Local journalists told the BBC that a warplane fired two missiles at classrooms on the top floor of the school in the urban Nuseirat refugee camp. Videos showed the destruction and a number of bodies.

Israel’s military said it had “conducted a precise strike on a Hamas compound” in the school and killed many of the 20 to 30 fighters it believed were inside.

Gaza’s Hamas-run Government Media Office denied the claim and accused Israel of carrying out a “horrific massacre”.

The head of the UN agency for Palestinian refugees (Unrwa), which runs the school, described the incident as “horrific” and said the claim that armed groups might have been inside a shelter was “shocking” but could not be confirmed.

Dead and wounded people were rushed to the al-Aqsa Martyrs’ Hospital, in the nearby town of Deir al-Balah, which has been overwhelmed since the Israeli military began a new ground operation against Hamas in central Gaza this week.

The circumstances of the strike in Nuseirat are still unclear and the BBC is working to verify the information coming in.

Local journalists and residents said it took place in the early hours of Thursday at al-Sardi school, which is in a south-eastern area of the densely-populated, decades-old camp, where Unrwa provides services.

The school was full of hundreds of displaced people who had fled the fighting elsewhere in Gaza, according to the residents. Many schools and other UN facilities have been used as shelters by the 1.7 million people who have fled their homes during the war, which has lasted almost eight months.

“I was asleep when the incident occurred. Suddenly, we heard a loud explosion and shattered glass and debris from the building fell on us,” Udai Abu Elias, a man who was living at the school, told BBC Arabic’s Gaza Today programme.

“Smoke filled the air, and I couldn’t see anything. I didn’t expect to make it out alive. I heard someone calling for survivors to come out from under the rubble. I struggled to see as I stumbled over the bodies of the martyrs.”

Residents initially said that more than 20 people were killed in the attack.

Later, an official at al-Aqsa hospital told a freelance journalist working for the BBC that it had received 40 bodies from the school.

Gaza’s Hamas-run health ministry said in a statement that 40 people were killed, including 14 children and nine women, and 74 others were injured. The same death toll was given by the director of the Hamas-run Government Media Office, Ismail al-Thawabta.

The head of the UN agency for Palestinian refugees (Unrwa), Philippe Lazzarini, said in a statement on X, formerly Twitter, that at least 35 people were killed and many more injured. The agency’s director of communications, Juliette Touma, told the BBC that “the figures are coming from our own Unrwa colleagues on the ground”.

In a statement, the Israel Defense Forces (IDF) said fighter jets had conducted a “precise strike on a Hamas compound embedded inside an Unrwa school in the area of Nuseirat”. An annotated aerial photograph highlighted classrooms on two upper floors of the building, which the IDF said were the “locations of the terrorists”.

The IDF said members of Hamas and Palestinian Islamic Jihad who took part in the 7 October attack on southern Israel, when around 1,200 people were killed and 251 others were taken hostage, had been operating in the building.

“Before the strike, a number of steps were taken to reduce the risk of harming uninvolved civilians during the strike, including conducting aerial surveillance, and additional intelligence information,” it added.

Later, IDF spokesman Lt Col Peter Lerner told reporters that between 20 and 30 fighters had been using the school to plan and carry out attacks, and that many of them were killed in the strike. “I’m not aware of any civilian casualties and I’d be very, very cautious of accepting anything that Hamas puts out,” he added.

He also said the IDF had called off the attack twice in order to limit civilian casualties and accused Hamas and Palestinian Islamic Jihad of deliberately using UN facilities as operational bases.

Mr Thawabta rejected the IDF’s claims, saying: “The occupation uses lying to the public opinion through false fabricated stories to justify the brutal crime it conducted against dozens of displaced people.”

Philippe Lazzarini said the school was hit “without prior warning” to his agency or the 6,000 displaced people who were sheltering there.

“Claims that armed groups may have been inside the shelter are shocking. We are however unable to verify these claims,” he added.

“Attacking, targeting or using UN buildings for military purposes are a blatant disregard of International Humanitarian law. UN staff, premises and operations must be protected at all times.”

Mr Lazzarini complained that more than 180 Unrwa buildings had been hit since the war began despite their co-ordinates being shared with parties to the conflict, and that more than 450 displaced people had been killed as a result.

“This must stop and all those responsible must be held accountable,” he said.

At least 36,650 people have been killed in Gaza since Israel launched a military campaign in response to the 7 October attack, according to the territory’s health ministry, whose figures do not differentiate between civilians and combatants.

On Wednesday, the Israeli military said it had taken “operational control” over eastern areas of Bureij refugee camp – which is just west of Nuseirat – and eastern Deir al-Balah.

