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DUBAI and GAZA CITY, Gaza Strip — For two weeks beginning in March, Israeli commandos besieged what was once the Gaza Strip's biggest and most advanced medical complex, Al-Shifa.

Israel's military said the target was militants who'd regrouped there, using its premises for shelter and internet access. It said Hamas hid behind the sick and injured, and insisted no civilians were killed in the raid. Israeli statements described it as a precise operation — a model for future military action in Gaza.

Early on Monday, April 1, Israeli troops withdrew under the cover of darkness, ending the siege. That's when Palestinians caught the first glimpses of its aftermath.

Photos and survivors' testimony gathered by NPR in Gaza City reveal a battle that destroyed nearly every corner of Al-Shifa, as well as the neighborhoods and homes around it — now heaps of twisted metal, debris and ashes from fires that were set alight.

Bodies lay decomposing in the hospital's dirt courtyard, which was laden with unexploded ordnance. Other people were shot and left to die in its hallways, maimed and crushed by tanks outside its gates, decomposing on side streets and in buildings.

As yet, there's no clear death toll and no clarity on how many of those killed may be civilians or suspected fighters.

One woman's screams pierced through the courtyard as bodies were freshly uncovered on Monday.

"It's enough, already! Enough, oh God!" she wailed.

Dead bodies outside Al-Shifa Hospital in Gaza City on April 1, 2024.

Caption

Dead bodies outside Al-Shifa Hospital in Gaza City on April 1, 2024. / Omar El Qattaa for NPR

Before and after satellite images by Maxar Technologies show the devastation at Al-Shifa and the streets around it from the war.

Israeli hails the operation as a model

Israel says the operation targeted Hamas, the group that launched a deadly attack on Israel on Oct. 7, sparking the war. The Associated Press reports Hamas had released videos of militants preparing shells that it said were directed toward Israeli forces in the hospital compound.

On two separate visits to Al-Shifa during the raid, Israel's military chief of staff, Lt. Gen. Herzi Halevi, praised the troops and the operation, saying part of its aim was to put pressure on negotiations with Hamas for a temporary ceasefire.

Israel said its forces uncovered many weapons inside the hospital during the raid, and killed and arrested hundreds of militants.

"We went in there with a surgical force, special operations and we took out over 200 terrorists. We apprehended over 900 terrorists with not a single civilian casualty," Israeli government spokesman Avi Hyman said.

Al-Shifa Hospital in Gaza City on Nov. 26, 2023, and on Monday, April 1, 2024.

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Al-Shifa Hospital in Gaza City on Nov. 26, 2023, and on Monday, April 1, 2024. / Omar El Qattaa/AFP via Getty Images; Omar El Qattaa for NPR

He added that the raid will be studied at top military academies like West Point in the U.S. and Sandhurst in the U.K. as the "gold standard for urban warfare."

Palestinians challenge the Israeli narrative of events

The acting chairman of Al-Shifa Hospital, Dr. Marwan Abu Saada, said three of his colleagues were killed during the siege, though he didn't provide details on the circumstances.

Speaking to reporters outside the destroyed medical complex in the hospital courtyard alongside other Palestinian doctors in white coats, hours after Israeli troops had ended their siege, Abu Saada said those killed included the chief engineer of the maintenance department, the head of pharmaceuticals and a reconstructive surgeon killed with his mother.

He and other hospital staff buried them all on Monday, he said.

He also named seven doctors detained by Israeli forces during the raid or still held from a previous raid in November, among them several intensive care doctors and general surgeons.

The World Health Organization says 21 patients died in the hospital during Israel's recent 14-day siege, and that more than 100 patients were trapped without enough food or water in squalid conditions. Severely injured children endured the raid alone, without their parents or caretakers, according to the WHO.

Emaciated-looking patients were carried out on stretchers after the raid ended and transported to other smaller, partially functioning hospitals in northern Gaza.

Emad Jibreel, one of the patients besieged inside Al-Shifa, told NPR they were forced to move to different rooms in the hospital by Israeli forces, and kept in rooms with no windows or ventilation at times.

