Missile’s Firing, Bomb Blasts and Sirens Shatter Gaza Calm

Suddenly, just after 2 p.m., the crowd was startled as militants near the hospital fired a missile — most likely one that landed near Jerusalem. In an instant, anticipation gave way to fear, and horror, as Israel [4] fired back, explosion after explosion in the distance.

And then came the sound of sirens roaring up the circular driveway, signaling what would become the bloodiest afternoon yet in the seven-day conflict with Israel.

First there were six ambulances, one after the other, unloading the bodies of men identified as militants, at least two of them decapitated. Then came three more, this time with children, dead and wounded. Another ambulance rushed in, then quickly sped back out.

Even the medics unloading the bodies grimaced.

“There’s a real massacre now,” said Fawzi Barhoum, theHamas [5] spokesman, who was at the hospital waiting for the diplomatic delegation. “At the same time when the Arab leaders came to Gaza [6], 10 persons are killed. At this moment, kids playing soccer are hit. It is a clear reflection of the mind and the thought of the occupation, thinking how to kill more and more Palestinians [7].”

It remains unclear whether the intense afternoon bombing was in retaliation for the Jerusalem strike, the second in five days, or an effort to take out as many targets as possible while final details of a cease-fire deal were being discussed. A frenzy of about 200 rockets also flew from Gaza into Israel on Tuesday, hitting the southern cities of Beersheba and Ashdod as well as the Tel Aviv suburb of Rishon LeZion; an Israeli soldier was killed in a week of cross-border battles, along with a civilian.

The violence, which health officials said brought the Palestinian death toll to more than 130, may complicate the efforts of the Hamas government to persuade people, especially rival factions, to abide by a cease-fire.

“Revenge, revenge,” the throng chanted as the bodies were brought inside the hospital. “Qassam Brigades, get revenge for us.”

Al Shifa, the largest of Gaza’s six public hospitals, has become a community hub over the last week. With airstrikes hitting homes, government offices and open areas, people saw it as a rare haven. Some came, of course, to hold the hands of wounded relatives in its crowded wards. Others just came. There is little else to do.

While most shops throughout the city have been shuttered, and the streets were relatively deserted, the strip of stands selling shwarma and fruit shakes outside Al Shifa has done a brisk business. Each morning, dozens crowd outside the morgue in back, waiting to take bodies for burial. On Monday, a hospital worker pressed the families to move more quickly.

“There’s no room,” the worker called out a window. “More martyrs will be coming.”

During a visit two months ago, Dr. Ayman Alsahbani, director of emergency medicine, said the 750-bed hospital faced critical shortages of antibiotics, anticoagulants and other medicines that improve outcomes of surgery, and even of basics like plastic gloves and IV saline solutions. There were expired vials of Cordarone, a heart medicine, and intubation kits dated November 2011.

But on Tuesday, Dr. Alsahbani and several of his colleagues said the hospital was managing the crisis with supplies and medical personnel sent by Egypt and other countries. They had kept a reserve of about 80 open beds, including six in the intensive care unit, throughout the week to be ready for a further escalation, Dr. Alsahbani said.

Dr. Mads Gilbert, a professor at the University Hospital of North Norway, said things were better organized this time than during Operation Cast Lead, Israel’s three-week assault on Gaza in 2008-9, also waged to stop rocket attacks. “They have learned a lot from the last attack,” Dr. Gilbert said. “So far the capacity is up to the numbers. But I think we haven’t seen the peak.”

He spoke around lunchtime, shortly after the bank of cameras had been arrayed for the invited foreign ministers, when the only casualty in sight was Hamad Lattif, an 18-month-old boy who was sleeping in his father’s arms after being treated and released for minor shrapnel wounds. It had been the quietest morning after the quietest night in a week.

By two hours later, everything changed. The crowd in the courtyard had quadrupled. The Jerusalem-bound rocket had been launched. Blood was everywhere.

The Hamas Health Ministry said several airstrikes hit around Gaza City around 4 p.m., an hour after the Israeli military began distributing leaflets in several neighborhoods urging people to evacuate to the city center. Drone attacks [8] hit two cars in the neighborhood of Al Sabra in the south, killing six, some of whom could not be quickly identified because of the severity of their injuries. In the Zeitoun area, officials said, two children were fatally struck while kicking a soccer ball on the street. A 22-year-old man was slain on Baghdad Street, on the city’s western side; three more followed in the same neighborhood soon afterward.

Just before 6 p.m., two camera operators for Hamas’s Al Aqsa Television network were burned to death when a bomb exploded their car on Al Shifa Street at the edge of the Beach Refuge Camp. Within the hour, deadly strikes fell in the northern city of Beit Hanoun, the southern town of Rafah and Deir al-Balah in between. Hamas’s military wing, meanwhile, proudly announced that six men suspected of collaborating with Israel had been killed and that their bodies had been dragged through the street.

Waiting for the Arab League delegation, reporters and residents alike heard the booms. Politicians and press officers circulated among the crowds, condemning. The call to prayer rang out from a nearby mosque, followed by special Koranic verses honoring martyrs. Night fell, a half-moon bright in the sky the rocket had soared through.

Ismail Haniya, the Hamas prime minister, led his colleagues through the wards and emerged at the entrance of the emergency room with his hands aloft in signs of victory, unity and defiance.

Then they left without addressing the crowd.