut to pieces, some fell to the ground, some were screaming and making noises, and I was running while the people were running,” she said.

“It was a tragic day,” she said. “I had never experienced anything like this day in my life.”

As night fell, ambulance vans pulled up to the hospital in Khan Younis, unloading wounded from Israel's relentless bombardment surrounded by distraught relatives — many looking stunned as medics ran to receive the new patients.

One woman collapsed in grief and was helped to her feet by bystanders, as hospital staff wheeled out bodies wrapped in white sheets from the front entrance.


UNITED NATIONS – U.S. senator and former Democratic presidential candidate Bernie Sanders says the humanitarian situation in Gaza must be addressed immediately “or thousands of people may die,” following a meeting with U.N. Secretary-General Antonio Guterres.

Sanders told reporters before Monday afternoon’s meeting that “we have a horrendous situation” where Hamas started a war “by a barbaric attack” against innocent people in Israel, where some 1,200 people were killed. At least 11,000 Palestinians have been killed in Israel’s response, “including many, many children,” Sanders said.

“The goal now is to do everything we can to save lives – get the humanitarian aid in as quickly as possible,” he said.

U.N. spokesman Stephane Dujarric said Guterres and Sanders discussed the situation in the Middle East, and the secretary-general briefed the senator on the U.N.’s humanitarian operations in the region. The U.N. chief has repeatedly called for a humanitarian ceasefire to deliver humanitarian aid to Gaza.

Sanders, who is an independent but caucuses with the Democrats, said he asked for the meeting with Guterres as Vermont’s senator, not as a representative of the Biden administration.


UNITED NATIONS – The fuel crisis in Gaza is so dramatic that trucks filled with aid arriving through the Rafah crossing from Egypt won’t be unloaded starting Tuesday because there is no fuel for the forklifts, or for vehicles to deliver the food, water and medicine they’re carrying to those in desperate need, a senior U.N. humanitarian official says.

Andrea De Domenico, the U.N. humanitarian coordinator for the Palestinian territories, said “lives in Gaza are hanging by a thread due to the bleeding of fuel and medical supplies.” And he said since Israeli troops arrived in Gaza City center five days ago, it has been too dangerous for the U.N. to coordinate any operation in the north.

De Domenico said in a video press conference with U.N. correspondents from east Jerusalem that the intensified fighting over the weekend around Shifa hospital, the biggest in Gaza City, damaged critical infrastructure including water tanks, oxygen stations and the cardiovascular facility in the maternity ward. Three nurses were reported killed, he said.


JERUSALEM — Israel's military released video Monday from what it said was a children’s hospital that its forces moved into over the weekend. The video showed weapons it said were found inside, as well as rooms in the basement where it believes the militants were holding some of the around 240 hostages they abducted during the initial attack.

“Hamas uses hospitals as an instrument of war,” said Rear Adm. Daniel Hagari, the army’s chief spokesman, standing in a room of the Rantisi Children’s Hospital decorated with a colorful children’s drawing of a tree, with explosive vests, grenades and RPGs displayed on the floor.

He showed another area that he said could have been used to hold hostages. It included what appeared to be a hastily installed toilet and air vent, a baby bottle and a motorcycle. He said forensic experts were examining the scenes.


WASHINGTON — President Joe Biden on Monday said that Gaza’s largest hospital “must be protected,” and called for “less intrusive action” by Israeli forces.

Fighting between Israeli forces and Palestinian militants has encircled the sprawling medical facility, prompting thousands to flee.

“It is my hope and expectation that there will be less intrusive action,” Biden said in the Oval Office.

Shifa hospital has been without electricity and water for three days, and gunfire and bombings outside the compound have made the situation more difficult.

“We do not want to see fire fights in hospitals,” said White House national security adviser Jake Sullivan at a briefing. “We want to see patients protected. We want to see hospitals protected. We have spoken with the Israeli government about this and they have said they share that view that they do not want to see fire fights in hospitals.”

Sullivan said there were no easy answers on how Israel pushes military operations around the hospital, but these were questions for the Israeli military and not the U.S.


GENEVA — The International Federation of Red Cross and Red Crescent Societies says a race to find survivors under the rubble of destroyed buildings in Gaza has been thwarted by insufficient access for rescuers, as Israel’s military campaign in the enclave continues.

Tommaso Della Longa, spokesman for the Geneva-based humanitarian agency, says the situation in Gaza remains “desperate.” The Al-Quds hospital operated by the Palestinian Red Crescent Societies “was simply closed” on Sunday, he said.

While access to bombed-out areas is difficult, even the paramedics who are able to get through have no access to heavy machinery like bulldozers that could help clear ground to access any possible survivors under the rubble.

“Our colleagues are literally trying to save people from the rubble with their hands,” Della Longa told the Associated Press.

Israel has allowed scores of aid trucks -- carrying food, water and medical supplies but no fuel -- to enter Gaza as the military campaign goes on. United Nations and other officials say that’s a trickle compared to the hundreds of trucks that entered Gaza daily before the conflict.

Della Longa applauded efforts to bring a humanitarian pause or more aid into Gaza, but “we know that is complicated” -- and time is of the essence.

“The problem we have,” he said, “is that the people in Gaza don’t have time.”


JERUSALEM — Families of hostages being held by Hamas in Gaza gathered outside the main U.N. offices in Jerusalem on Monday to demand the world body secures the release of their loved ones.

A representative of the group handed over a letter to the top U.N. official in Jerusalem addressed to Secretary-General Antonio Guterres.

“We urge you to exercise your moral and executive authority as secretary general of the United Nations,” Gil Dickman said reading out the letter addressed to Guterres.

The family members held pictures of their loved ones as they gathered around toddler beds placed outside the U.N. compound in Jerusalem.

“I just came to ask for the U.N. to help us,” said Yoav Engel, father of Ofir Engel, held hostage by Hamas.

“My kid is there 38 days and other 238 people, babies, kids, teenagers, adults, sick men. And no one know what’s going on with them,” Engel said.

Pascal Soto, the top official of the Office of the United Nations Special Coordinator for the Middle East Peace Process, told the families Guterres is “doing his outmost” to secure the release of hostages and was in talks with different stakeholders, including Qatar,