The Beit Hanoun hospital is now effectively closed following a series of violent incidents on Monday. Four patients were killed inside the hospital including one in the operating theatre and as many as 10 others wounded. The hospital was evacuated and later damaged.

At the Shifa Hospital armed groups within the hospital exchanged fire with nearby positions held by opposing groups. Fighting around the hospital continued into the night of Monday and Tuesday morning.

The ICRC reminds all sides involved in the fighting that attacks on medical institutions, their patients and their staff are serious violations of international humanitarian law. It also underlines that medical institutions must not be used for belligerent purposes.

"Medical facilities and staff must be allowed to function at all times but particularly in times of crises," says Claudia Locher, the Deputy Head of the ICRC's sub-delegation in Gaza. "It is only through respect of these institutions that life saving services can be provided to the civilian population and those injured in the fighting."

The ICRC emphasizes that ambulances must be allowed free access to victims and to medical facilities. The ICRC remains available in Gaza to facilitate humanitarian evacuations as well as the movement of medical personnel and supplies.

The ICRC also reiterates that all sides must take every reasonable precaution to ensure the safety of civilians and those not involved in the fighting. The deliberate targeting of civilians, particularly women and children is unacceptable by any international standard.