Israeli forces and Palestinian fighters battled in close combat around Gaza’s Al Shifa Hospital on Thursday, where the armed wings of Hamas and Islamic Jihad said they attacked Israeli soldiers and tanks with rockets and mortar fire.

The Israeli army said it continued to operate around the hospital complex in Gaza City after storming it more than a week ago. Its forces had killed around 200 gunmen since the start of the operation “while preventing harm to civilians, patients, medical teams, and medical equipment”, it said.

Gaza’s health ministry said wounded people and patients were being held inside an administration building in Al Shifa that was not equipped to provide them with healthcare. Five patients had died since the Israeli raid began due to shortages of food, water and medical care, the Hamas-run ministry said.

Al Shifa, the Gaza Strip’s biggest hospital before the war, had been one of the few healthcare facilities even partially operational in north Gaza before the latest fighting. It had also been housing displaced civilians.

Unverified footage on social media showed its surgery unit blackened by flames and nearby apartments on fire or destroyed.

The armed wings of the Hamas and Islamic Jihad militant groups said in a statement they “bombed, with a barrage of mortar shells, gatherings of Israeli soldiers in the vicinity of the Al Shifa Complex” in a joint operation.

Islamic Jihad targeted an Israeli tank with an anti-tank rocket outside the hospital, it said in another statement. The Israeli military said militants fired at its troops from inside and outside the ER building.

Israel says it is targeting Hamas militants who use civilian buildings, including apartment blocks and hospitals, for cover. Hamas denies doing so.

At least 32,552 Palestinians have been killed and 74,980 wounded in Israel’s military offensive in the Gaza Strip since October 7, the territory’s health ministry said on Thursday. Thousands more dead are believed to be buried under rubble and over 80 per cent of Gaza’s 2.3 million population is displaced.

Israeli forces continued to blockade Al-Amal and Nasser hospitals in Khan Younis, while several other areas in the southern Gaza city came under Israeli fire, residents said. The Palestinian Red Crescent said seven people working for the organisation arrested in a raid on Al-Amal hospital on February 9 had been released.