"I spent about eight days without changing the dressing on my leg," Jibreel said. "It became infected twice. And the doctors and nurses couldn't care for us because they said they didn't have gloves or gauze."

Destruction all around Al-Shifa as people mourn lives and homes lost

The raid not only focused on the hospital, but also its surrounding streets, where fierce battles took place. Photos taken by NPR show entire buildings turned to rubble.

In the early hours of March 18, as Israeli forces swept into Al-Shifa with heavy gunfire and tanks, residents nearby said other Israeli troops went pounding door to door, throwing stun grenades into homes as they rounded up people for interrogation.

Nariman Qanita tells NPR she was startled awake by the sound of heavy gunfire and shelling a few hours after evening Ramadan prayers had ended. She said Israeli forces entered the her apartment building as if they were battling militants, not entering the homes of families with children.

"When they raided and came into the building, there were kids sleeping in their room — kids 12 and 13 years old. They cried out, baba, baba (Daddy, Daddy)," she said. "We saw one bleeding out, wounded in his organs, not from bullets. He had a hole no smaller than 20 centimeters [8 inches] in him."

It's unclear how the boy was wounded. Israeli forces used stun grenades when pounding down doors, and employed artillery, airstrikes and heavy gunfire throughout their operation, according to residents.

She said the boy bled for hours until Israeli forces allowed him out of the building, but not, she says, before the boy's mother had to watch him bleeding heavily for some time. Qanita doesn't know if he survived.

Hours later, Israeli troops ordered the women and children to follow a strict evacuation route. They weren't allowed to take anything with them, not their phones or IDs, she said. The men were stripped down to their underwear.

Other Palestinians told NPR similar stories. Qanita returned home when the siege ended. It was turned to rubble.

"There are no suitable homes to live in. Where do we go, people?" she said. "While you're preparing your Eid clothes and Eid cookies, we're preparing shrouds and how to retrieve the dead from under our homes. It's enough already," she said, describing the festive Muslim holiday after Ramadan that's nearing.

The damaged area around the Al-Shifa Hospital in Gaza City on April 1, 2024.

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The damaged area around the Al-Shifa Hospital in Gaza City on April 1, 2024. / Omar El Qattaa for NPR

Journalist Bayan Abusultan lives near Al-Shifa Hospital. She posted a reel on Instagram showing some of the moments she survived during the raid, including prayers over the body of her brother and another person wrapped in white shrouds. She doesn't say how he died, just that he was killed by Israeli forces.

In another scene, she shows people she describes as her neighbors wounded and bleeding with nowhere to go for treatment. She also shows a fire in an apartment in the building next to hers. Numerous homes in western Gaza City burned during the raid.

NPR could not immediately reach Abusultan for more details on what she lived through and the circumstances of her brother's death.

Complete collapse of Gaza's biggest hospital

This raid was the second major assault on Al-Shifa since the start of the war nearly six months ago, and proved to be its most decisive.

"The Al-Shifa Medical Complex is out of service forever," Abu Saada, its acting chairman, told reporters.

He said the hospital once had capacity for almost 800 beds. More than a quarter-million people were rushed through its emergency rooms a year. The hospital used to perform more than 17,000 surgeries annually.

It was a beacon in Gaza, he said, a place where bright medical students would train, where visiting doctors would perform surgery and assist in past conflicts and where journalists would flock to report on the casualties and human toll of wars with Israel.

The hospital cannot receive patients anymore, said Abu Saada. There's nowhere to perform surgeries, lab tests or dialysis, he said, because everything was destroyed or burned down. He called for the establishment of an immediate field hospital in Gaza City.

Out of 36 hospitals across the Gaza Strip, only about a dozen are partially functioning due to the war and Israeli raids. Those hospitals lack enough supplies like basic anesthesia, bed space and equipment.

The World Health Organization this week said its multiple requests to Israeli authorities to facilitate a visit to Al-Shifa to speak with staff and see what can be saved in the wake of the raid have so far been denied or impeded.

Omar El Qattaa reported from Gaza City. Aya Batrawy reported from Dubai. Anas Baba contributed to this story from Rafah, Gaza Strip.