November 18, 2023 Israel-Hamas war

Our live coverage of the Israel-Hamas war has moved here.

CNN spoke to some of the hundreds of Palestinians fleeing northern Gaza for the south on Saturday. 

Crowds of people — women, children, the elderly and wounded — made their way down Salah al-Din street, carrying bags, food and water. Most were on foot. A few moved by donkey and cart.

Some said their journey would be more than 5 kilometers (3.1 miles) long.

Israeli tanks could be seen at the side of the road and at times the sound of gunfire sent people running, with parents separated from their children amid the chaos.

At one point, the evacuees put cardboard over blankets that appeared to cover bodies on the street.

Among the evacuees were those who had sought refuge at Al-Shifa hospital, including Gaza health ministry spokesperson Ashraf Al-Qidra and journalist Ibrahim Shaqoura.

“The Israeli soldiers bombed the intensive care unit at Al-Shifa hospital, and they threatened us to bomb the lower floor, so we decided to leave,” Shaqoura told CNN.

“The hospital is not a hospital anymore. It is a military station. There were not people attacking them from there.”

A woman who was carrying her child recalled the moment when the school they were sheltering in, in Jabalya, collapsed.

“Three [other] girls and three women also lost their lives. I managed to pull this child out from under the rubble. All my children are barefoot. I grabbed them and we just ran away."

Um Muhammad Hamada, a mother from Sheikh Radwan, sat by the roadside with her three children and two bird cages.

The crack of gunfire made her flinch and her daughter cover her ears.

"These birds mean a lot to me. They are like spirits that God saved, just like we were saved," she said.

"I couldn't leave them behind."

A group of United Nations humanitarian workers visited the Al-Shifa hospital in northern Gaza on Saturday, the World Health Organisation (WHO) said in a post on X.

The group spent one hour inside the hospital during which time there was heavy fighting in close proximity to the facility, the WHO said.

UN staff described the hospital as a “death zone” where “signs of shelling and gunfire” were evident.

"The team saw a mass grave at the entrance of the hospital and was told more than 80 people were buried there," it said.

The WHO said that several patients had died over the past two to three days due to the lack of medical services.

"There are 25 health workers and 291 patients remaining in Al-Shifa, with several patient deaths having occurred over the previous two to three days due to the shutting down of medical services," it said.

It added: "Patients include 32 babies in extremely critical condition, two people in intensive care without ventilation, and 22 dialysis patients whose access to life-saving treatment has been severely compromised."

Staff and patients who spoke to UN workers were “terrified for their safety and health," WHO said, adding that they "pleaded for evacuation."

The WHO says it is “urgently developing plans” to evacuate staff and patients to two hospitals in southern Gaza.

"The vast majority of patients are victims of war trauma, including many with complex fractures and amputations, head injuries, burns, chest and abdominal trauma, and 29 patients with serious spinal injuries who are unable to move without medical assistance," WHO said.

Some context: Israel launched a “targeted” operation against Hamas early Wednesday morning inside Gaza’s largest hospital, where thousands of displaced Palestinians had been sheltering alongside patients and medical staff.

Israel claims Hamas is using the hospital complex for military purposes and has built a command center under the facility – allegations repeatedly rejected by both Hamas and hospital officials. CNN has not verified the claims of either Israel or Hamas.

The intervening days have seen the hospital turn from civilian sanctuary to battlefield with heavy fighting taking place in and around the complex, amid an already rapidly deteriorating humanitarian situation.

Israel is facing mounting international pressure to prove its claims about Hamas’ infiltration of the hospital, in order to justify some of its military decisions, which could otherwise constitute a possible serious violation of international humanitarian law.

Many women and children were among those killed when a blast rocked a United Nations school in northern Gaza on Saturday, a UN relief agency confirmed. Video from the scene shows bloodied bodies in a series of rooms on two floors of the building, which had been used as a shelter for displaced Palestinians.

Saturday’s incident was the second time in 24 hours that a school run by the UN Relief and Works Agency for Palestine Refugees had been hit, the agency said. It did not have any further details about what caused the explosion or who was responsible.

