Fighting between Israeli forces and Palestinian militants outside Gaza's largest hospital has prompted thousands of people to flee from the sprawling medical facility, but hundreds of patients and others displaced by the war remained inside, health officials said Monday.

World Health Organization Director-General Tedros Adhanom Ghebreyesus said a day earlier that the UN agency was in contact with Shifa hospital, which he said had been without electricity and water for three days, and noted that gunfire and bombings outside the compound “have exacerbated the already critical circumstances."

“Regrettably, the hospital is not functioning as a hospital anymore,” he said in a post on X, formerly known as Twitter.

Patients inside the hospital include dozens of babies at risk of dying because of a lack of electricity, health officials at the facility said.

More than two-thirds of Gaza’s population of 2.3 million have fled their homes since the war began.

Gaza City, the largest urban area in the territory, is the focus of Israel’s campaign to crush Hamas following the militant group's deadly Oct. 7 incursion into southern Israel that set off the war.

More than 11,000 Palestinians, two-thirds of them women and minors, have been killed since the war began, according to the Health Ministry in Gaza, which does not differentiate between civilian and militant deaths. About 2,700 people have been reported missing.

More than 1,200 people in Israel died, most of them in the Hamas attack, and about 240 hostages were taken from Israel into Gaza by Palestinian militants.

Currently:

— Thousands flee Gaza's main hospital but hundreds, including babies, still trapped by fighting

— Hospitals have special protection under the rules of war. Why are they in the crosshairs in Gaza?

— Biden's certitude on Israel gives way to the complexities and casualties of a brutal war

— Attacks by Lebanon's Hezbollah group wound 7 Israeli troops, 10 others along border with Israel

— US conducts airstrikes against Iran-backed groups in Syria, retaliating for attacks on US troops

— Find more of AP’s coverage at https://apnews.com/hub/israel-hamas-war

Here’s what is happening in the latest Israel-Hamas war:

DEIR AL-BALAH, Gaza Strip — Municipal officials in Gaza say sewage is overflowing into the streets because of the lack of electricity, causing a health and environmental disaster.

“A complete halt of all sewage pumps, which led to the overflow of sewage in the streets and neighborhoods, is creating a health and environmental abomination and the spread of diseases," said Ahmad al Soufi, president of Rafah municipality.

"We are now witnessing a deterioration in the environmental situation resulting from the accumulation of waste in the streets, alleys and all neighborhoods and the spread of diseases and epidemics of all kinds.”

DEIR AL-BALAH, Gaza Strip — The director of hospitals in Gaza said Monday that 32 wounded people have died at Shifa hospital, the territory's largest, including seven patients in the Intensive care unit.

Mohammed Zaqout said 36 newborn babies have not been evacuated from the hospital yet and there has been no coordination on moving them. He said there is no place to take patients, and called for the opening of a “safe passage” to take them to Egypt for treatment.

Responding to Israeli statements that the hospital had rejected an offer of fuel, Zaqout said the Israeli military offered 300 liters (79 gallons) — “not enough to keep the hospital running for an hour.” He said the hospital needs 8,000 liters (2,110 gallons) of fuel a day.

Zaqout said Israel’s military shelled the oxygen department at Shifa and the hospital is now relying on its remaining oxygen bottles.

He said 10 hospitals remain in service in Gaza and they will not be able to continue operating if fuel is not brought in.

BEIRUT — The Israeli military carried out airstrikes on Monday along the border with Lebanon after the militant Hezbollah group fired anti-tank missiles toward Israeli troops near the tense border’s western sector.

Hezbollah said in a statement that it had inflicted injuries. The Israeli military did not immediately comment.

Clashes between Hezbollah and the Israeli military continue to intensify in the western and central areas along the tense border.

Hezbollah said it also conducted two other attacks on Monday — a rocket attack on the strategic Biranit barracks and an attack on a position targeting Israeli troops, both in the central sector along the border.

The clashes have remained largely contained since they began on Oct. 8, but the Lebanese government and the international community are attempting to keep them from spiraling into a wider war.

CAIRO — The U.N. agency for Palestinian refugees said Monday that Israel’s navy struck one of its facilities in southern Gaza, despite sharing coordinates with warring parties.

The agency, known as UNRWA, said Sunday’s strike caused “significant damage” to its guesthouse in Rafah, adding that no casualties were reported since U.N. staff left the facility 90 minutes before the attack.

There was no immediate comment from the Israeli military.

“This recent attack is yet another indication that nowhere in Gaza is safe. Not the north, not the middle areas and not the south,” said UNRWA Commissioner-General Philippe Lazzarini.

UNRWA says it has shared the coordinates of the UN international staff guesthouse twice with the warring parties, including on Nov. 10.

BRUSSELS — Germany’s foreign minister is pushing anew for reliable “humanitarian pauses” in the war between Israel and Hamas, but is rejecting calls for a cease-fire that ends the fighting.

Germany has staunchly backed Israel since Hamas’ attack on Oct. 7 while also pushing for humanitarian aid for civilians in Gaza.

