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    • In growing tide, civilians flee north Gaza or shelter at hospital as Israel, Hamas battle in city

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    DEIR AL-BALAH, Gaza Strip -

    Crowds of Palestinian families stretching as far as the eye could see walked out of Gaza City and surrounding areas toward the south Thursday to escape Israeli airstrikes and ground troops battling Hamas militants in dense urban neighborhoods. Others joined tens of thousands taking shelter at the city's biggest hospital, not far from the fighting.

    Gaza's largest city is the focus of Israel's campaign to crush Hamas following its deadly Oct. 7 incursion -- and the Israeli military says Hamas' main command centre is located in and under the Shifa Hospital complex. The militant group and hospital staff deny that claim, saying the military is creating a pretext to strike it.

    Growing numbers of people have been living in and around the hospital complex, hoping it will be safer than their homes or UN shelters in the north, several of which have been hit repeatedly. Israeli troops were around 3 kilometres from the hospital, according to its director.

    The accelerating exodus to the south came as Israel agreed to a four-hour humanitarian pause each day and to open a second route for people to flee the north, the White House said.

    Asked about the agreement in a Fox News interview that aired Thursday, Israeli Prime Minister Benjamin Netanyahu replied that "the fighting continues against the Hamas enemy, the Hamas terrorists, but in specific locations for a given period, a few hours here, a few hours there, we want to facilitate a safe passage of civilians away from the zone of fighting. And we're doing that."

    Meanwhile, Western and Arab officials gathered in Paris on Thursday to discuss ways of providing more aid to civilians in Gaza.

    Separately, mediators worked on a possible deal for a three-day cease-fire in exchange for the release of around a dozen hostages held by Hamas, according to two Egyptian officials, a United Nations official and a Western diplomat.

    BATTLES NEAR SHIFA HOSPITAL

    Israeli ground forces battled near Gaza's largest hospital, Shifa. Conditions for tens of thousands of people sheltering there have become "catastrophic," said Wafaa Abu Hajajj, a Palestinian journalist at the hospital.

    She, as well as several people who left the hospital to go south, said families are sleeping in hospital rooms, emergency rooms, surgical theaters and the maternity ward, or on the streets outside. Daily food distributions helped a tiny number for a time, but there has been no bread for the past four days, they said. Water is scarce and usually polluted, and few people can bathe.

    Still more families are arriving, believing it is safer than fleeing to the south, where airstrikes also continue -- though some have started to leave because of nearby missile strikes and the sound of clashes between Israeli forces and Hamas fighters, Abu Hajajj said.

    The hospital has been overwhelmed with daily waves of wounded from airstrikes, while medical supplies have been running low and electricity shut off in many wards. The UN delivered two truckloads of supplies Wednesday night, the second delivery since the war began -- enough to last a few hours, the director said.

    "The conditions here are disastrous in every sense of the word," the director Mohammed Abu Selmia told The Associated Press on Thursday. "We're short on medicine and equipment, and the doctors and nurses are exhausted. ...We're unable to do much for the patients."

    International journalists who entered the north on a tour led by the Israeli military on Wednesday saw heavily damaged buildings, fields of rubble and toppled trees along the Mediterranean shoreline.

    More than two-thirds of Gaza's population of 2.3 million have fled their homes since the war began, with hundreds of thousands heeding Israeli orders to flee to the southern part of the enclave.

    But the conditions there are also dire. Israel has continued to strike what it says are militant targets in the south, but often crushing homes with families inside.

    Aid deliveries into Gaza from Egypt have reached an average of 100 trucks a day, the U.S. humanitarian envoy for the war David Satterfield said Thursday. Relief workers say that is still far below what is needed.

    A QUICKENING EXODUS

    The exodus from Gaza City and surrounding areas in the north has picked up in recent days. The UN said 50,000 people fled south on Gaza's main highway Wednesday.

    Similar-sized crowds streamed out on Thursday, according to an Associated Press reporter on the scene as they arrived out of the northern zone. Shots rang out in the distance and smoke rose from blocks away as families made their way on foot with only what they could carry. Others rode on horse-drawn carts.

    "I'm carrying my house on my back," said Kamal Nsew, a 28-year-old, pointing to the possessions tied to his body. He had been walking three hours, he said. "We've been expelled, we've been put through a catastrophe. I don't know where my people are and don't know what is coming for us."

    His use of the Arabic word "nakba," -- which literally means "catastrophe" -- is a reference to the expulsion or flight of about 700,000 Palestinians from their homes in what is now Israel during the 1948 war around Israel's creation. More than half of Gaza's residents are refugees from that war, or their descendants.

    The Hamas-run Interior Ministry, which has urged Palestinians to stay in their homes, has told news outlets not to circulate footage of people fleeing.

    A month of relentless bombardment in Gaza since the Hamas attack has killed more than 10,800 Palestinians -- nearly two-thirds of them women and minors, according to the Health Ministry in the Hamas-run territory. More than 2,300 others are believed to have been buried by strikes that in some cases have demolished entire city blocks.

    Israeli officials say thousands of Palestinian militants have been killed, and blame civilian deaths on Hamas, accusing it of operating in residential areas and using Palestinian civilians as human shields. Hamas has denied this. Gaza's Health Ministry does not distinguish between civilians and combatants in its casualty reports.

    More than 1,400 people have died in Israel since the start of the war, most of them civilians killed by Hamas militants during their initial incursion. Israel says 32 of its soldiers have been killed in Gaza since the ground offensive began.

    Palestinian militants have continued to fire rockets into Israel, and some 250,000 Israelis have been forced to evacuate from communities near Gaza and along the northern border with Lebanon, where Israeli forces and Hezbollah militants have traded fire repeatedly.

    A drone exploded in the yard of a house in Israel's Red Sea city of Eilat, causing no injuries, and a long-range surface-to-surface missile -- whose source was under investigation -- was intercepted before entering Israeli airspace, the military said. Yemen's Houthi rebels said they fired a batch of missiles at Israel on Thursday, including toward Eilat -- at least the fifth time the Iranian-backed force has tried to strike Israel.

    In the occupied West Bank, Israeli forces carried out its most intense raid in decades, storming the city of Jenin before dawn, sparking battles with Palestinian fighters that lasted into the afternoon and included an Israeli drone strike. At least 13 Palestinians were killed in the fighting, the Palestinian Health Ministry said, and Hamas acknowledged nine of them as its fighters. The Israeli military put the number of militants killed at 10.

    ------

    Associated Press writers Najib Jobain in Khan Younis; Amy Teibel and Isabel DeBre in Jerusalem; Samy Magdy in Cairo; Kareem Chehayeb in Beirut; and Matthew Lee in Washington contributed to this report. Mroue reported from Beirut and Jeffery from Cairo.

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