Israeli forces fighting to seize the southern Gaza Strip’s main city pounded areas near the biggest hospital still functioning in the enclave on Thursday, sending patients and residents fleeing a battle they feared would lay the city to waste.

The heaviest battle of the year so far was under way in Khan Younis, a city that is sheltering hundreds of thousands of people who fled the north earlier in the war, now in its fourth month.

The charity Medecins Sans Frontieres, which has doctors at the city’s Nasser Hospital, said patients and displaced people sheltering there were fleeing in panic.

In Rafah, further south, 16 bodies were laid out on the bloodstained cobbles outside a morgue, most in white shrouds, a few in plastic body bags: a branch of the Zameli family wiped out in a strike that destroyed their home overnight.

Half the bundles were tiny, holding the bodies of small children. Authorities said 17 people were killed in total.

A grey-haired man howled in sorrow as he clung to one of the bodies, burying his face in the face of the shrouded corpse. A woman in a pink headscarf keened and stroked one of the shrouds.

At the scene of the bombing, the home had been completely obliterated. A girl’s tattered princess schoolbag lay in the rubble. Tears rolled down the cheeks of 10-year-old cousin Mahmoud al-Zameli, who lived next door and had escaped.

“Yesterday, I was playing with the children over there. They have all died,” he sobbed.

“I’m the only one still alive.”

More than three months into a war that has killed more than 24,000 Palestinians and laid much of the Gaza Strip to waste, Israel has said it is planning to wind down its ground operations and shift to smaller-scale tactics.

But before doing so, it appears determined to capture all of Khan Younis, which Israel says is a main base for the Hamas fighters who stormed through the border fence on October 7, killing 1,200 people and seizing 240 hostages.

Khan Younis residents said on Thursday the fighting had come closer than ever to Nasser Hospital, the biggest hospital still working in the enclave, raising fears it would fall under siege and be shut like Shifa, the main hospital in the north, captured by Israeli forces in November.

“What is happening in Khan Younis now is complete madness: the occupation bombards the city in all directions, from the air and the ground too,” said Abu El-Abed, 45, displaced several times with his family of seven since leaving Gaza City in the north earlier in the war.