Israel’s military chief spokesman was in full combat gear as he gave his daily war update from a new location deep within Gaza City’s Rantisi Children’s Hospital on Monday night.

Pointing to suicide-bomb vests, grenades and anti-tank missiles, Rear Admiral Daniel Hagari alleged that hostages taken by Hamas on Oct. 7 were likely held in the basement there. He showed viewers a wall calendar that — he said — appeared to lay out a guard schedule starting on that date.

A captured house 200 meters away had previously been occupied by the head of Hamas’s naval operations, Hagari said, with a tunnel built between the dwelling and the hospital.

“The world has to understand who Israel is fighting against,” he said.

The briefing was part of Israel’s efforts to persuade the world that attacking Gaza’s major hospitals is not, as many charge, to target vulnerable civilians, but to get at Hamas military infrastructure located beneath them. The tactic has come to represent the latest phase of Israel’s five-week campaign on the enclave, which has so far killed more than 11,000 people, according to authorities in Hamas-run Gaza, and displaced many thousands more.

Hamas is designated a terrorist organization by the US and European Union. The deathtoll figures haven’t been independently verified.

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The view prevalent outside Israel is that medical facilities should be out of bounds. “International humanitarian law does require the protection of hospitals, of patients and of medical staff,” said Australian Foreign Minister Penny Wong — encapsulating a broader consensus. And US President Joe Biden called on Israel Monday to take “less intrusive action” at Al-Shifa hospital — Gaza’s largest — as diplomatic pressure intensified.

Desperate Work

Gaza’s hospitals are still in operation, with surgeons desperately trying to save limbs from injured children and treat massive burns caused by Israeli bombing raids. They also serve as shelters for those driven by war from their homes, turning them into makeshift refugee camps.

Israel has left Gaza hospitals mostly alone in previous campaigns, but this time the goal is more ambitious — to destroy Hamas following the Oct. 7 attack that killed 1,200 people and took 240 hostages. The dilemma is that if the army moves troops into hospitals, many more civilians will suffer and fierce condemnation will follow. If it doesn’t, it won’t be able to show how Hamas hides under the facilities.

“We don’t want to see hospitals the subject of crossfire,” US State Department spokesman Matthew Miller said at his own Monday briefing. “We want to see the civilians who are sheltering in hospitals, including babies, protected. At the same time, I would say Hamas continues to use hospitals as locations for its command posts. So this is a very difficult issue.”

It hasn’t been easy for Israel to prove its point. Even Hagari’s demonstration was short of conclusive. There were weapons and some evidence of people having hidden in the basement, but that’s not the same as a command-and-control center — which would make the hospital a vital military target.

‘Not Enough’

“The fact that the military spokesman stands somewhere and says I am in an underground facility of the hospital is not enough,” Dr. Guy Shalev, Executive Director of Physicians for Human Rights Israel, said by phone. “We need to verify that. And even if their assessment is correct, on the basis of international humanitarian law and basic morality, patients and civilians can’t be targeted.”

The situation at Al-Shifa is particularly dire and Israel says it needs to be empty for Hamas to be exposed.

“There are 36 premature babies in need of urgent care — three have already died due to a lack of provisions at the hospital,” Shalev said. “Surgery is taking place without anesthesia and clean tools, and surgeons are sometimes using their mobile-phone lights to see patients being operated on at night due to power shortages.”

About 100 dead bodies are decomposing in the courtyard of the hospital with 70 more inside, while 650 patients are in need of life-saving care, according to Shalev.

Lack of Power

The United Nations’ Office for the Coordination of Humanitarian Affairs said Monday that all but one of the hospitals in northern Gaza are out of service due to lack of power, medical consumables, oxygen, food and water, compounded by bombardments and fighting.

Israeli authorities have called for the evacuation of all hospitals in the north. The World Health Organization has said this would be a “death sentence,” given the entire medical system is collapsing and hospitals in southern Gaza cannot admit more patients.

Al-Shifa may prove the deciding factor, as Israel says that’s where Hamas has its central command headquarters and where it stores arms and ammunition. But some fear the militants may already have left and that when Israeli troops show up, they won’t find the kind of evidence needed to persuade the world of the value of the takeover.

So far, they’re still waiting at the hospital’s outskirts.