Health officials said they had refused orders by the Israeli army, which started a new incursion into the territory’s north more than two weeks ago, to evacuate the three hospitals in the area or leave the patients unattended.

Later, Hussam Abu Safiya, director of Kamal Adwan Hospital said at least two critically wounded patients at the facility’s intensive care unit died because of the lack of medical supplies.

“The hospital’s blood units have run out completely... We are implementing a priority treatment method for patients. This is the reality,” said Abu Safiya in a video message to media outlets.

Troops remained outside the hospital but did not enter, they said. Medics at a second hospital, Kamal Adwan, reported heavy Israeli fire near the hospital at night.

“The army is burning the schools next to the hospital, and no one can enter or leave the hospital,” said one nurse at the Indonesian Hospital, who asked not to be named.

The Israeli statement said Israel was in contact with the international community and Gaza’s healthcare system to ensure hospital emergency services were operating, it said.

Last week, the United States told Israel it must take steps in the next month to improve the humanitarian situation in Gaza or face potential restrictions on US military aid.

Israel has intensified its campaigns both in Gaza and Lebanon after the killing of Hamas leader Yahya Sinwar last week had raised hopes of an opening for ceasefire talks to end more than a year of conflict.

It has vowed to eradicate Hamas, the group that formerly controlled Gaza and whose attack on Israel last year triggered the war, but in doing so has laid waste to much of the territory and killed some 42,500 people. Another 10,000 uncounted dead are thought to lie under the rubble, Gaza health authorities say. More than 1.9 million people have been left destitute and desperate for food.

“We are facing death by bombs, by thirst and hunger,” said Raed, a resident of Jabalia camp. “Jabalia is being wiped out and there is no witness to the crime, the world is blinding its eyes.”

Forced to live in toilets

Hadeel Obeid, a supervisor nurse at the Indonesian hospital, said they were running out of medical supplies, including sterile gauze and medications. The water supply has been cut off and there was no food for the fourth consecutive day, she said.

The United Nations said it had been unable to reach the three hospitals in northern Gaza.

The UN Human Rights Office accused Israeli forces of unlawful interference with humanitarian assistance and issuing orders that were causing forced displacement. It said their conduct “may be causing the destruction of the Palestinian population in Gaza’s northernmost governate through death and displacement”.

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UNRWA’S Lazzarini said injured people were lying without care in hospitals that had been hit.

“UNRWA remaining shelters are so overcrowded, some displaced people are now forced to live in the toilets,” he said.

Israel says it is getting large quantities of humanitarian supplies into Gaza with land deliveries and airdrops. It also says it has facilitated the evacuation of patients from the Kamal Adwan Hospital.

Palestinians say no aid entered northern Gaza areas where the operation is active.

Reuters reported earlier this month that food supplies have fallen sharply since Israeli authorities introduced a new customs rule on some humanitarian aid and are separately scaling down deliveries organised by businesses.

Residents and medics said Israeli forces had tightened their siege on Jabalia by positioning tanks in nearby Beit Hanoun and Beit Lahiya towns and ordering residents to leave.

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Hamas accused Israel of carrying out acts of “genocide and ethnic cleansing” to force people to leave northern Gaza. Israel also faces charges of violations of the 1948 Genocide Convention at the International Court of Justice.

The Hamas armed wing said fighters attacked forces there with anti-tank rockets and mortar fire, and detonated bombs against troops inside tanks and stationed in houses.

Elsewhere in the enclave, Israeli strikes killed at least five people in Rafah in the southern Gaza Strip and four in two separate strikes in Gaza City, medics said.

US Secretary of State Antony Blinken is en route to the Middle East to try to bring about a ceasefire between Israel and Hamas amid signs of Washington’s limited influence over Israeli policy.

The trip - Blinken’s 11th to the region since the Hamas attack on Israel is almost certainly the final one before the US election, and it is a sign of the Biden administration’s waning power.

The slain Sinwar was one of the alleged masterminds of the October 7, 2023, cross-border attack on Israeli communities that killed around 1200 people, with about 253 more taken back to Gaza as hostages, according to Israeli tallies.