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Smoke rising during an Israeli raid at Al-Shifa Hospital and the surrounding area in Gaza City on Thursday.Credit…Dawoud Abu Alkas/Reuters

Israel’s military said on Thursday that it had killed dozens of people it described as terrorists in the previous 24 hours as its raid on Al-Shifa Hospital in northern Gaza, the largest medical facility in the territory, stretched into a fourth day.

Israel has staged a series of raids on hospitals in Gaza, arguing that Hamas has used the facilities as command centers, taking advantage of the cover they provide to dig tunnels in which it has stored weapons and placed fighters. The latest attack on Al-Shifa, which began on Monday, appears to have been the most deadly since the start of the war in Gaza more than five months ago.

The Israeli account on Thursday could not be independently verified, and a lack of communication and access to northern Gaza has made it difficult to follow developments at the hospital complex.

The Al Jazeera news network and Wafa, the Palestinian Authority’s news agency, reported on Thursday that Israeli forces had blown up a building used for surgery that is one of the largest at the complex. The Israeli military did not immediately respond to a request for comment on the reports, which could not immediately be verified.

The military said in an earlier statement that it was continuing to “conduct precise operational activity in the Shifa hospital, eliminating dozens of terrorists over the past day during exchanges of fire.” It also said it was preventing harm to civilians and had located storage sites for weapons. Hamas has denied using hospitals for military purposes.

Israel made northern Gaza the initial target of its ground invasion of the enclave, which started on Oct. 27, and it first raided the hospital in November. It later provided evidence that Hamas had, in fact, constructed a lengthy tunnel under the hospital, though a later analysis by The New York Times found little evidence that the complex had been used as a command center.

Israeli officials said earlier this week that Hamas personnel had returned to the hospital, prompting the current operation. Military analysts said Israel’s decision to withdraw most of its forces from the north, in part to concentrate on defeating Hamas in other parts of Gaza, had effectively left a security vacuum.

The initial raid on Al-Shifa became a lightning rod for criticism of Israel over military action around hospitals and the danger it poses to patients and medical staff. The raid also became a symbol of a broader debate about the human cost of Israel’s military campaign to destroy Hamas in Gaza, in which tens of thousands of civilians have been killed or wounded.

Lauren Leatherby contributed reporting.

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