Gaza - Palestinians said Friday a deadly strike hit Gaza's largest hospital compound as Israel's assault has sent tens of thousands of civilians fleeing their homes.

Gaza's Hamas government, which reported a death toll of 13, and the director of the Al-Shifa hospital blamed Israeli troops for the strike at the facility sheltering people trying to flee the fighting. Israel did not immediately comment.

Al-Shifa hospital director Mohammad Abu Salmiya reported two people were killed and 10 wounded in a strike that he said hit the compound's maternity ward.

A Hamas government statement said: "Thirteen martyrs and dozens wounded in an Israeli strike on Al-Shifa compound today" in central Gaza City.

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On Thursday, Israel had reported heavy fighting near the hospital, saying it had killed dozens of militants and destroyed tunnels that are key to Hamas' capacity to fight.

The Israeli army has repeatedly accused Hamas of using hospitals, particularly Al-Shifa, to coordinate their attacks and also as hideouts for its commanders. Hamas authorities deny the accusations.

Israel launched an offensive in Gaza after Hamas fighters crossed the militarized border on October 7, killing 1,400 people, mostly civilians, and taking around 240 hostages. The attacks came after decades of Israeli occupation and oppression of Palestinians.

Israel retaliated with bombardment and a ground campaign that the Gazan health ministry says has killed more than 10,800 people, mostly civilians and many of them children.

Abu Mohammad (32) had taken refuge in the hospital along with 15 relatives after the bombardments of his neighborhood in the northeast part of Gaza City.

"There is no safe place left. The army hit Al-Shifa. I don't know what to do," he said. "There is shooting... at the hospital. We are afraid to go out."

Witnesses said tanks had surrounded some other hospitals in Gaza City as fierce fighting continued, forcing hundreds of thousands of people to flee to the south of the territory over the past few weeks.

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AFPTV footage showed a fireball and smoke rising over the city at dawn. Early Friday sounds of apparent gunfire and explosions could be heard.

The heavy fighting in the densely populated coastal territory, which is effectively sealed off, has prompted repeated calls for a ceasefire to protect civilian lives.

Prime Minister Benjamin Netanyahu has repeatedly rejected halting the fighting, telling Fox News Thursday that a "ceasefire with Hamas means surrender to Hamas, surrender to terror."

He also looked ahead to the war's end, saying Israel does not "seek to occupy" Gaza, although the Palestinian Territories are already under Israeli occupation.

Tens of thousands of civilians have streamed out of devastated northern Gaza in recent days, with men, women, and children clutching meager possessions as they emerge from the devastated war zone.

The UN agency responsible for Palestinian refugees, UNRWA, said 70,000 people had traveled south on the route since November 4, most of them walking. Almost 1.6 million people have been internally displaced since October 7, it added, more than half the area's population.

But the UN estimates hundreds of thousands of civilians remain in the fiercest battle zones in the north.