Al Shifa Hospital
Palestinians rush a man, whom medics said was wounded by Israeli shelling near a market in Shejaia, to a hospital in Gaza City July 30, 2014. Reuters/Suhaib Salem

GAZA CITY, Gaza Strip -- A white sedan with bullet holes and dented doors sped into the roundabout driveway of Al-Shifa Hospital in Gaza City, its brakes screeching as the car came to an abrupt stop in front of the Emergency Room door. The young man at the wheel rushed to the back seat and lifted a child wrapped in a bloodied blanket who looked about the age of three. He handed the boy to a team of doctors.

As a bomb detonated, doctors and hundreds of people wandering outside the hospital stopped in their tracks. Ducking their heads, they looked up to the sky, searching for black smoke -- a sign of how far away the bomb struck. Black billows appeared over the top of buildings just to the west of the hospital. Then, another boom.

For people living in Gaza amid continued conflict, places to go for help during wartime are in short supply. Al-Shifa hospital is supposed to be one of those places, officially designated a safe zone by Palestinian authorities, meaning refugees are invited to find shelter there. Yet such places are not impervious to the consequences of continued warfare. At least six schools operated by the United Nations agency that provides relief to Gaza and West Bank residents have been hit by Israeli bombardments in the past month.

Since the conflict began last month, patients at Al-Shifa complain that the hospital has become a target. As they hope to heal from injuries sustained when bomb blasts hit their homes, they live in constant fear that they could at any moment be hit again and perhaps die from an attack on the hospital. In some sense, patients said, they would be safer on the streets of Gaza than in a building that is under direct threat from the Israeli military.

Early on in the conflict, a blast hit the gates of the hospital. The Israel Defense Forces (IDF) and Hamas both denied involvement in the attack, though some journalists who were there at the time said it was an Israeli airstrike.

Al-Shifa, one of the only operating hospitals in the Strip, has been accused by some media outlets of housing Hamas militants. A U.S. Embassy cable from Jerusalem from 2009 released on Wikileaks claimed Hamas operated “interrogation rooms in hospitals.” The cable described the hospital as "an operations center for Hamas."

On a visit to Gaza earlier this month, this reporter saw Hamas officials at the hospital only after an attack on the area of Shejaiya, when dozens of people who had been injured from the blasts flooded the front gates, seeking medical attention. In a video report, one Finnish journalist claimed to have seen Hamas militants fire rockets from a back lot behind the hospital earlier this month.

If Hamas officials were hiding in the hospital, it would be difficult to tell. Al-Shifa Hospital barely looks like a hospital anymore. It has become a de-facto refugee camp, a media hub and a local hangout. What is supposed to be a sanctuary for healing has become a cauldron of chaos. There is no security -- anyone is free to roam the halls, which is causing a massive overcrowding issue.

Hundreds of people gather outside the hospital -- some waiting for news about family members in surgery, others because they can’t find room in a U.N.-led shelter. There is nothing for them to do at the hospital besides wait for the fighting to end.

When ambulances arrive, those outside the hospital gather around the emergency room doors, crowding around the medics to get a look at the newest patients. Those who have lost their homes but have not found shelter elsewhere are at the hospital every day, counting the number of bodies that come in -- including those that have been killed and transferred to the refrigeration boxes in the morgue -- the city’s epicenter of grieving.

Doctors at Al-Shifa say they are not equipped to help patients recover. Dr. Ashraf Qedra, a spokesman for the hospital, said it was at 95 percent capacity by the middle of July. He said it was so full that patients had to sleep on the floor.

“They sleep on blood,” he said.

As a result, at least 200 patients are being transported to Turkey for treatment.

The inside of the hospital looks a little different from the outside. Through the front doors of the hospital, men and women sit on the ground, some trying to find outlets to charge their phones, others simply trying to find a place to sleep, including doctors. And in patients’ rooms, family members sleep next to the hospital beds on old couch cushions, waking intermittently to speak with the doctors.

Ahmed, a 9-year-old boy, sat in the pediatric floor of Al-Shifa, recovering from surgery where doctors had to reconstruct part of his skull that shrapnel had cut into. His father, brother and mother were all living in the hospital with him because their home had been destroyed. While Ahmed’s mother said her son was recovering, they could find “little peace” in the hospital.

Palestinians have several times taken to Twitter with reports that doctors at the hospital have received phone calls saying it would be bombed. Those threats have eventually reached patients -- including the children, who doctors say are struggling psychologically in part because of a lack of sleep.

On his fourth day in the hospital, nurses brought Ahmed a toy truck from a donation bin. He kept it on his bed by his side as his father fed him grapes from a plastic bag. Earlier in the day, a cease-fire between Hamas and the Israel Defense Forces collapsed, and fighting resumed.

The fighting, though, was no longer contained in the north -- it had moved closer to Gaza City -- where hundreds of thousands of people were seeking safety, including at Al-Shifa.

Doctors pushed a boy with black scarring on his face into the elevator on a gurney. There was no room for him. In the emergency room on the first level, doctors shuffled to make space for new patients as makeshift ambulances rushed into the driveway, delivering more people who had been injured.

The smoke was no longer hovering over the hospital, yet the sound of blasts -- maybe rockets, maybe bombs -- echoed in the distance.