Residents reported intense bombardment and the charity Médecins Sans Frontières (MSF) said at least 70 bodies – the majority women and children – had been brought to al-Aqsa hospital over the previous 24 hours.

Last month, there was global outrage after an Israeli air strike, which the IDF said targeted two senior Hamas officials, and a resulting fire reportedly killed dozens of Palestinians at a tented camp for displaced people near a Unrwa logistics base in the southern city of Rafah.

The IDF said the loss of life was “tragic” and that it was investigating the possibility that ammunition stored by Hamas could have exploded.

That incident prompted mediators to revive their efforts to broker a ceasefire and hostage release deal between Israel and Hamas.

US President Joe Biden outlined last Friday what he described as an Israeli proposal that had been presented to Hamas.

The first phase of the plan would last six weeks and include a temporary truce that would see the release of some of the hostages still being held in Gaza in return for Palestinians from Israeli jails. The second phase would include a permanent cessation of hostilities.

On Thursday, the US, UK and 16 other countries with citizens among the hostages issued a joint statement calling on the leaders of Israel and Hamas “to make whatever final compromises are necessary to close this deal and bring relief to the families of our hostages”.

Hamas political leader Ismail Haniyeh said on Wednesday that the group would deal “seriously and positively” with a proposal based on an end to the war and a full Israeli withdrawal from Gaza.

Israel’s Prime Minister Benjamin Netanyahu has insisted he will not agree to a permanent ceasefire before Hamas is defeated and the hostages are released. On Wednesday, he declared that the country was “striving for total victory”.

The foreign secretary called for “answers from the Israelis”.

Three medical staff told the BBC they were humiliated, beaten, doused with cold water, and forced to kneel for hours. They said they were detained for days.

Israel said “any abuse of detainees is strictly prohibited”.

Lord Cameron told the House of Lords: “These are very disturbing pictures and reports that have come out from this hospital and we need to get to the bottom of what exactly happened and we need answers from the Israelis about that.”

The foreign secretary was questioned about the BBC’s report by Labour peer, Lord Collins of Highbury, during a series of questions about the Israel-Gaza conflict in the upper chamber.

Earlier in the day, Mr Cameron’s deputy in the House of Commons Andrew Mitchell called for an investigation and a “full explanation” when responding to questions from MPs.

Asked about the BBC report, Foreign Office minister Mr Mitchell said: “There needs to be a full and thorough investigation and accountability for what was reported today by the BBC… the Foreign Office is pressing for full transparency and accountability in that matter.”

Mr Mitchell was responding to a question from the shadow international development secretary, Lisa Nandy, who said the BBC report raised “serious allegations”.

After being asked about the report by another Labour MP, Beth Winter, Mr Mitchell said a “full explanation… is required”.

Ms Winter had also asked: “Does the UK government believe that the Israeli government is responsible for the conduct of its forces and that this clearly appears to be torture and is in breach on international law, including the universal declaration of human rights and the Geneva Convention article 18?”

Mr Mitchell responded that “Israel must comply” with Article 18 of the Geneva Convention which states that: “Civilian hospitals organised to give care to the wounded and sick, the infirm and maternity cases, may in no circumstances be the object of attack, but shall at all times be respected and protected by the parties to the conflict.”

Mr Mitchell said there were lawyers embedded in the Israeli and the IDF command that should ensure the “acceptance and honouring of international humanitarian law is kept”.

Amnesty International UK’s Chief Executive Sacha Deshmukh said Mr Mitchell’s response was “simply not good enough”.

In a statement, Mr Deshmukh said: “Ministers are being either woefully naïve or simply disingenuous if they believe the Israeli authorities can reliably investigate themselves.”

He added: “We need major change from the UK over this terrible crisis, and this should include calling for an immediate ceasefire, exerting concerted pressure on Israel over allowing vastly scaled-up aid deliveries, while also demanding that Israel end its 17-year-long blockade of Gaza, which is an act of collective punishment.”

The report relates to an IDF raid on the Nasser hospital in the southern Gazan city of Khan Younis – which was one of the few in the Strip still functioning – on 15 February. The Israel Defense Forces (IDF) said intelligence indicated that the hospital housed Hamas operatives.

They also said Israeli hostages taken by Hamas on 7 October had been held there – and some of the hostages themselves have publicly said they were kept at Nasser. Hamas has denied that its fighters operate inside medical facilities.

Footage secretly filmed in the hospital on 16 February, the day the medics were detained, was shared with the BBC.

It shows a row of men stripped to their underwear in front of the hospital’s emergency building, kneeling with their hands behind their heads. Medical robes are lying in front of some of them.