Here are other headlines you should know:

• No deal on hostages: Israeli Prime Minister Benjamin Netanyahu says there is still no deal to release some of the hostages captured by Hamas during the militant group's October 7 attacks. Netanyahu denied what he called false reports that Israel was considering a proposal for the release of at least 50 abductees. The Israel Defense Forces said Friday that the military’s official estimate of hostages being held in Gaza is 237. 
• Biden rejects ceasefire: US President Joe Biden has rejected the mounting calls for a ceasefire in Gaza, saying in an op-ed published Saturday that it would not achieve peace, because it would allow Hamas to regroup and continue its attacks. Biden called for Israel to respect humanitarian law and minimize the loss of civilian life. The US leader also used the piece to condemn extremist violence against Palestinians in the West Bank — which has been a concern among officials — saying the US is prepared to issue visa bans against the perpetrators.
• Fuel in, evacuees out of Gaza: Six hundred seventy-four foreign nationals and nine injured Palestinians, along with 11 companions, have left Gaza for Egypt through the Rafah crossing Saturday, according to a statement by the Rafah crossing administration. Meanwhile, 50 trucks made their way into Gaza, including fuel trucks delivering 127,000 liters of fuel designated for UN relief workers, the statement added. The delivery is part of a new Israeli commitment to daily fuel shipments for Gaza, which has proven controversial domestically.
• Al-Shifa evacuations: Several doctors from Al-Shifa told Al Jazeera on Saturday morning they had left the hospital after the Israel Defense Forces ordered them to evacuate – a claim the IDF denies. Dr. Munir Al-Bursh said the hospital director had received the order over a phone call, when he was told to evacuate the entire hospital and instruct those leaving to wave white flags or handkerchiefs. Six doctors will stay behind to take care of 120 patients who cannot move due to poor health conditions, the head of plastic surgery, Ahmed El Mokhallalati, wrote on X (formerly Twitter) Saturday. Meanwhile, the UN has called for access to the hospital so it can investigate Israel's claims that Hamas is using the medical center for combat purposes. Hamas and Gaza medical officials deny that claim.

Israeli Prime Minister Benjamin Netanyahu said the Palestinian Authority is “not competent” in its current form to lead Gaza at a news conference Saturday.

Netanyahu accused Palestinian Authority President Mahmoud Abbas of not condemning Hamas’ October 7 attack on Israel and said some of Abbas’ senior ministers celebrated the attack.

“After fighting and pulling this whole thing, we’d give it to them?” Netanyahu said.

"You know full well how they educate their children," he added. "If this doesn’t change, what have we done?"

The prime minister's comments come after US President Joe Biden said in an op-ed published Saturday that Gaza and the West Bank should ultimately be reunited under “a revitalized” Palestinian Authority after the Israel-Hamas war.

Remember: The Palestinian Authority is a government body with limited self-rule in the West Bank. It is a political rival to Hamas, which controls Gaza and is at war with Israel.

The Palestinian Authority was established in the 1993 Oslo Accords, a peace pact between Israel and the Palestine Liberation Organization that saw the PLO give up armed resistance against Israel in return for promises of an independent Palestinian state.

Hamas — which is designated as a terrorist organization by the US, European Union and other countries — presents itself as an alternative to the Palestinian Authority, which has recognized Israel and has engaged in multiple failed peace initiatives with it.

CNN's Abbas Al Lawati and Nadeen Ebrahim contributed reporting to this post.

The United Nations confirmed one of its schools in northern Gaza, which was being used as a shelter, was hit on Saturday.

Video from the scene shows bloodied bodies in a series of rooms on two floors of the two-story building. Many women and children are among the dead. 

One room appears to contain about a dozen bodies lying on the floor covered in dust. Desks are strewn and smashed up, and a huge hole can be seen in one of the room’s walls. In the courtyard of the building, a canopy roof across a metal structure appears to have been torn off, and there is debris on the ground as well.

A spokesperson for the main UN relief agency in Gaza, which runs the schools in Palestinian refugee camps, confirmed the building as the al-Fakhoura School in Jabalya.

The spokesperson, Juliette Touma, said the relief agency – the UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) – was not able to confirm the number of casualties as information was still coming in.

UNRWA chief Philippe Lazzarini, who called the images “horrifying” on X, formerly known as Twitter, said that thousands of displaced people had been sheltering there at the time of the incident. 

Touma said the UN did not know what caused the incident, nor who was responsible. 

The Israeli military told CNN it was aware of the incident and that it was under review but had no further comment to make.

Egypt and Qatar have already blamed Israel. The Egyptian foreign ministry called it a “bombing,” and said it was the latest in a series of Israeli violations against civilians in Gaza.

Qatar said independent investigators from the UN needed to go to Gaza to examine what it said was the “ongoing targeting of schools and hospitals.” The UN has already called for independent access to Al-Shifa Hospital in Gaza City.

