Israeli strikes pounded Gaza City overnight into Thursday as ground forces battled Hamas militants in dense urban neighbourhoods from which tens of thousands have fled in recent days.

Israeli troops were around 3km from Shifa Hospital in the heart of downtown, the hospital’s director said. Israel has been vague on troop movements, but officials say Gaza’s largest city is the focus of their campaign to crush Hamas following its deadly October 7 assault inside Israel.

Israeli ground forces battled near Gaza’s largest hospital, Shifa, where tens of thousands are sheltering alongside patients, according to the hospital’s general director, Mohammed Abu Selmia.

The Israeli military says Hamas’s main command centre is located in and under the hospital complex and that senior leaders are hiding there, using the facility as a shield. Hamas and hospital staff deny the claims and say the military is creating a pretext to strike it.

Scores of wounded people were rushed to Shifa overnight, Abu Selmia told The Associated Press on Thursday. “At dawn, a shell landed very close to the hospital, but thank God only a few people had minor injuries,” he said.

“The conditions here are disastrous in every sense of the word,” he said. “We’re short on medicine and equipment, and the doctors and nurses are exhausted.… We’re unable to do much for the patients.”