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GAZA CITY — Gaza’s largest hospital has been gutted. Combat bulldozers have moved sand into the courtyards. The buildings are scorched. It smells like death. Israeli commandos pulled out before dawn on Monday.

A sprawling medical campus that housed maternity wards, surgery suites and emergency rooms has been mostly destroyed after two weeks of <a href="https://www.washingtonpost.com/world/2024/03/18/israel-hamas-gaza-shifa-issa/" target=_blank>intense assault</a> by Israeli troops battling Hamas militants who Israel said were barricading themselves inside the complex.

Spokesmen for the Israel Defense Forces brought a handful of foreign journalists into the compound Sunday afternoon, just hours before the last special forces troops withdrew. A reporter and photographer from The Washington Post were there.

The IDF offered a narrow view — a pinhole, really — but what we saw was destruction on a massive scale. Military censors did not review our words or photos.

Lorenzo Tugnoli

It is hard to overstate the importance of <a href="https://www.washingtonpost.com/world/2023/12/21/al-shifa-hospital-gaza-hamas-israel/" target=_blank>al-Shifa</a>, where the dueling narratives of this war have converged.

The hospital has served as a beacon of refuge and resilience for Palestinians. The Israelis described it as a mustering point and command center for terrorists who used the doctors and patients as human shields.

The staff who have toiled at al-Shifa said they just wanted to care for the sick and wounded. “We are doctors: Our job is to treat people. We have nothing to do with this,” said Amr Fawzi Jedbah, a 31-year-old vascular surgeon, who spoke to The Post in the early days of the raid.

As we emerged from the windowless armored personnel carriers that brought us to the site, the first view was sand, and, for a moment, there was silence. Gaza City, more rubble now than city, was quiet.

The compound smelled of bodies. And rot. Everything that could be broken, smashed or twisted, was, after 14 days of fighting. Dozens of fighters had been killed, the IDF said, but said it could not provide a precise count. Some desperately ill patients had been evacuated; others, aid groups said, died during the siege.

Before this <a href="https://www.washingtonpost.com/world/2024/03/22/shifa-hospital-israel-gaza/" target=_blank>second offensive</a> against al-Shifa, the hospital was still functioning, if just barely, after a <a href="https://www.washingtonpost.com/world/2023/11/19/israel-gaza-war-shifa-hospital/" target=_blank>first raid</a> by Israel soldiers in November. When the March assault began two weeks ago, there were 6,000 people sheltering on the grounds, according to the IDF — patients, medical staff and displaced families.

On Sunday, we didn’t see a single Palestinian.

In the central quad, there were new sand dunes shaped by bulldozers. Israeli armor and personnel carriers encircled the complex; troops moved quickly from spot to spot.

We were told that Palestinian snipers remained in the area and that a handful of Hamas operatives might still be moving around the hospital buildings, based on night-vision sweeps of the compound.

We saw only Israeli soldiers. In one darkened room, a platoon of commandos slept on the floor beside hallways strewn with trash.

There were sporadic bursts of automatic rifle fire in the distance and what we guessed were heavier rounds being fired. It was unclear who was shooting, or at what.

The Israeli special forces described close-quarter combat with desperate fighters from Hamas who had been taken by surprise and barricaded themselves in emptied hospital wards, including elevator shafts and operating rooms.

The Israelis said two Palestinian militants, in confrontations, used grenades to kill themselves, in what would be the first reported suicide bombings of this latest <a href="https://www.washingtonpost.com/israel-hamas-war/" target="_blank" class="contextual_link">Gaza war</a>. This could not be confirmed.

We were hustled into a mid-rise medical office building seized by Israeli Navy SEALs, our masked escorts who guided us to the top floors to see the destruction below.

All of the main structures of al-Shifa were blasted and blackened, walls missing, shards of cement flooring pulling against twisted rebar.

These buildings were not pancaked by big bombs, but targeted by Israel’s air force strikes, artillery fire and small arms. The building that housed the Israeli commandos was also pocked by bullet holes and shattered glass.

What the Israeli military described at the outset as a “precise operation” looked more like all-out urban warfare.

We were not given access to the last 140 Palestinians — staff and patients — who the IDF said were sheltering in a nearby building, waiting to be evacuated. The rest of the civilians had already been sent to other medical facilities, the military said, or were told to head south.

“There was no medical care or drinking water or food” for the first three days of the raid, according to Mohamed al-Sikafi, 18, who texted with The Post last Tuesday after making it out of al-Shifa to a nearby hospital, one of the few still functioning in the north. “There are many patients whose health conditions declined.”

Tedros Adhanom Ghebreyesus, the director general of the World Health Organization, <a href="https://twitter.com/DrTedros/status/1774541424391848057" target=_blank>wrote</a> on X late Sunday that 21 patients had died at al-Shifa “since the hospital came under siege.” The IDF said no medical staff or patients died as a “direct result” of the Israeli raid, adding that some may have died of “natural causes.”

Reporters were led to an unlit room for a briefing by a top officer in the navy special operations unit called Flotilla 13, one the most secretive in the Israeli forces, famous since the founding of the Jewish state.

Col. “E” — we were not allowed to name him or photograph his face — described his mission: Kill or capture Hamas fighters and spare the innocents.

The colonel said that after the Israeli forces left the hospital after the first raid in November, Hamas fighters streamed back into the complex to take up arms, seek shelter and mix with civilians.

