At least five Palestinians were killed and 70 others injured by several Israeli tank shells fired by at al-Aqsa Hospital in Deir al-Balah, in central Gaza.
The bombing carried on throughout much of the day, and according to hospital sources has continued well into the evening.
One patient was killed while patients, visitors and hospital staff were among those injured and some 20 medical workers caught up in the shelling, said Dr. Ashraf al-Qudra, head of public relations at the Health Ministry in Gaza.
The strike has left the hospital unable to receive or treat medical cases, with ambulances forced to try and ferry the wounded to other facilities.
However, two ambulances which tried to move the wounded to Shifa hospital, in Gaza City, were then also hit by tank shells.
According to Qudra, the missile damaged several operating rooms as well as key equipment including an oxygen production unit, which is used in a wide range of operations and procedures.
The third and fourth floors and the reception area as well as the upper floor have all been badly damaged, medical sources told the Middle East Eye.
Subsequent rounds of shelling then proceeded to damage the x-ray facilities and maternity wards.
Israel has repeatedly denied targeting medical facilities, although it does routinely insist that Hamas uses civilian infrastructure including houses, schools and hospitals to hide weapons.
“You are allowed to hit targets where their [Hamas] war machine is using to hide rockets,” Mark Regev, spokesman for Israeli Prime Minister Benjamin Netanyahu, told Al Jazeera:
“I have no doubt Hamas uses, has used and continues to use, hospitals … we do not target civilians. But I am not aware of this specific situation.”
Dr. Khalil Khattab was operating on a patient injured in a separate strike when the shells first hit. He quickly ran downstairs and saw many of his colleagues injured. Many had been hit while trying to treat patients, but now patients, doctors and nurses alike lay injured and bleeding.
“The elevator is destroyed and all hospital assets are badly damaged,” Khattab told MEE, inspecting the destruction around him.
Aqsa hospital in central Gaza is the only hospital providing services to several refugee camps, including al-Maghazi, al-Nuseirat as well as some towns and villages including Deir el Balah and Juhu al-Dik. Health officials estimate that Aqsa is the main hospital serving over 350,000 residents of Gaza .
Since the start of Operation Protective Edge, more than 550 Palestinians, mostly civilians, have been killed at least 3,350 injured. One Israeli civilian and 25 Israeli soldiers have also been killed in the fighting.
Gaza’s medical infrastructure was already hard hit by the conflict, but the hit on Aqsa has further stretched resources.
Seriously injured patients have now been evacuated to the ground floor, leaving the hospital crammed, grossly under-equipped and with both staff and patients in sheer panic.
Dr al-Qidra, another doctor caught up in the Aqsa shelling, was conducting a surgical intervention at the Intensive Care Unit (ICU) when the first Israeli tank shell hit the hospital.
Qidra is calling on the World Health Organization and other groups to intervene urgently to stop Israeli attacks on hospitals, patients, medical crews and ambulances.
Human rights groups have also intensified their calls for greater protections.
“Today’s attack on the Aqsa hospital is the latest in a series of attacks on and near medical facilities in Gaza, which have been struggling to cope with thousands of injured people since the Israeli offensive began on 8 July,” Philip Luther, Director of the Middle East and North Africa Programme at Amnesty International said in a statement.
“There can be no justification for targeting medical facilities at any time. Attacks on medical facilities underline the need for a prompt, impartial international investigation mandated by the UN.”
It is unclear whether the hospital will be able to function in the days to come, and there have been serious attempts to evacuate all patients and staff to other locations so that they can receive appropriate care.
“It’s not possible for doctors to do surgical operations or procedures while Israeli tank shells are continuously dropping from overhead”, says Khattab.
Last week, Israeli air strikes hit al-Wafa Rehabilitation Hospital, despite international peace activists announcing that they would be acting as human shields at the building.
Following the strike, doctors were forced to evacuate 18 people to another hospital, although only minor injuries were reported.
Gaza European hospital has also been hit by Israeli air strikes, which damaged the operating room.
This kind of targeting has made patients and civilians of all stripes feel unsafe in and close to hospitals, which were previously regarded as safe havens protected by international law.
“Are we going to wait for our wounds to be hit again? Israel knows this is a hospital, but still they bombed us,” says Abuel Abed, a 44-year old who lives close to Aqsa Hospital.
“This war is between two parties: but why target a hospital that has nothing to do with politics?”
“Such hospitals provided vital public services to victims and families, and there is no valid reason to bomb them – no rockets are fired from nearby,” he adds.
Nor is it just patients and civilians who are afraid – even doctors, who are trained to deal with high-intensity situations, are struggling to cope under the pressure of near-constant Israeli bombardment.
Now, Abuel Abed says, “Israel will let our patients die, even without bombing them.”