By The Associated Press

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.

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.

Currently:

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

— Hospitals have special protection under the rules of war. Why are they in the crosshairs in Gaza?

— Biden’s certitude on Israel gives way to the complexities and casualties of a brutal war

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

— Attacks by Lebanon’s Hezbollah group wound 7 Israeli troops, 10 others along border with Israel

— US conducts airstrikes against Iran-backed groups in Syria, retaliating for attacks on US troops

— Find more of AP’s coverage at https://apnews.com/hub/israel-hamas-war

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

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,

Israel’s Foreign Minister Eli Cohen told reporters Monday that international pressure for a cease-fire is mounting and that Israel has a “window” of two to three weeks for continued operations in Gaza before pressure for a cease-fire intensifies.

However, later Monday, the foreign minister said on social media that “there is no hourglass” and Israel would keep fighting in Gaza.

“Even once international credit runs out, we will continue to advance our two goals: dismantling Hamas, and returning all the hostages,” Cohen said in a video on X, formerly known as Twitter.

Some Israeli politicians dismissed Cohen’s comments about the mounting calls for a cease-fire.

“With all due respect to political pressures, our commitment is first to the residents of the south and Israeli civilians who paid a heavy and terrible price,” Minister of Culture and Sports Miki Zohar posted on X. “We must win this war and return the hostages home. No matter how long it takes.”

At the United Nations headquarters in New York and offices of the world body across the globe, flags were lowered to half-staff to honor 101 employees and support staff at the U.N. agency that assists Palestine refugees, the UNRWA, who have been killed in Gaza.

U.N. Secretary-General Antonio Guterres and other senior officials observed a minute of silence.

Israeli Prime Minister Benjamin Netanyahu Monday described Hamas fighters as “simply savages” and vowed to press ahead till achieving “total victory.”

Visiting fighters of Israel’s Desert Reconnaissance Battalion – also known as the “Bedouin Battalion” – Netanyahu said: “Our partnership is the future of all of us against these savages, simply savages. You are all imbued with the same goal – we are going to win.”

Netanyahu’s language about Hamas is part of Israel’s broader messaging that the country is battling a war of good vs. evil.

“There are no breaks here, there are no half things here. It’s not an ‘operation’, it’s not a ‘round,’” he said. “We will go until total victory here.”

Bedouins make up a small group within Israel’s Arab minority.

AMMAN, Jordan — Jordan’s Foreign Ministry says an evacuation is underway for 69 Jordanian citizens residing in Gaza who were allowed to leave through the Rafah crossing on Monday.

A team from the Jordanian Embassy in Egypt was at the crossing and was receiving the citizens, providing medical assistance and securing their return to Jordan as quickly as possible.

It said 640 Jordanians residing in Gaza are currently registered with the ministry.

CAIRO — The director of the U.N. agency for Palestinian refugees says all of the group’s aid operations in Gaza will cease in the next 48 hours unless fuel is allowed into the besieged enclave.

Thomas White, director of UNRWA in Gaza, made the comment on X, formerly known as Twitter.

While truckloads of medical and food supplies have been trickling into Gaza through the Rafah border crossing with Egypt, Israel has prohibited fuel from entering. It fears the fuel would be taken by Hamas and have accused the militant group of secretly stockpiling it.

UNRWA earlier said it had scaled back operations due to a lack of fuel.

BRUSSELS — The 27 European Union nations have jointly condemned Hamas for what they described as the use of hospitals and civilians as “human shields” in the war against Israel.

At the same time, EU foreign affairs chief Josep Borrell said Monday that the bloc asked Israel “for maximum restraint in targeting in order to avoid human casualties.”

At a meeting of the bloc’s foreign affairs ministers, Borrell brandished a statement he issued on behalf of the 27 nations as a show of unity following weeks of often contrasting statements on how the group should address the Israel-Hamas war.

Israel says Hamas shields itself among civilians in hospitals, and that Shifa Hospital is a prime example. Israel claims the militants have a command center inside and beneath the medical compound. It has not provided photos or videos to back up its claims although it has shared videos of militants operating in residential neighborhoods and positioning rockets and weapons near schools and mosques.

Hamas, which is considered a terrorist organization by the EU, accused Borrell of distorting facts. It described his comments as a “cover-up” for Israel to “to commit more crimes against children and defenseless civilians.”

BEIRUT — Lebanon’s state-run National News Agency says an Israeli airstrike on a Lebanese border village killed two people and wounded others who were inside a home that was extensively damaged.

NNA said the two dead and the wounded were taken by paramedics to a nearby hospital from their home on the edge of the border village of Ainata.

In the nearby village of Yaroun, a group of journalists were subjected to shelling while they were reporting on an Israeli air strike that hit a home.

A journalist for Al Jazeera TV was lightly wounded in the leg, and a vehicle for the Qatari-run satellite channel was damaged and left behind as the journalists left the area.

DEIR AL-BALAH, Gaza Strip — Municipal officials in Gaza say sewage is overflowing into the streets because of the lack of electricity, causing a health and environmental disaster.

“A complete halt of all sewage pumps, which led to the overflow of sewage in the streets and neighborhoods, is creating a health and environmental abomination and the spread of diseases,” said Ahmad al-Soufi, president of Rafah municipality.

