Meanwhile, Israeli forces continued an offensive in the northern Gaza Strip, where the military has said it is battling Hamas fighters who regrouped there.

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Shell fire hit Kamal Adwan Hospital in northern Gaza, injuring patients, including children, the hospital’s director, Hossam Abu Safiya, said in a statement to the media. He said the shells hit the hospital’s nursery, dormitory and water tanks, just after a delegation from the World Health Organisation had ended a visit.

Kamal Adwan and two other nearby hospitals have been hit by Israel several times amid the fighting. Earlier this month, Israeli troops stormed Kamal Adwan, detaining several people, including much of the staff, Abu Safiya said at the time. The military said those detained included members of Hamas, without providing evidence, and said weapons were found in the facility.

“Attacks on civilians, including humanitarian workers, and what remains of Gaza’s civilian facilities and infrastructure must stop. The entire Palestinian population in North Gaza, especially children, is at imminent risk of dying from disease, famine and the ongoing bombardments,” UNICEF executive director Catherine Russell said in a statement.

In southern Gaza, an Israeli strike hit a group of people gathered outside in an eastern district of Khan Younis, killing at least eight Palestinians, including four children and a woman, said the territory’s Health Ministry emergency services. The city’s Nasser Hospital, which received most of the bodies, confirmed the figures.

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Palestinian officials said an Israeli drone strike on Saturday hit a clinic in northern Gaza where children were being vaccinated for polio, wounding six people, including four children. The Israeli military denied responsibility.

Dr Munir al-Boursh, director general of the Gaza Health Ministry, said a quadcopter struck the Sheikh Radwan clinic in Gaza City early on Saturday afternoon, local time, just a few minutes after a United Nations delegation left the facility.

The WHO and the UN children’s agency, known as UNICEF, which are jointly carrying out the polio vaccination campaign, expressed concern at the reported strike. Rosalia Bollen, a spokesperson for UNICEF, said the strike occurred when a “humanitarian pause” agreed to by Israel to allow vaccinations was in effect.

Lieutenant Colonel Nadav Shoshani, an Israeli military spokesman, said: “Contrary to the claims, an initial review determined that the [Israeli military] did not strike in the area at the specified time.”

It was not possible to resolve the conflicting accounts. Israeli forces have repeatedly raided hospitals in Gaza over the course of the war, saying Hamas uses them for militant purposes, allegations denied by Palestinian health officials. Hamas fighters are also operating in the north, battling Israeli forces.

Northern Gaza has been encircled by Israeli forces and largely isolated for the past year. Israel has been carrying out another offensive there in recent weeks that has killed hundreds of people and displaced tens of thousands.

A scaled-down campaign to administer a second dose of the polio vaccine began on Saturday in parts of northern Gaza. It had been postponed from October 23 due to a lack of access, Israeli bombings and mass evacuation orders, and the lack of assurances for humanitarian pauses, a UN statement said.

Administration of the first dose was carried out in September across the Gaza Strip, including the north.

At least 100,000 people have been forced to evacuate from areas of north Gaza towards Gaza City in the past few weeks, but about 15,000 children under the age of 10 remain in northern towns, including Jabalia, Beit Lahiya and Beit Hanoun, which are inaccessible, the UN said.

The final phase of the polio vaccination campaign had aimed to reach 119,000 children in the north, with a second dose of the oral polio vaccine, the agencies said, but “achieving this target is now unlikely due to access constraints”.

They say 90 per cent of children in every community must be vaccinated to prevent the spread of the disease.

The campaign was launched after the first polio case was reported in Gaza in 25 years – a 10-month-old boy, now paralysed in the leg. The World Health Organisation said the presence of a paralysis case indicates there could be hundreds more who have been infected but aren’t showing symptoms.

The Israel-Hamas war began on October 7, 2023, when Hamas-led militants stormed into southern Israel, killing some 1200 people, mostly civilians, and abducting another 250. Israel’s subsequent offensive has killed more than 43,000 Palestinians, according to Gaza health authorities, who do not say how many were combatants but say more than half were women and children.