Smoke billows during Israeli bombardment of north Gaza on November 17

Gaza Strip (Palestinian Territories) (AFP) - A first consignment of fuel entered Gaza from Egypt late Friday after Israel agreed to a US request to allow limited deliveries to end a communications blackout that has halted aid convoys for two days.

UN agencies have spoken of an increasingly desperate situation for the 2.4 million Palestinians trapped inside the besieged territory, which Israel has been pounding by land and air for the past six weeks.

The fuel delivery came as troops combed Gaza’s largest hospital in a search for the Hamas operations centre that Israel says lies hidden in bunkers beneath.

Israel has vowed to “crush” Hamas in response to the group’s October 7 attack, when it broke through Gaza’s militarised border to kill about 1,200 people, most of them civilians, and take about 240 hostages, according to Israeli officials.

The army’s air and ground campaign has killed 12,000 people, including 5,000 children, according to Hamas, which has ruled Gaza since 2007.

Map of the Gaza Strip

In response to a US request, Israel’s war cabinet unanimously agreed to “provide two tankers of fuel a day to run the wastewater treatment facilities… which are facing collapse due to the lack of electricity”, national security adviser Tzachi Hanegbi said.

“We took that decision to prevent the spread of epidemics. We don’t need epidemics that will harm civilians or our fighters,” he said.

A senior US official said Washington had exerted huge pressure on Israel for weeks to allow fuel in through the Rafah crossing from Egypt, with US Secretary of State Antony Blinken making clear Israel needed to act immediately to avoid a humanitarian catastrophe.

Israel has repeatedly demanded assurances that any fuel delivered to Gaza will not be diverted by Hamas for military purposes.

The UN agency for Palestinian refugees (UNRWA) said 70 percent of people have no access to clean water in south Gaza, where raw sewage had started to flow on the streets.

Under the deal, 140,000 litres (37,000 gallons) of fuel will be allowed in every 48 hours, of which 20,000 litres will be earmarked for generators to restore the phone network, the US official said.

A first consignment of some 17,000 litres of fuel for telecommunications company Paltel passed through the Rafah crossing from Egypt late Friday, a Palestinian border official said.

A man evacuates a wounded girl after bombardment in Rafah on November 17

It comes after aid trucks were unable to enter Gaza from Egypt for two straight days due to the near-total communications blackout, UNRWA said.

UN humanitarian chief Martin Griffiths said fuel was “critical for the onward distribution of aid throughout Gaza, and for the functioning of vital services.”

He told the UN General Assembly that the fuel currently being provided to UNRWA to distribute aid was “welcome but is a fraction of what is needed to meet the minimum of our humanitarian responsibilities”.

- ‘One building at a time’ -

As Israeli troops kept up their search operation at Gaza’s Al-Shifa hospital Friday, the health ministry in the Hamas-ruled enclave said that 24 patients had died in the space of 48 hours due to the lack of fuel for generators.

Israeli troops search a building in the northern Gaza Strip

Hamas rejects an Israeli charge that it has a command centre under the hospital, where thousands of people, including wounded patients and premature babies, are believed to be inside. The hospital also denies the claim.

“Twenty-four patients… have died over the last 48 hours as vital medical equipment has stopped functioning because of the power outage,” health ministry spokesman Ashraf al-Qudra said.

Israel has defended its Al-Shifa operation, with the military saying it found rifles, ammunition, explosives and the entrance to a tunnel shaft at the hospital complex.

Its prime minister, Benjamin Netanyahu, alleged hostages may even have been held at the medical facility.

“We had strong indications that they were held in the Shifa Hospital, which is one of the reasons we entered the hospital,” he told “CBS Evening News”.

“If they were, they were taken out,” he said.

Negotiations are ongoing for the release of the hostages, including children, in exchange for a pause in fighting

Israel said its forces were searching Al-Shifa “one building at a time”.

The military also said troops had recovered the remains of kidnapped woman soldier Noa Marciano, 19, “from a structure adjacent to Al-Shifa hospital”.

On Thursday, the army said soldiers near Al-Shifa found the body of another hostage. Yehudit Weiss, 65, had been kidnapped from the kibbutz community of Beeri.

- ‘Civilians face starvation’ -

People inspect the damage at the Nuseirat refugee camp in central Gaza on November 17

Israel has come under increasing pressure to back up its allegations that Hamas is using hospitals as command centres.

The United States has stood behind its ally, however, with President Joe Biden this week saying he had asked Israel to be “incredibly careful” in its military moves around Gaza hospitals.

More than half of Gaza’s hospitals are no longer functional due to combat, damage or shortages, and Israel’s raid on Al-Shifa left extensive damage to the radiology, burns and dialysis units, Hamas said.

AFPTV video showed Palestinian children waiting in ambulances at Deir al-Balah for evacuation to the United Arab Emirates via the Rafah crossing to Egypt.

Wounded Palestinian children wait in an ambulance ahead of crossing into Egypt from the Gaza Strip through the Rafah border crossing

“In the beginning, they told (us) she would be martyred. She has fractures in her skull, pelvis and the thigh,” said Adam al-Madhoun, father of four-year-old Kenza, who already had her right hand amputated after an attack on the Jabalia refugee camp.

Conditions for Palestinian civilians are rapidly deteriorating, the UN warned.

More than 1.5 million people have been internally displaced, and Israel’s blockade of the territory means “civilians are facing the immediate possibility of starvation”, World Food Programme head Cindy McCain said.

- West Bank violence -

Israel’s ground operation has so far focused on north Gaza, where it has announced the seizure of key buildings and a port. It says 51 of its troops have been killed.

Alongside the war in Gaza, there is growing concern about violence in the Israeli-occupied West Bank, where attacks by Israeli settlers against Palestinians have surged.

Raids by Israel’s military, which says it is responding to “a significant rise in terrorist attacks”, have also multiplied and the Palestinian death toll has soared.

The Israeli army said on Friday it had killed at least seven militants in two separate confrontations in the West Bank.

And overnight, the Red Crescent said five people were killed in a strike on a building in the West Bank’s Balata refugee camp.

US Secretary of State Antony Blinken has urged Israel to take “urgent” action to “de-escalate tensions in the West Bank, including by confronting rising levels of settler extremist violence”, the State Department said.