The Israeli operation in northern Gaza left dozens of people dead and threatened to shut down three hospitals over a year into the war with Hamas, Palestinian officials and residents said.

The continuing cycle of destruction and death in Gaza, unleashed by Hamas’ October 7, 2023, attack on southern Israel, comes as Israel expands a weeklong ground offensive against Hezbollah in Lebanon and considers a major retaliatory strike on Iran following Iran’s October 1 missile barrage.

Our strike will be lethal, precise and above all, surprising. They won’t understand what happened and how. They will see the results, Defence Minister Yoav Gallant said during a speech to troops. Whoever strikes us will be harmed and pay a price.

Iran fired dozens of missiles at Israel on October 1 which the United States helped fend off. Biden has said he would not support a retaliatory strike on sites related to Tehran’s nuclear programme.

On Wednesday, Hezbollah claimed a rocket attack that killed two people in the northern Israeli town of Kiryat Shmona. The town’s acting mayor, Ofir Yehezkeli, said the two killed were a couple walking their dogs.

Dozens killed in Gaza and survivors fear displacement

In northern Gaza, there was heavy fighting in Jabaliya, an urban refugee camp dating back to the 1948 war surrounding Israel’s creation, where Israeli forces have carried out several major operations over the course of the war and then returned as militants regroup.

The entire north, including Gaza City, has suffered heavy destruction and has been largely isolated by Israeli forces since late last year.

In Gaza, Jabaliya residents said thousands of people have been trapped in their homes since the operation began Sunday, as Israeli jets and drones buzz overhead and troops battle militants in the streets.

It’s like hell. We can’t get out, said Mohamed Awda, who lives with his parents and six siblings. He said there were three bodies in the street outside his home that could not be retrieved because of the fighting.

The quadcopters are everywhere, and they fire at anyone. You can’t even open the window, he told The Associated Press by phone, speaking over the sound of explosions.

Gaza’s Health Ministry said it recovered 40 bodies from Jabaliya from Sunday until Tuesday, and another 14 from communities farther north. There are likely more bodies under rubble and in areas that can’t be accessed, it said.

Jabaliya residents fear Israel aims to depopulate the north and turn it into a closed military zone or a Jewish settlement. Israel has blocked all roads except for the main highway leading south from Jabaliya, according to residents.

We are concerned about the displacement to the south, Ahmed Qamar, who lives in Jabaliya with his wife, children and parents, said in a text message. “People here say clearly that they will die here in northern Gaza and won’t go to southern Gaza.

Hospitals are under threat

Fadel Naeem, the director of Al-Ahly Hospital in Gaza City, said it had received dozens of wounded people and bodies from the north. We declared a state of emergency, suspended scheduled surgeries, and discharged patients whose conditions are stable,” he told AP in a text message.

Israel’s offensive has gutted Gaza’s health sector, forcing most hospitals to shut down and leaving the rest only partially functioning.

Naeem said three hospitals farther north Kamal Adwan, Awda and the Indonesian Hospital — have become almost inaccessible because of the fighting. The Gaza Health Ministry says the Israeli army has ordered all three to evacuate staff and patients. Meanwhile, no humanitarian aid has entered the north since October 1, according to UN data.

Israel’s authority coordinating humanitarian affairs in Palestinian territories said Israel has not halted the entry or coordination of humanitarian aid entering from its territory into the northern Gaza Strip.

Israel says it only targets militants and blames civilian deaths on Hamas because it fights in residential areas.

Israel ordered the wholesale evacuation of northern Gaza, including Gaza City, in the opening weeks of the war, but hundreds of thousands of people are believed to have remained there. Israel reiterated those instructions over the weekend, telling people to flee south to a humanitarian zone where hundreds of thousands are already crammed into squalid tent camps.

The war began just over a year ago, when Hamas-led militants stormed into southern Israel, killing some 1,200 people, mostly civilians, and abducting around 250. They still hold around 100 hostages, a third of whom are believed to be dead.

Israel’s offensive has killed over 42,000 Palestinians, according to the Gaza Health Ministry, which does not say how many were fighters. It has said women and children make up over half of the dead. The offensive has also caused staggering destruction across the territory and displaced around 90% of the population of 2.3 million people, often multiple times.

Israeli Prime Minister Benjamin Netanyahu has vowed to keep fighting until total victory over Hamas and the return of all hostages.

Israel warns Lebanon it could end up like Gaza

On Tuesday, Netanyahu said Lebanon would meet the same fate as Gaza if its people did not rise up against Hezbollah.

Video verified by The Associated Press shows what appears to be a group of Israeli soldiers raising an Israeli flag in a village in southern Lebanon.

In the video, which appears to have been filmed in Maroun A-Ras, three soldiers are seen hoisting up a flag atop a pile of debris. A soldier off camera speaks in Hebrew and refers to the nearby Israeli village of Avivim. The date it was filmed wasn’t immediately known.

The video follows other similar acts that took place throughout Israel’s ground offensive in Gaza. The Israeli military had no immediate comment.

An Israeli strike killed four people and wounded another 10 at a hotel sheltering displaced people in the southern Lebanese town of Wardaniyeh on Wednesday, Lebanon’s Health Ministry said.

An Associated Press reporter in a nearby town heard two sonic booms from Israeli jets before the strike. Plumes of smoke rose from the building after the explosion.

In recent weeks Israel has waged a heavy air campaign across large parts of Lebanon, targeting what it says are Hezbollah rocket launchers and other militant sites. A series of strikes had killed Hezbollah leader Hassan Nasrallah and most of his top commanders.

The Israeli military said on Wednesday that Hezbollah has fired more than 12,000 rockets, missiles and drones at Israel in the past year.