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Israeli soldiers raided Shifa Hospital in Gaza early Wednesday, looking for Hamas militants after giving Health Ministry officials a few minutes' warning.
"Based on intelligence information and an operational necessity, IDF forces are carrying out a precise and targeted operation against Hamas in a specified area in the Shifa hospital," the Israel Defense Forces said in a statement. It urged all Hamas fighters to surrender.
The IDF said its forces consisted of "medical teams and Arabic speakers, who have undergone specified training to prepare for this complex and sensitive environment, with the intent that no harm is caused to the civilians."
The military also said it has delivered incubators, baby food and medical supplies to the embattled hospital.
After searching the medical complex, Israel said it found weapons, intelligence material and communications gear belonging to Hamas. The Hamas-run Health Ministry said the Israeli military did not find any weapons.
Israeli Prime Minister Benjamin Netanyahu said in a statement, "There is no place in Gaza that we cannot reach. There are no hideouts. There is no shelter or refuge for the Hamas murderers."
"We will reach and eliminate Hamas, and we will bring back our hostages," the Israeli leader said. "These are two sacred missions."
Munir al-Boursh, a senior official with Gaza's Health Ministry, said Israeli forces ransacked the basement and other buildings at Shifa, including those housing the emergency and surgery departments.
"They are still here," he said by phone from inside the hospital, hours after the raid began. "Patients, women and children are terrified."
It was not possible to independently assess the situation inside.
Earlier, the United States backed up Israel's claims that Hamas - a U.S.-designated terror group - is using hospitals as cover for its fighters. Israel says Shifa specifically had a command center underneath it.
Israel has not provided photos or videos to back up its claims about Hamas militants at Shifa, although it has shared footage of militants operating in residential neighborhoods and positioning rockets and weapons near schools and mosques.
Hamas and the hospital deny the allegations.
The militant group said in a statement that the administration of U.S. President Joe Biden essentially gave the IDF a "green light" to carry out the raid and said Biden would be "fully responsible" for the operation's results.
The White House rejected Hamas' claim. National Security Council spokesman John Kirby told reporters, "We did not give an OK to their military operations around the hospital."
Hamas said about 650 patients and 5,000 to 7,000 Palestinian civilians have taken shelter on the hospital grounds.
After the hospital raid, Biden spoke with Netanyahu about the latest developments in the war. The White House said they discussed at length ongoing efforts to secure the release of hostages, including nine Americans and a foreign national with U.S. employment rights.
Biden said Tuesday he believes hostages being held by Hamas militants in Gaza are going to be released but gave no timetable. He sent a message to the estimated 240 hostages being held: "Hang in there. We are coming."
Calls for cease-fire
World Health Organization head Tedros Adhanom Ghebreyesus said the Israeli raid on the Shifa Hospital was "totally unacceptable."
"Hospitals are not battlegrounds," he said Wednesday.
United Nations humanitarian chief Martin Griffiths issued a statement saying, "As the carnage in Gaza reaches new levels of horror every day, the world continues to watch in shock as hospitals come under fire, premature babies die, and an entire population is deprived of the basic means of survival. This cannot be allowed to continue."
He urged the warring parties to "respect international humanitarian law, agree to a humanitarian cease-fire and stop the fighting."
Hospital must be protected
On Tuesday, Biden said hospitals in Gaza "must be protected" as Israeli forces continue to target health care facilities in the Palestinian enclave over claims Hamas is using them as cover to hide its command centers and weaponry.
Kirby told reporters that Hamas and Palestinian Islamic Jihad militants operated a command-and-control node from Shifa and use tunnels underneath to support their military operations and hold hostages. He said the militants have stored weapons there and were prepared to respond to an Israeli military operation against that facility.
"Now to be clear, we're not supporting striking a hospital from the air, and we do not want to see a firefight in the hospital where innocent people, helpless people, sick people are simply trying to get the medical care that they deserve, not to be caught in a crossfire," Kirby said, adding that Hamas' actions "do not lessen Israel's responsibilities to protect civilians in Gaza."
Death toll
Palestinian authorities in Gaza say more than 11,000 people - about 40% of them children - have been killed since Israel launched a major air and ground offensive in response to the October 7 attack by Hamas militants on southern Israel that killed 1,200 people. About 240 people were kidnapped and are currently being held hostage by Hamas in Gaza.
The United Nations humanitarian office said Tuesday that more than two-thirds of Gaza's population of 2.3 million have fled their homes since the war began.
The Israeli military said it has seized several government facilities in Gaza City, including the territory's legislature building, the Hamas police headquarters and a compound housing Hamas' military intelligence headquarters.
"In every location, the enemy forces were eliminated, the location was demolished," an Israeli commander said.
As its military incursion advances, Israel has rejected growing and intense international pressure to impose a cease-fire to allow for the delivery of critically needed humanitarian aid to Gaza. It has, however, agreed to four-hour daily humanitarian pauses to allow the opening of two corridors to let Palestinians evacuate northern Gaza.
The NSC's Kirby said Tuesday that in the past 24 hours, around 115 more trucks carrying humanitarian aid were able to enter Gaza, bringing the total to 1,100.
United Nations correspondent Margaret Besheer and White House bureau chief Patsy Widakuswara contributed to this report. Some information for this article came from The Associated Press, Reuters and Agence France-Presse.