The Israeli military says it stormed Al-Shifa Hospital in Gaza City in search of high-ranking Hamas leaders. The army said on Monday that the soldiers would carry out a “precise” mission. They were shot at and they returned fire. “The operation is based on information indicating use of the hospital by senior Hamas terrorists,” the army said in its justification.

Eyewitnesses on site told the AFP news agency that Israel had carried out airstrikes in the al-Rimal district, where the hospital is located. Dozens of tanks were positioned around the hospital building.

Al-Shifa Hospital is the largest hospital in the Gaza Strip. The Israeli army entered the hospital grounds for the first time in November. The military operation in the clinic sparked international criticism. Israel had accused Hamas of operating a command center beneath the hospital. Israel has long accused Hamas of using hospitals as shelters. The Islamist group denies this.

The Israeli military said troops had been instructed to act cautiously during the operation. Accordingly, injuries to patients, civilians and medical staff should be avoided. Patients are not obliged to vacate the complex.

The authorities in Gaza, on the other hand, report chaotic conditions. The health authority said there was a fire at the entrance to the complex. Refugee women and children suffocated because of the smoke. People are trapped in operating rooms and the emergency room. Communication with the hospital was lost. "There are casualties, including dead and injured, and it is impossible to save anyone because the fire is so intense," the agency said in a statement. Anyone who comes near the windows will be targeted.

The radical Islamic group Hamas said the Israeli military had shelled the hospital building without caring for patients, medical staff or refugees seeking protection there. According to the health authority in the Gaza Strip, a fire has broken out.

During the "precise" operation, terrorists opened fire on the Israeli soldiers from the hospital, the Israeli army justified itself. The troops returned fire and “found hits”. The operation of the army and air force on the site of the largest hospital in the sealed-off coastal area in the city of Gaza continues, and terrorists are being arrested, it said.

Intelligence information revealed that the hospital was being used by senior members of Hamas to carry out terrorist activities. It is known that the Islamists have regrouped there to command attacks against Israel, said army spokesman Daniel Hagari. There is no obligation for patients and medical staff to leave the hospital. But opportunities have been created for them.