Arriving Monday at a meeting with European Union counterparts, Foreign Minister Annalena Baerbock said she understands “the impetus for a cease-fire,” but questioned how those who seek one can guarantee Israel’s security in “this terrible situation” and wondered about the fate of the people Hamas has taken hostage.

Baerbock defended the less far-reaching approach of humanitarian pauses, saying while it “breaks one’s heart, is from my point of view the only possible policy to really curb this suffering in this situation.”

CAIRO — Many displaced Palestinians, along with some medical patients, have left Gaza’s largest hospital, which is surrounded by Israeli forces, a U.N. health official said Monday.

About 650 patients, 500 healthcare workers and an estimated 2,500 displaced people remain in the sprawling Shifa hospital compound, said Mohammed Zaqout, director of hospitals in Gaza. This would signal a significant departure since the weekend when Gaza health officials had said about 1,500 patients, along with 1,500 medical workers and 15,000 displaced people were at Shifa.

Israeli forces and Hamas gunmen have waged heavy battles outside Shifa, and some hospital officials have said Shifa was under siege, with those inside being pinned down by Israeli fire. Israel has said it had offered safe passage to those wanting to leave.

The situation at Shifa deteriorated over the weekend, with doctors reporting that the last generator had run out of fuel, leading to the deaths of several patients, including premature babies.

The U.N. official said Monday that many of the displaced fled the compound and that some families took relatives with moderate injuries with them. He said remaining patients require special procedures for evacuation including equipped ambulances to take them to Egyptian hospitals. The official spoke on condition of anonymity because he was not authorized to speak to journalists.

Another hospital in Gaza City, Al-Quds, was forced to shut down on Sunday because it ran out of fuel. The Palestinian Red Crescent, which operates the facility, said Israeli forces are stationed nearby and that preparations are being made to evacuate some 6,000 patients, medics and displaced people.

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Associated Press writer Samy Magdy contributed.

JERUSALEM — The Israeli government has blocked the Hezbollah-affiliated, Beirut-based Al Mayadeen TV news channel from broadcasting in Israel.

“Broadcasts that identify with the enemy are harmful to the state’s security and should be blocked,” Communications Minister Shlomo Karhi wrote in a joint statement with Defense Minister Yoav Gallant.

Last month, the government approved emergency regulations allowing it to block the wartime operations of foreign channels it deems hostile to the state. Karhi had also pressed to shut down the Israeli office of Qatar-based Al Jazeera, but Doha is leading efforts to release hostages captured from southern Israel during Hamas’ bloody Oct. 7 incursion, and the Israeli government hasn’t moved ahead on his plan.

BEIRUT — World Health Organization Director-General Tedros Adhanom Ghebreyesus said the UN agency was in contact with Shifa Hospital late Sunday, which he said had been without electricity and water for three days.

“The constant gunfire and bombings in the area have exacerbated the already critical circumstances,” he said in a post on X, formerly known as Twitter. “Regrettably, the hospital is not functioning as a hospital anymore.”

Several charities and humanitarian agencies that support Shifa have told The Associated Press they were unable to reach the hospital throughout the day.

BUCHAREST, Romania — A group of 86 Romanian citizens were evacuated on Sunday from the Gaza Strip into Egypt, Romania’s Foreign Ministry said.

The latest group of evacuees left Gaza through the Rafah border crossing and were on their way to Cairo, it said. Earlier Sunday, 41 Romanians were flown to Romania from Egypt after being evacuated from Gaza, bringing the total to 134 since the conflict with Israel started.

Since Hamas launched its attack on Israel on Oct. 7, at least five Romanian citizens have been confirmed killed. Six Romanians who hold dual Romanian-Israeli citizenship are also among the hostages held by Hamas.

Meanwhile, Albania's foreign minister said Sunday that the first Albanian citizens, a mother and her four children, were evacuated from Gaza. Igli Hasani posted on X, formerly known as Twitter, that the five people were safe in Egypt “while we continue the procedures for their return to Albania as soon as possible.”

Hasani thanked Israel and Egypt for their cooperation and UN migration and the International Committee of the Red Cross for their support “in this complex operation."

Also Sunday, a group of 32 Brazilians was en route to Cairo after they were allowed to cross from Gaza into Egypt, according to a statement from Brazil’s Foreign Ministry posted on X. From Cairo, the group will fly to Brazil on a plane belonging to the Brazilian armed forces. They are scheduled to arrive Monday evening.

And Czech Foreign Minister Jan Lipavsky said one Czech national and a relative were evacuated from Gaza to Egypt through the Rafah crossing. Lipavsky declined to give any further details. The Foreign Ministry said there are nine other Czech people who are seeking evacuation from Gaza.

BEIRUT — Jordanian Foreign Minister Ayman Safadi said Sunday that he asked European Union foreign policy chief Josep Borrell to apply the same “legal, moral grounds” for its support of Ukraine to “define its stand on Israel’s war crimes.”

“Israel crossed every legal, ethical (and) humanitarian red line in its barbaric war on Gazans,” Safadi said on X, formerly known as Twitter. “Message to the region: Identity of aggressor & victim determines applicability of Int’l law.”