Witnesses to an Israeli air strike at a hospital compound in Gaza described scenes of horror and helplessness as people, many of them women and children, were caught in a fire that followed the attack. The strike, which hit the al-Aqsa Hospital compound in Deir al-Balah early Monday morning, ignited makeshift shelters housing displaced families, leaving at least four people dead and dozens injured, according to Gaza’s Hamas-run health ministry.

A mother living in a tent behind the hospital told the BBC, “This is one of the worst scenes we’ve witnessed. There were explosions everywhere, and we were shocked at whether this was gas or weapons.” She explained how they woke up to “explosions and fires erupting around the tents,” adding, “It’s hard, really hard.”

Another witness, a photographer who captured footage of the aftermath, described his devastation at being unable to help. “I was so broken down,” he said. “I was unable to do anything but watch as people burned.”

The strike occurred at approximately 01:15 local time on Monday (23:15 BST on Sunday). It hit an area between buildings filled with makeshift shelters near an outpatient waiting area, which was vacant during the night, according to Anna Halford, emergency coordinator for Doctors Without Borders (MSF) in Gaza. While she wasn’t at the hospital during the strike, she recounted her colleagues’ horror at the scene, saying, “You come home with the smell of it on your clothes. It’s a viscerally affecting experience. It stays with you.”

Eleven-year-old Lina, who sustained shrapnel injuries, described hearing screams around her. “Our neighbour’s daughter was injured in her head and her dad was killed,” she said. “The people next to us tore down the tent to get us out.” Her grandmother, Um Yaser Abdel Hamid Daher, also shared their tragedy, explaining that the family “lost their tent and everything they had.” Lina’s younger siblings were among those who suffered injuries.

The Israeli military later confirmed that the strike targeted Hamas fighters allegedly operating from a command centre in the hospital’s parking lot. The fire that followed, the military suggested, was “likely due to secondary explosions.” However, MSF, which operates at the al-Aqsa Hospital, said it had “no knowledge” of any Hamas centre and emphasized that “the hospital functions as a hospital.”

The UN’s humanitarian affairs agency condemned the incident, stating that “people burned to death” and calling for an end to the violence. “Atrocities must end,” read the UN statement, while a spokesperson from the White House National Security Council told the BBC’s partner CBS that the footage of civilians burning was “disturbing.” They added, “Israel has a responsibility to do more to avoid civilian casualties, and what happened here is horrifying, even if Hamas was operating near the hospital in an attempt to use civilians as human shields.”

MSF reported a higher casualty toll on Tuesday, stating that five people had died in the strike, with their bodies burned beyond recognition. In addition to the fatalities, 65 people were injured. Of those, 40 were treated at al-Aqsa Hospital, including 22 men, eight women, and 10 children. Eight others were transferred to a specialist burns unit for further care. Halford said that some of the burn victims were in such critical condition that “there is very little you can do for burn victims of that severity.”

One of the mothers the BBC spoke to had already evacuated her children from northern Gaza, only for them to suffer burns in the strike on the hospital tent camp. They are now left with nothing.

This latest strike on the hospital was the seventh since March and the third in the past two weeks, according to MSF. When Halford arrived at the hospital after the attack, she described the scene as chaotic, with people sifting through the charred debris in search of any belongings they could salvage.

The attack occurred in an area to which civilians from northern Gaza had been instructed to relocate for safety, a point highlighted by the UN’s Office for the Coordination of Humanitarian Affairs. “There is no safe place in Gaza for people to go,” the agency stated, reflecting the dire situation for those caught in the conflict, as civilians continue to be targeted amid escalating violence.

As the fighting continues, Gaza’s civilian population, many already displaced multiple times, faces mounting uncertainty and peril, with no clear refuge in sight.