Fighting, fuel shortages and Israeli raids have put the Gaza Strip's second-largest hospital completely out of service, local and UN health officials say.
The Nasser Hospital in the southern city of Khan Younis still sheltered scores of patients suffering from war wounds and Gaza's worsening health crisis, but there was no power and not enough staff to treat them all, health officials said.
"It's gone completely out of service," Gaza health ministry spokesperson Ashraf al-Qidra told Reuters on Sunday.
"There are only four medical teams - 25 staff - currently caring for patients inside the facility," he said.
Qidra said water supply to the hospital had halted because generators had been out of action for three days, sewage was flooding emergency rooms and the remaining staff had no way of treating intensive care patients.
Lack of oxygen supplies - also a result of having no power - had caused the deaths of at least seven patients, he said.
Gaza's hospitals have been a focal point of the four-month-old war between Israel and Palestinian militant group Hamas, which controls the besieged territory.
Most have been put out of action by fighting and lack of fuel, leaving a population of 2.3 million without proper healthcare while tens of thousands have been wounded by airstrikes and many others suffer from chronic illness and, increasingly, starvation.
Israel has raided medical facilities alleging that Hamas keeps weapons and hostages in hospitals. Hamas denies this. The international community says hospitals, which are protected under international law, must be protected.
The World Health Organisation (WHO) urged Israel to grant its staff access to the hospital, where it said a week-long siege and raids by Israeli forces searching for Hamas militants had stopped them from helping patients.
"Both yesterday and the day before, the @WHO team was not permitted to enter the hospital to assess the conditions of the patients and critical medical needs, despite reaching the hospital compound to deliver fuel," WHO head Tedros Adhanom Ghebreyesus said on social media platform X.
The Israeli military said its special forces were operating in and around Nasser Hospital, and had killed dozens of Palestinian militants and seized a large amount of weapons in fighting across Gaza over the past day.
"Dozens of terrorists were eliminated and large quantities of weapons were seized," it said in a statement.
The military said this week it was hunting for militants in Nasser and had arrested at least 100 suspects on the premises, killed gunmen near the hospital and found weapons inside it.
Hamas has denied allegations that its fighters use medical facilities for cover.
Israel's air and ground offensive has devastated much of Gaza and forced nearly all of its inhabitants from their homes. Palestinian health authorities say 28,985 people, mostly civilians, have been killed.
The war began when Hamas sent fighters into Israel on October 7, killing 1200 people, mostly civilians, and seizing 253 hostages, according to Israeli tallies.
More than half Gaza's population has been pushed into Rafah, the Gaza-Egypt border town which is the only crossing not controlled by Israel. Israeli plans to storm the city have prompted international concern.
Israeli planes carried out attacks on two areas in Rafah on Sunday, including an empty building near the border with Egypt, local residents and Hamas media officials said.
The second of the two strikes hit an open space where displaced people were sheltering, killing six people, local medics said.
Israel's Prime Minister Benjamin Netanyahu, embattled at home over the government's failure to stop the October 7 attack and under pressure to get the remaining hostages released, on Saturday pledged to push on with the military campaign.
