Israeli air strikes on a hospital compound in the Gaza Strip killed at least 200 people, officials in the Hamas-run Palestinian territory said on Tuesday, on the eve of US President Joe Biden's visit to the Middle East. Reuters quoted unnamed health officials as saying the toll was at least 500.

Biden's visit, potentially the riskiest of his presidency, is expected to see him reaffirm US backing for Israel and try to stop the escalating war against Hamas spiralling into wider conflict.

Thousands of people have been killed since the militants' October 7 attack, with most of the dead on both sides civilians.

The health ministry on Tuesday said between 200 and 300 people displaced by 10 days of heavy bombardment were killed in "occupation (Israeli) strikes" at the Ahli Arab hospital in cental Gaza.

"Hundreds of victims are still under the rubble," a statement said, calling it a "war crime".

The World Health Organization (WHO) condemned the attack.

"This attack is unprecedented in scale," said Richard Peeperkorn, WHO Representative for the West Bank and Gaza. "We have seen consistent attacks on healthcare in the occupied Palestinian territory."

Peeperkorn said there so far have been 51 attacks against healthcare facilities in Gaza, with 15 health workers killed and 27 injured.

The Israeli military blamed on a failed rocket launch by a Palestinian militant group.

Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean, said there were patients, healthcare workers and internally displaced people in the hospital when it was struck.

"The hospital was one of 20 in the north of the Gaza Strip facing evacuation orders from the Israeli military," he said.

"The order for evacuation has been impossible to carry out given the current insecurity, critical condition of many patients, and lack of ambulances, staff, health system bed capacity, and alternative shelter for those displaced," he added.

Mike Ryan, executive director of WHO's Health Emergencies Programme, said it was "inhumane" to leave Gaza's health workers with the dilemma of caring for their patients or fleeing to save their own lives. He said doctors and nurses were choosing their patients over themselves.

Separately, the United Nations agency supporting Palestinian refugees said six people were killed when one of its schools sheltering displaced families was hit, during Israeli air strikes.

UNRWA commissioner-general Philippe Lazzarini called the bombing at Al-Maghazi refugee camp, also in central Gaza, "outrageous" and warned the death toll would likely rise.

"It again shows a flagrant disregard for the lives of civilians. No place is safe in Gaza anymore, not even UNRWA facilities," he added.

Biden's trip will come 12 days after the Palestinian militants of Hamas burst through Israel's heavily fortified Gaza border, shooting, mutilating and burning more than 1,400 people.

Shell-shocked Israel has responded with withering air strikes against targets in Gaza, leaving about 3,000 Gazans dead, according to a toll from the health ministry in Gaza before the Ahli Arab strike.

Israel has also imposed a crippling siege on the impoverished territory and deployed tens of thousands of troops in preparation for a full-scale ground offensive.

Israel has vowed to destroy Hamas while also seeking to rescue the at least 199 hostages taken into Gaza by Hamas, which has released a video of one of the captives, French-Israeli woman Mia Shem.

Her mother, Keren Shem, made an emotional plea for her safe return, at a Tel Aviv press conference.

"I ask world leaders that my daughter be returned to us in the state that she is today, as well as the other hostages," she said.

"I am begging the world to bring my baby back home."

Diplomatic bids to free the hostages have gathered pace. Turkey said it was in talks with Hamas to secure their release.

But there were mixed views about how effective Biden could be, with some Palestinians blaming the United States for backing Israel, and even Israelis sceptical.

"We don't believe anymore in politicians," said Omer Nevo, 23. "I don't trust anyone anymore after what has happened here."

Army spokesman Jonathan Conricus said on Tuesday that Israeli forces "will commence the enhanced military activities when the timing suits the goal".

The army later announced the killing of a senior Hamas commander, Ayman Nofal. Hamas also confirmed his death.

Israelis are still reeling from the worst attack in the country's 75-year history, which has sparked a mass mobilisation of reservists and the evacuation of residents from areas near Gaza and Lebanon. (AFP, Reuters)
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Last updated: 2023-10-18 HKT 05:25