AMY GOODMAN: “The nightmare in Gaza is intensifying.” Those are the words of a top U.N. official as Israel escalates its war amidst a devastating siege and forced expulsion of Palestinians in northern Gaza. Health officials there say at least 87 people were killed in an Israeli airstrike on Beit Lahia on Saturday. Survivors said the dead include many women and children.

AHMED AL HAJEEN: [translated] We were asleep around 12 a.m. when it suddenly felt like an earthquake hit the area. Debris was falling on us. We rushed outside after hearing screams of women and children and found that our neighbors had been targeted by massive bombs. Tons of explosives had fallen on a residential neighborhood full of civilians and displaced families. All those who were martyred here are children, women and displaced people who fled from other areas due to heavy strikes, seeking shelter in what they believed to be a safer place.

AMY GOODMAN: Today, Al Jazeera reports at least 33 more Palestinians in Gaza were killed by Israeli attacks, including 18 in the Jabaliya refugee camp alone. Palestinians have shared footage on social media that appears to show people in Jabaliya being hit by a strike as they try to rescue an injured person in the street.

Israel is also targeting the last three functioning hospitals in northern Gaza: the Indonesian, Al-Awda and Kamal Adwan hospitals. Doctors Without Borders reports more than 350 patients are believed to be trapped inside the hospitals. This is an urgent video call for help made Sunday by Dr. Marwan Sultan, director of the Indonesian Hospital in northern Gaza.

DR. MARWAN SULTAN: As-salamu alaykum. I’m Dr. Marwan Sultan, director of the Indonesian Hospital. Since middle of the night, the Indonesia Hospital exposed to attack by the Israeli forces, and they attack the second and third floor. Now we have 40 patients. Thirty of them, they are injured patients. There’s some of the patients, they are very serious, and they need oxygen, and they need critical care. So, the light, electricity is off since midnight. And the medical staff, they cannot make the generator on because of the — a lot of attack and a lot of danger. So, we are calling you to make the medical staff and the hospital safe. Please, our brother and sister, all the humanitarian societies, urgent call just to, please, help our medical staff and the injured people.

AMY GOODMAN: Dr. Marwan Sultan is the director of Indonesia Hospital in northern Gaza, speaking to us from there.

Meanwhile, Israel has blocked six medical NGOs from entering Gaza. The groups include Glia and the Palestinian American Medical Association. Israel also killed four water engineers who were traveling to make repairs to the water infrastructure near Khan Younis. According to Oxfam, the engineers were traveling in a clearly marked vehicle when they were attacked. The destruction of the water system in Gaza has led to many diseases.

On Sunday, the Palestinian Authority denounced Israel’s escalating attacks, saying in a statement, quote, “Genocide is unfolding in northern Gaza in its clearest form — in full view of the world — marked by siege, starvation, forced displacement, destruction of buildings, aerial bombardment, targeting of health centres, and mass killings,” unquote.

Earlier today, the Palestinian journalist Abubaker Abed reported Farah al-Dalou had died of severe burns at a hospital, just days after her 19-year-old brother Sha’ban al-Dalou burned to death last week in an Israeli strike on Al-Aqsa Hospital that led to a major fire that burned the displaced people encampment near the hospital.

For more, we’re joined by Dr. Ayaz Pathan, an emergency medicine doctor who returned from Gaza in August, spent time at the Indonesian and Nasser hospitals.

Doctor, welcome to Democracy Now! Thank you so much for joining us. We just heard Dr. Sultan describing what’s happening there at Indonesian Hospital. Can you tell us more, having spent time there and having direct contact with people continuing through to today?

DR. AYAZ PATHAN: Yeah. Thank you for having me, Amy.

You know, Dr. Sultan does an amazing job at this hospital. As a matter of fact, he was very clear about the fact that after the hospital was besieged — and from that besiegement, we could see all sorts of damage. I have spent weeks in that hospital. I have seen, essentially, every inch of that hospital, including the damaged floors from what happened late in 2023, the burned medical equipment, the drone fire attacks that we’ve seen. And one thing that he said is that he would invite the Israelis into that hospital anytime, anyplace, to see what is going on, because there was no operations other than medical operations that were going on in that facility.

AMY GOODMAN: So, if you can talk about the conditions and the number of women and children in this hospital, what the siege over the last weeks of northern Gaza means, and particularly in these three hospitals? You’ve spent time in one.

DR. AYAZ PATHAN: Yeah, absolutely. So, you know, what I found during my time there — and this is identical to the stories that you will hear from every healthcare worker that is both there or has traveled there — is that the types of patients you see essentially represent the population. And so, when we talk about the strip, we talk about a population which is about 50% children that are high school age or younger. And so, everyone’s experience is that you find a lot of children, you find a lot of women. And absolutely, are there men there? Completely. But in that age group that you would consider potentially enemy combatants, I would say that represented about 25%, maybe 30%, of the total injured population that I would see. And even that percentage I’m giving you is assuming that 100% of those males in that category are enemy combatants. So, I think we’re seeing a lot of collateral damage, far more than is acceptable by any stretch of the imagination.

AMY GOODMAN: And the effects, Dr. Pathan, of the whole area not being able to get humanitarian aid?

DR. AYAZ PATHAN: Yeah. So, even when I was there, it was quite a challenge. Food insecurity was a huge issue. I was able to go to Kamal Adwan Hospital, which you had mentioned, and see their malnutrition clinic. I, myself, who had privileged rights to food, lost about 13 pounds in about two weeks there. And now you can only imagine what people over months and months have had to deal with over there. And that’s only the food issue.

Now, talk about medications, there were times that I knew the exact medication I needed to use, whether it was pain medication or an antibiotic, and unable to find that or use that and realizing that in any other situation or country in the world — and quite honestly, even in the south, we had a little bit more access to some of these medications — it was tragic to watch people be in pain, die in pain, die of infections which are completely preventable. And all in all, you’re talking about Gaza, which has had about three dozen functional hospitals prior to all of this, that number has been taken down to essentially a third. And even the hospitals that we talk about, such as Indonesia Hospital, where I was in, half of that capacity was shut down due to damage from prior besiegement.

AMY GOODMAN: Dr. Pathan, we just have reports that Israel has killed four water engineers who were traveling to make repairs to the water infrastructure near Khan Younis. According to Oxfam, they were traveling in a clearly marked vehicle when they were attacked. If you can talk — I mean, the horror of them being killed is horrifying enough, but the fact that they were trying to fix the water infrastructure, what that means, how devastated the infrastructure is, leading to disease, including polio?

DR. AYAZ PATHAN: Yeah. So, absolutely. I think water and the safety of the water is something that UNICEF has looked at, and I think on the order of 98% of the water that is available is not considered good for human consumption. So, now you take an injured population, a sick population — even in the cases that are medical, for example, say, pneumonia or something along those lines — the ability to be able to take care of these patients without something as simple as water, to be able to clean wounds, to be able to hydrate people, is a huge issue.

I think the other point that you made is about just traveling. And so, this is something we’ve seen time and time again, including my own experience, including experiences from other healthcare workers that have been there, and then other NGOs, World Central Kitchen. We’ve seen the United Nations World Food Programme being targeted despite being in vehicles that had been given permission to travel and are clearly marked.

AMY GOODMAN: Well, Dr. Ayaz Pathan, I want to thank you for being with us from North Carolina, emergency medicine doctor who returned from Gaza in August, spending time at the Indonesian Hospital in northern Gaza and Nasser Hospital.

When we come back, Israel has also escalated its attacks on Lebanon, including hitting bank branches all over the country. Stay with us.