“They go where they know,” the colonel said, suggesting that in bombed-out Gaza City, the al-Shifa complex offered shelter, food, water, electricity and internet service.

Earlier in the war, the IDF made much of the tunnels it found on the hospital grounds. The IDF described a vast underground command and control center, a virtual city. But definitive evidence was <a href="https://www.washingtonpost.com/world/2023/12/21/al-shifa-hospital-gaza-hamas-israel/" target=_blank>lacking</a>. There were clearly tunnels. But where was Hamas?

As it turns out, the Israeli commando colonel stressed that the tunnel system may not have been as important as the IDF once thought. Instead, the colonel said, the Hamas operatives in recent months were working above ground, inside offices and wards. The IDF showed pictures of what it said were cash, rifles, RPGs, grenades, mortars and some Hamas documents found on-site.

Basem Naim, a Hamas official, denied Sunday that militants were using the hospital as a staging ground, telling The Post it was “propaganda to justify the attack on our people.”

“Even if some Hamas members were present in the hospital as refugees,” he continued, “does this justify destroying hospitals?”

Medical staff stated repeatedly that the complex was not used for military purposes. <a href="https://www.washingtonpost.com/world/2023/12/15/gaza-ghassan-abu-sitta-recollections/" target=_blank>Ghassan Abu Sitta</a>, a British Palestinian doctor who spent several weeks tending to the wounded at al-Shifa late last year, said Monday that his friend and colleague Ahmad Maqadmeh, “a beautiful soul and a great surgeon,” was among the dead.

“He refused to leave the north and kept sending me photos of his surgeries,” Abu Sitta <a href="https://www.instagram.com/p/C5N25bXsgdT/?igsh=MTRycG9wZXllMWpseQ%3D%3D" target=_blank>wrote</a> on Instagram. “He leaves behind a wife and baby.”

The Israeli colonel — and the IDF spokesman — both repeated that the al-Shifa offensive represented “a success and a tragedy.”

“It is a success that we struck Hamas so hard, that this was a brutal hit against them, that Hamas now tell us that they are ‘out of business’ in the north,” IDF spokesman Daniel Hagari said. But he said it was a tragedy that Israeli soldiers were “forced” to destroy the hospital buildings.

“We had no choice but to fight back,” said the navy special forces commander.

As the journalists looked out at the destruction, one of Hagari’s officers said, “This is what they made us do.”

Since the beginning of the raid, the IDF said it has detained 900 suspected Hamas fighters and that 540 have been sent to Israel.

How many Palestinian fighters were killed here over two weeks of fighting? The IDF did not provide an exact figure. Hagari said “about 40” were killed inside the hospital compound. The commando leader said “a few dozens.” Another 150 suspected militants were killed in the surrounding area, the military said.

No death toll has been provided yet by Palestinian authorities, who gained access to the site again on Monday as the Israelis withdrew. Mahmoud Bassal, spokesman for Gaza’s Civil Defense, said emergency workers entered the compound at dawn.

“The scene here is one of the ugliest we have seen since October 7,” he said. “The hospital has become completely unfit to be a medical center. The situation is tragic in every sense of the word.”

During the offensive, the IDF said it killed Faiq al-Mabhouh, whom Israel called a commander in the Hamas internal security forces. Hamas said he was a police commander charged with coordinating and protecting aid deliveries.

“They consider that everyone who works with the government in Gaza is a Hamas activist and can be killed or arrested, even doctors, nurses, journalists and civilian police,” said Naim, the Hamas official.

The IDF said it also “eliminated” a senior Hamas official named Ra’ad Tabath, whom it described as a leader of the group’s supply lines.

IDF officers have described the raid at al-Shifa as a <a href="https://www.washingtonpost.com/world/2024/03/27/israel-gaza-hamas-war-fighting/" target=_blank>model</a> for future action in Gaza: intense but focused strikes by commandos. One question, though, is why such a large and destructive operation was required.

The military claimed in late December that it was close to establishing “full operational control” of northern Gaza. More recently, it <a href="https://www.washingtonpost.com/world/2024/01/23/israel-military-gaza-strategy-hamas/" target=_blank>said</a> it had “dismantled” Hamas’s battalions in the north. It was only natural, the special forces commander said, that Hamas fighters would regroup around al-Shifa.

Now, he said, there was no hospital left for them to return to.

The journalists piled back in armored personnel carriers for the trip back to Israel. We stopped, without warning, along the way. The soldiers told us they had come across a family of four Palestinians: a mother and father and two children. We could not see them.

The soldiers said the family were in an area where they were not allowed to be. They were offered water and a chocolate bar and then detained, we were told; the father would be closely questioned. Hagari, the military spokesman, told us it was the best course of action.

Had the family proceeded in a no-go zone, he said, the IDF soldiers “could have shot them.”

<i>Miriam Berger in Jerusalem, Hajar Harb in London and Hazem Balousha in Amman, Jordan, contributed to this report.</i>

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William Booth is The Washington Post’s London bureau chief. He was previously bureau chief in Jerusalem, Mexico City, Los Angeles and Miami.

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Inside the ruins of Gaza’s al-Shifa Hospital 

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Inside Gaza’s al-shifa hospital on an embed with Israeli forces

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A photo of two IDF soldiers standing in a destroyed hallway of a hospital with the headline: Inside the ruins of Gaza's al-Shifa Hospital

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Inside the ruins of Gaza's al-Shifa Hospital

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