Israel faced growing calls Saturday to protect civilians in Gaza as its battle with Hamas encircled the territory's main hospital, where an aid agency described the situation as "catastrophic".
Heavy fighting between Hamas and Israeli forces has raged near Gaza's biggest hospital, Al-Shifa, an AFP correspondent at the scene said, stretching the area's already crippled health system.
The Hamas government and the hospital's director said a strike on the key health facility on Friday killed 13 people. They accused Israel of being responsible -- a claim that was impossible to verify.
"We call on all international and Arab parties to immediately intervene to stop the targeting of hospitals in Gaza," said a spokesman for the Hamas-run Gaza health ministry, Ahsraf Al-Qudra.
Aid agency Doctors Without Borders said it was was "extremely concerned" about the safety of patients and medical staff at Al-Shifa hospital.
"Over the last few hours, the attacks against Al-Shifa Hospital have dramatically intensified," it said in a statement posted online on Saturday morning.
"Our staff at the hospital have reported a catastrophic situation inside just few hours ago."
Maher Sharif, a nurse heading to the Al-Shifa hospital when it was struck on Friday, described how people threw themselves to the ground.
"I saw dead bodies, including women and children," she said, according to a statement by Doctors Without Borders.
"The scene was horrific."
Gaza resident Hanane told AFP his daughter was being treated at Al-Shifa after being wounded as she queued outside a bakery. She "starts shaking" with each explosion, he said.
Israel has denied targeting hospitals and its army has accused Hamas of using the medical facilities as command centres and hideouts, a charge the Palestinian militant group denies.
- 'Babies killed' -
French President Emmanuel Macron said Israel had the right to defend itself, after Hamas fighters smashed through the border on October 7, killing 1,200 people and taking 239 people hostage, according to updated Israeli figures.
But Macron told the BBC that civilians were dying as a result of Israel's air and expanding ground campaign.
"These babies, these ladies, these old people are bombed and killed," the French leader said. "So there is no reason for that and no legitimacy. So we do urge Israel to stop," he added.
The Gaza health ministry says Israeli fighting has killed more than 11,000 people, mostly civilians and many of them children, figures that cannot be independently verified.
US Secretary of State Antony Blinken also expressed concern over the civilian toll.
"Far too many Palestinians have been killed," he said during a visit to New Delhi on Friday.
Blinken repeated his support for Israel and welcomed "progress" after the country formally agreed to four-hour pauses in its campaign in parts of Gaza where tens of thousands have fled in search of safety.
"I was also very clear that much more needs to be done in terms of protecting civilians and getting humanitarian assistance to them," Blinken said.
Israeli Prime Minister Benjamin Netanyahu said in response to Macron's comments that Hamas, not Israel, was to blame for the civilian deaths.
Netanyahu repeated that Israel was trying to avoid harming civilians but that Hamas was preventing them from moving to safe areas and using them as "human shields" -- a charge Hamas denies.
Israel's defence force said it had killed about 150 "terrorists" and gained control over Hamas strongholds in northern Gaza.
- 'On its knees' -
Palestinians reported strikes or sniper fire at two hospitals and a school in Gaza on Friday.
The bodies of 50 people killed in a strike on Gaza City's Al-Buraq school were taken to the Al-Shifa hospital, its director said. The toll at the school could not be independently verified.
Fighting has reduced some streets in the city to ruins, AFP correspondents there said, describing the sound of heavy gunfire, explosions and the buzz of Israeli military drones as night fell.
After five weeks of conflict, the Gazan health system was "on its knees", the head of the World Health Organization, Tedros Adhanom Ghebreyesus, told the UN Security Council.
The International Committee of the Red Cross echied his comments: "Overstretched, running on thin supplies and increasingly unsafe, the healthcare system in Gaza has reached a point of no return."
In Israel, medical services reported two women were wounded in rocket attacks in Tel Aviv.
Hamas's military wing said it had targeted the Israeli commercial hub.
- War expansion risk -
Tens of thousands of people have fled to the south of the territory in recent days, often on foot and taking only the things they could carry.
Almost 1.6 million people have been internally displaced since October 7, the UN agency for Palestinian refugees (UNRWA) said -- nearly two thirds of Gaza's population.
But the UN estimates tens of thousands of civilians remain in the fiercest battle zones in the north.
Complicating Israel's military push is the fate of the hostages abducted on October 7.
Four hostages have been freed so far by Hamas and another rescued in an Israeli operation. The desperate relatives of those still held in Gaza have piled pressure on Israeli and US authorities to secure the release of their loved ones.
The conflict has also stoked regional tensions, with cross-border exchanges between the Israeli army and Lebanon's Hezbollah.
Yemen's Iran-backed Huthi rebels say they have launched "ballistic missiles" at southern Israel.
Iran's Foreign Minister Hossein Amir-Abdollahian said the expansion of the Israel-Hamas war had become "inevitable".
Iran, which supports Hamas financially and militarily, has hailed the militant group's attack on Israel as a "success" but denied any involvement.
Saudi Arabia is hosting Arab leaders and Iran's president for a summit this weekend in emergency meetings of the Arab League and the Organisation of Islamic Cooperation.
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