Evidence Points to Israeli Shells in Strikes on Gaza’s Largest Hospital

Minutes after 1 a.m. Friday, as active fighting raged between Israeli forces and Hamas militants, a projectile streaked over Gaza’s largest medical complex and crashed into the center of the courtyard of Al-Shifa Hospital, a place where thousands of displaced Gazans had sought shelter.

It landed just a few feet from Ahmed Hijazi, a social media personality who has been documenting the conflict. He filmed a video of the projectile flying in, and then of a man in agony, his leg mangled by the impact.

It was the first of at least four strikes involving multiple munitions on different sections of the sprawling complex between 1 a.m. and 10 a.m. Friday morning. Al-Shifa’s director, Dr. Mohammed Abu Salmiya, said in a phone interview that seven people had been killed and several others had been wounded.

Hours after the final blast, the Israeli military blamed unspecified Palestinian militants, saying a “misfired projectile” aimed at Israel Defense Forces troops deployed nearby had instead hit the hospital.

But at least three of the projectiles that struck it appear to have been Israeli munitions, according to pictures of weapons fragments collected and verified by The New York Times and analyzed by experts.

The strikes did not cause mass casualties, but Israel is under increasing international pressure to avoid targeting hospitals. Al-Shifa has emerged as a particular flashpoint: Israel contends it has evidence that the hospital sits on top of an underground Hamas command center and has been warning those still inside to evacuate, even as its troops have been actively working to surround the facility. Hospital officials deny Hamas operates there and have said patients are dying for lack of food, fuel and other supplies.

Israel’s assertion that Al-Shifa was actually hit by a Palestinian projectile echoed similar — and unresolved — claims and counterclaims following munitions that hit the courtyard of another Gaza hospital, Al-Ahli, nearly a month ago.

The evidence reviewed by The Times from Al-Shifa points more directly to strikes by Israel — whether on purpose or by accident is unclear.

In addition to the weapons remnants, an analysis of video footage shows that three of the projectiles were fired into the hospital from the north and south, contrary to the western trajectory indicated on a map released by the I.D.F., which it said was based on radar detections. A review of satellite images showed there were I.D.F. positions north and south of the hospital early Friday.

The strikes analyzed by The Times did not appear to be targeting underground infrastructure. Two of the most severe strikes hit upper floors of the maternity ward.

The I.D.F. declined to comment on the evidence presented by The Times. It said that Israeli forces had been engaged in an intense battle against Hamas and that because of the “specific military activity currently underway, we are unable to address or confirm specific queries.”

The first projectile filmed by Mr. Hijazi in the courtyard was also captured by Saleh al-Jafarawi, a Gazan Instagram personality who has been camped out at the hospital for weeks. Mr. al-Jafarawi has been the subject of various internet controversies for his prolific social media posts. The Times has done extensive independent verification of the material he captured at Al-Shifa.

A review of Mr. al-Jafarawi’s video metadata confirmed he filmed the scene immediately after the strike. He was filmed at the scene in another video provided by a Gazan journalist, Motasem Mortaja. Mr. al-Jafarawi’s videos of the scene match images taken by Mr. Mortaja and Mr. Hijazi, and comport with the accounts provided by the hospital’s director, weapons experts and other witnesses.

Marc Garlasco, a former Pentagon senior intelligence analyst, identified the projectile as the shell of an Israeli illumination artillery round commonly used to identify targets at night. Richard Stevens, a former explosive ordnance disposal soldier with the British Army, also identified it as an illumination round and noted the absence of a high-explosive detonation upon the shell’s impact.

Sometime after 2 a.m., the hospital was hit again, this time by explosive rounds that pierced the fifth-floor wall of the maternity building.

A video filmed in the immediate aftermath showed blankets, chairs and shoes strewn around the room. Amid the debris were two metal fins that Mr. Garlasco identified as the tails of 120-millimeter tank shells of a type used only by Israeli forces, not by Palestinian militants, who don’t have tanks. He said the damage to the room was “very consistent with 120-millimeter H.E. tank shells,” referring to high-explosive shells.

The Times has established that these shells were likely fired from a southern direction toward the hospital, again contrary to the map issued by the Israeli military. Dr. Abu Salmiya, the hospital’s director, said that a 61-year-old man had been killed in the strike and that two women had been injured.

By 8 a.m., the same wing of the maternity building had been struck again. This time a section of the exterior wall was blown out and the interior of the building was considerably damaged.

This blast, Dr. Abu Salmiya said, ripped through the hospital, killing three people who had been sheltering inside and injuring others. Video filmed in the immediate aftermath showed extensive damage and dozens of people leaving the area.

The hospital appeared to have been jammed to capacity when it was hit. Since the war began, hospitals in Gaza have been used not just to treat the wounded but also to shelter thousands of Gazans.

Videos filmed by a reporter working with Al Jazeera inside the hospital on Oct. 30 and provided to The Times showed women, children and infants filling the corridors and stairwells of the maternity building. One video shows over 20 women and children camped inside the same area that appears to have been later hit by the Israeli shells.

About an hour and a half after the maternity unit was hit for the second time, a projectile hit the other side of the hospital complex by a busy entrance to the outpatient clinic, witnesses said.

A video filmed by Mr. Hijazi showed chaotic scenes of men, women and children wounded in the strike. Two children were sprawled lifeless on the ground. A young girl with blood across her face screamed into the camera.

This strike killed three people and wounded seven others, the hospital chief said.

A photo obtained by The Times showed the damage caused by the projectile that hit the outpatient area, but Mr. Garlasco and Mr. Stevens, the weapons experts, said the image did not provide enough detail to determine what kind of munition was used in the strike.

Thousands of people left Al-Shifa Hospital on Friday afternoon and headed south, but hundreds of staff, patients and people seeking shelter remained, the hospital director said.

“There are dead people on the streets,” the aid group Doctors Without Borders said, quoting one of its staff members at the hospital. “We see people being shot at. We can see injured people. We hear them crying for help, but we cannot do anything. It is too dangerous to go outside.”The Biden administration warned Israel on Sunday against engaging in combat in hospitals in Gaza, even as it endorsed Israel’s assertion that Hamas uses such civilian facilities to shield its fighters and store weapons.

Malachy Browne reported from Limerick, Ireland, and Neil Collier from Cairo. Reporting was contributed by Aaron Boxerman, Patrick Kingsley and Raja Abdulrahim in Jerusalem, by Iyad Abuheweila in Cairo, and by Christoph Koettl in New York. Videos produced by Ainara Tiefenthäler and David Botti.