“We are now witnessing a deterioration in the environmental situation resulting from the accumulation of waste in the streets, alleys and all neighborhoods and the spread of diseases and epidemics of all kinds.”

DEIR AL-BALAH, Gaza Strip — The director of hospitals in Gaza said Monday that 32 wounded people have died at Shifa hospital, the territory’s largest, including seven patients in the intensive care unit.

Mohammed Zaqout said 36 newborn babies have not been evacuated from the hospital yet and there has been no coordination on moving them. He said there is no place to take patients, and called for the opening of a “safe passage” to take them to Egypt for treatment.

Responding to Israeli statements that the hospital had rejected an offer of fuel, Zaqout said the Israeli military offered 300 liters (79 gallons) — “not enough to keep the hospital running for an hour.” He said the hospital needs 8,000 liters (2,110 gallons) of fuel a day.

Zaqout said Israel’s military shelled the oxygen department at Shifa and the hospital is now relying on its remaining oxygen bottles.

He said 10 hospitals remain in service in Gaza and they will not be able to continue operating if fuel is not brought in.

BEIRUT — The Israeli military carried out airstrikes on Monday along the border with Lebanon after the militant Hezbollah group fired anti-tank missiles toward Israeli troops near the tense border’s western sector.

Hezbollah said in a statement that it had inflicted injuries. The Israeli military did not immediately comment.

Clashes between Hezbollah and the Israeli military continue to intensify in the western and central areas along the tense border.

Hezbollah said it also conducted two other attacks on Monday — a rocket attack on the strategic Biranit barracks and an attack on a position targeting Israeli troops, both in the central sector along the border.

The clashes have remained largely contained since they began on Oct. 8, but the Lebanese government and the international community are attempting to keep them from spiraling into a wider war.

CAIRO — The U.N. agency for Palestinian refugees said Monday that Israel’s navy struck one of its facilities in southern Gaza, despite sharing coordinates with warring parties.

The agency, known as UNRWA, said Sunday’s strike caused “significant damage” to its guesthouse in Rafah, adding that no casualties were reported because U.N. staff left the facility 90 minutes before the attack.

There was no immediate comment from the Israeli military.

“This recent attack is yet another indication that nowhere in Gaza is safe. Not the north, not the middle areas and not the south,” said UNRWA Commissioner-General Philippe Lazzarini.

UNRWA says it shared the coordinates of the U.N. international staff guesthouse twice with the warring parties, including on Nov. 10.

BRUSSELS — Germany’s foreign minister is pushing anew for reliable “humanitarian pauses” in the war between Israel and Hamas, but is rejecting calls for a cease-fire that ends the fighting.

Germany has staunchly backed Israel since Hamas’ attack on Oct. 7 while also pushing for humanitarian aid for civilians in Gaza.

Arriving Monday at a meeting with European Union counterparts, Foreign Minister Annalena Baerbock said she understands “the impetus for a cease-fire,” but questioned how those who seek one can guarantee Israel’s security in “this terrible situation” and wondered about the fate of the people Hamas has taken hostage.

Baerbock defended the less far-reaching approach of humanitarian pauses, saying while it “breaks one’s heart, is from my point of view the only possible policy to really curb this suffering in this situation.”

CAIRO — Many displaced Palestinians, along with some medical patients, have left Gaza’s largest hospital, which is surrounded by Israeli forces, a U.N. health official said Monday.

About 650 patients, 500 healthcare workers and an estimated 2,500 displaced people remain in the sprawling Shifa hospital compound, said Mohammed Zaqout, director of hospitals in Gaza. This would signal a significant departure since the weekend when Gaza health officials said about 1,500 patients, along with 1,500 medical workers and 15,000 displaced people were at Shifa.

Israeli soldiers and Hamas militants have waged heavy battles outside Shifa, and some hospital officials have said Shifa was under siege, with those inside being pinned down by Israeli fire. Israel has said it had offered safe passage to those wanting to leave.

The situation at Shifa deteriorated over the weekend, with doctors reporting that the last generator had run out of fuel, leading to the deaths of several patients, including premature babies.

The U.N. official said Monday that many of the displaced fled the compound and that some families took relatives with moderate injuries with them. He said remaining patients require special procedures for evacuation including equipped ambulances to take them to Egyptian hospitals. The official spoke on condition of anonymity because he was not authorized to speak to journalists.

Another hospital in Gaza City, Al-Quds, was forced to shut down on Sunday because it ran out of fuel. The Palestinian Red Crescent, which operates the facility, said Israeli forces are stationed nearby and that preparations are being made to evacuate some 6,000 patients, medics and displaced people.

___

Associated Press writer Samy Magdy contributed.

JERUSALEM — The Israeli government has blocked the Hezbollah-affiliated, Beirut-based Al Mayadeen TV news channel from broadcasting in Israel.

“Broadcasts that identify with the enemy are harmful to the state’s security and should be blocked,” Communications Minister Shlomo Karhi wrote in a joint statement with Defense Minister Yoav Gallant.

Last month, the government approved emergency regulations allowing it to block the wartime operations of foreign channels it deems hostile to the state.

Karhi had also pressed to shut down the Israeli office of Qatar-based Al Jazeera, but Doha is leading efforts to release hostages captured from southern Israel during Hamas’ bloody Oct. 7 incursion, and the Israeli government hasn’t moved ahead on his plan.