Another school hit: Saturday’s incident was the second time in 24 hours an UNRWA school in northern Gaza had been hit, the agency said.

A school in Zaitoun — which was being used by 4,000 people as a shelter — had been struck multiple times on Friday, Touma told CNN. She said ambulances had reportedly been unable to get to the school, which she said was most likely due to the fighting and the communications blackout.

Lazzarini posted that dozens of people were believed to have been killed in the Friday incident.

“These attacks cannot become commonplace, they must stop. A humanitarian ceasefire cannot wait any longer,” he said. 

US President Joe Biden has rejected the mounting calls for a ceasefire in Gaza, saying in an op-ed published Saturday that it would not achieve peace.

“As long as Hamas clings to its ideology of destruction, a cease-fire is not peace. To Hamas’s members, every cease-fire is time they exploit to rebuild their stockpile of rockets, reposition fighters and restart the killing by attacking innocents again,” he wrote in the piece for the Washington Post. “Our goal should not be simply to stop the war for today — it should be to end the war forever, break the cycle of unceasing violence, and build something stronger in Gaza and across the Middle East so that history does not keep repeating itself.”

Biden also called for Israel to respect humanitarian law and minimize the loss of civilian life, saying he counseled Israeli officials during his trip to Tel Aviv “against letting their hurt and rage mislead them into making mistakes we ourselves have made in the past.”

Biden said a two-state solution is the only solution to the enduring conflict in the region, and that, in the meantime, there should be governance under the Palestinian Authority.

“As we strive for peace, Gaza and the West Bank should be reunited under a single governance structure, ultimately under a revitalized Palestinian Authority, as we all work toward a two-state solution," he wrote.

Eyes on the West Bank: Biden also took aim at extremist violence against Palestinians in the West Bank — which has been a concern among officials — saying the US is prepared to issue visa bans against the perpetrators.

"I have been emphatic with Israel’s leaders that extremist violence against Palestinians in the West Bank must stop and that those committing the violence must be held accountable," the president wrote.

The warning came amid concerns over Israel violating the Visa Waiver Program — which allows eligible travelers to apply to enter the US without a visa, and went into effect in late October.

“I won't get into full details of our private diplomatic conversations, but we expect Israel to address those concerns,” State Department spokesperson Matt Miller said this week.

More background: Biden's op-ed is the latest example of efforts from the White House to remind Americans that conflicts abroad also affect US national security, as the administration’s supplemental funding request remains stalled.

Last month, the Biden administration requested more than $105 billion from Congress as part of a package it said will provide security assistance for the conflicts in Ukraine and Israel. At the time, Biden made his own impassioned plea for the funding in a primetime Oval Office address to the nation, calling the moment “an inflection point” in American history.

The president closed with condemning the rising antisemitism and Islamophobia since the conflict between Israel and Hamas began.

Israeli Prime Minister Benjamin Netanyahu says there is still no deal to release some of the hostages captured by Hamas during the militant group's October 7 attacks.

Netanyahu denied what he called false reports that Israel was considering a proposal for the release of at least 50 abductees. When the government has something to say, authorities will report it, he said.

The Israel Defense Forces said Friday that the military’s official estimate of hostages being held in Gaza is 237. 

Netanyahu said he has invited the representatives of the hostages’ families to a meeting with Israel’s war cabinet later this week.

On fuel tankers: The prime minister also defended the war cabinet’s decision to allow two fuel tankers to enter Gaza daily after several Israeli officials criticized the move.

He said the tankers will supply a minimal emergency amount of fuel to operate water and sewage pumps in Gaza. He also denied that the move was a change of policy, saying instead that it was a specific and limited solution to prevent diseases.

Six hundred seventy-four foreign nationals and nine injured Palestinians, along with 11 companions, have left Gaza for Egypt through the Rafah crossing Saturday, according to a statement by the Rafah crossing administration.

In addition, 50 trucks made their way into Gaza, including fuel trucks delivering 127,000 liters of fuel designated for the United Nations Relief and Works Agency for Palestine Refugees in the Near East, the statement added. 

Remember: Rafah is the only crossing in and out of Gaza that is not controlled by Israel, making it the sole option for foreigners trying to leave the besieged enclave.

Waves of foreign nationals have begun to escape the war-torn territory, alongside a limited number of wounded Palestinians, after spending weeks stuck in Gaza.