This article is more than 6 years old

This article is more than 6 years old

The Palestinian death toll in the conflict between Hamas and Israel reached 548 on Monday as officials said four were killed when a Gaza hospital was hit by Israeli fire.

It followed the bloodiest day of the conflict so far on Sunday when at least 120 Palestinians were killed in Shujai'iya, a third of them women and children. Thirteen Israeli soldiers were also killed – two of them US citizens – in the heaviest loss of life for the Israeli military in years.

Staff at the al-Asqa Martyrs hospital were said to be in shock that the building was hit. "People can't believe this is happening – that a medical hospital was shelled without the briefest warning. It was already full with patients," said Fikr Shalltoot, director of programmes at Medical Aid for Palestinians in Gaza city.

"Five people, I gather, were killed, and 15 were injured, including medical staff. I know the staff very well. My nephew is a medical doctor there."

Facebook Twitter Pinterest A Palestinian employee inspects damages at the Al-Aqsa Martyrs hospital in Deir al-Balah, in the central Gaza Strip. Photograph: Mohammed Abed/AFP/Getty Images

The US president, Barack Obama, has called for an immediate ceasefire between Israel and Hamas.

Israel continued its action on the Gaza City neighbourhood of Shujai'iya on Monday, where bombardment and fierce fighting on the ground the day before had left shattered streets littered with bodies.



Mounting international pressure for a ceasefire came amid continuing violence in Gaza. Overnight, Israeli strikes hit Gaza city, and the south and centre of the coastal enclave, home to 1.8 million people.



Twenty-five members of the same family were reported killed in an air strike in the south of Gaza, and a further 10 people were killed near Khan Younis.

In the West Bank, Palestinians began three days of mourning for the dead in Gaza. A general strike was under way on Monday.

The Israel Defence Forces said it had foiled attempts by Hamas fighters to infiltrate Israel through two tunnels from Gaza on Monday. Ten militants were killed in air strikes. The IDF also suffered casualties, Israel Radio reported.

Meanwhile, army spokesman Peter Lerner said the IDF could not rule out the kidnapping of an Israeli soldier by Hamas, despite denials late on Sunday by the Israeli ambassador to the UN, Ron Prosor. Investigations were continuing, the IDF said.

By Monday morning, 43 access points to 16 different tunnels had been discovered by Israeli troops on the ground. Military sources said the “sophisticated network of tunnels” within Gaza and under the border to Israel was much more extensive that originally thought.

The conflict is rapidly threatening to turn into a major humanitarian crisis hitting electricity and water supplies and seeing large numbers driven from their homes. The UN agency for Palestinian refugees, UNRWA, has opened 60 of its schools to shelter more than 83,000 people who have fled so far.

Obama's appeal came as the United Nations security council opened urgent talks on efforts to strike a ceasefire deal as Israel ramped up a major military offensive with fresh strikes on Monday in the Palestinian territory.



"The members of the security council expressed serious concern about the growing number of casualties. The members of the security council called for an immediate cessation of hostilities," Rwandan UN ambassador Eugene Gasana told reporters after an emergency meeting of the 15-member council.

Amid signs of mounting pressure on both sides to end the conflict, the UN secretary general, Ban Ki-moon, who is in the Middle East in an attempt to help broker a ceasefire, condemned the Israeli assault in Shuji'iya as an "atrocious action".

The call of a halt to the fighting came as the US secretary of state, John Kerry, was due to fly to Cairo on Monday for meetings with senior officials from Egypt and other countries, as diplomatic efforts to end the two-week long conflict appeared to be gaining some momentum.

The state department said Kerry would leave early on Monday for Egypt where he will join diplomatic efforts to resume a truce that had been agreed to in November 2012.

In a statement on Sunday evening, department spokeswoman Jen Psaki said the US and its international partners were "deeply concerned about the risk of further escalation, and the loss of more innocent life".

Ceasefire discussions between Hamas leader Khaled Meshaal and the Palestinian president were due to take place on Monday after being delayed by a day.

UN chief Ban was also in Doha where he urged Israel to "exercise maximum restraint".

"Too many innocent people are dying … [and] living in constant fear," he told a news conference in Doha.

Speaking to the Israeli prime minister, Binyamin Netanyahu, by telephone early on Monday, Obama expressed his concern over the deaths on both sides, the White House said in a statement.

In their second call in three days, Obama "reaffirmed Israel's right to defend itself" and called for an immediate ceasefire in Gaza.

David Cameron also spoke to Netanyahu, reiterating "the UK's strong support for Israel's right to take proportionate action to defend itself from" Gaza rockets, while expressing condolences over the Israeli deaths and concern over the "mounting civilian casualties in Gaza".

Cameron agreed with Netanyahu that the way out of the "spiral of violence" was through the Egyptian ceasefire initiative, a spokesman for the British PM said.

So far, truce efforts have been rejected by Hamas, which has pressed on with its own attacks, undaunted by the Israeli bombardment by land, sea and air.

The Doctors Without Borders charity urged Israel to "stop bombing civilians trapped in the Gaza Strip", noting the majority of the injured arriving in the Al-Shifa hospital were women and children.

"While the official line is that the ground offensive is aimed at destroying tunnels, what we see on the ground is that bombing is indiscriminate and that those who are dying are civilians," the French NGO said in a statement.