Ahmed Abu Sabha, a doctor at the hospital, described to the BBC being held for a week in detention, where, he said, muzzled dogs were set upon him and his hand was broken by an Israeli soldier.

His account closely matches those of two other medics who wanted to remain anonymous for fear of reprisals.

The BBC supplied details of their allegations to the IDF. They did not respond directly to questions about these accounts, or deny specific claims of mistreatment. But they denied that medical staff were harmed during their operation.

They said that “any abuse of detainees is contrary to IDF orders and is therefore strictly prohibited”.

The report was raised at a briefing by the US State Department – the Washington equivalent of the Foreign Office – by a reporter from the international Reuters news agency, who asked if Dr Abu Sabha’s case had been raised with the Israeli government.

State Department spokesperson Matthew Miller was unable to confirm whether Dr Abu Sabha’s case had been raised – after earlier saying the issue of detainee conditions had been – but said “I would expect that we would”.

“It’s the type of cases that we that we often raise with them to seek more information and to make clear as we always have that any detainees should be treated in strict compliance with international humanitarian law,” he added.

The BBC investigated the hospital’s story for several weeks, speaking to doctors, nurses, pharmacists and displaced people camping in the courtyard. We have cross-checked details in these accounts.

We were given the names of 49 Nasser medical personnel said to have been detained. Of those, 26 were named by multiple sources, including medics on the ground, the Hamas-run health ministry, international groups, and the families of those missing.

The war began when Hamas gunmen attacked southern Israel on 7 October, killing about 1,200 people and seizing 253 hostages. More than 31,180 people have been killed in Gaza since then, the Hamas-run health Ministry says.

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She said “there must be an immediate ceasefire for at least the next six weeks”, which would “get the [Israeli] hostages out”.

Earlier, Israel did not attend truce talks in Egypt, saying Hamas was not giving a list of hostages still alive.

Hamas told the BBC it was unable to do so because of the Israeli bombing.

Hamas’s team and mediators from the US and Qatar are understood to be in Egypt’s capital Cairo for the planned negotiations.

Pressure for a ceasefire deal intensified after Thursday’s incident outside Gaza City in the north of the Palestinian enclave where at least 112 people were killed when crowds rushed an aid convoy and Israeli troops opened fire.

Speaking at an event in Alabama on Sunday, Ms Harris said: “What we are seeing every day in Gaza is devastating. We have seen reports of families eating leaves or animal feed, women giving birth to malnourished babies with little or no medical care, and children dying from malnutrition and dehydration.

“As I have said many times, too many innocent Palestinians have been killed.”

The vice-president stressed that “our common humanity compels us to act”, reiterating President Joe Biden’s commitment “to urgently get more life-saving assistance to innocent Palestinians in need”.

On Monday Ms Harris is due to have talks in Washington with Benny Gantz, an influential member of Israel’s war cabinet, to discuss a possible ceasefire deal and increased humanitarian aid for Gaza.

Ms Harris said “there is a deal on the table and as we have said, Hamas needs to agree to that deal. Let’s get a ceasefire. Let’s reunite the hostages with their families, and let’s provide immediate relief to the people of Gaza.”

She also said “the Israeli government must do more to significantly increase the flow of aid. No excuses.”

She was speaking in Selma, Alabama, at an event marking the 1965 attack by state troopers on civil rights demonstrators, known as Bloody Sunday.

The Israeli military launched a large-scale air and ground campaign to destroy Hamas after its gunmen killed about 1,200 people in southern Israel on 7 October and took 253 back to Gaza as hostages.

Gaza’s Hamas-run health ministry says at least 30,410 people, including 21,000 children and women, have been killed in Gaza since then, with some 7,000 missing and 71,700 injured.

A senior Hamas official, Dr Basem Naim, told the BBC’s Newshour programme on Sunday that the group was unable to provide Israel with a full list of surviving hostages. “Practically it is impossible to know who is still alive because of the Israeli bombardment and blockage. They are in different areas with different groups.

“We have asked for a ceasefire to collect that data”, he said, adding: “we cannot accept any preconditions”.

The UK, US and their Western partners consider Iranian-backed Hamas to be a terrorist organisation.

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In a statement, Mr Netanyahu cited polls showing that more than 80% of Americans support Israel during the conflict in Gaza.

His comments come after US President Joe Biden warned that Israel risks losing global support in the war.

US officials say they are working on a possible ceasefire deal.

In his statement on Tuesday, Mr Netanyahu said that, since the beginning of the conflict, he has been leading a campaign “countering international pressure to end the war ahead of time and mobilise support for Israel.”

“We have significant successes in this area,” Mr Netanyahu added, citing a recent Harvard-Harris poll showing that 82% of the American public supports Israel. “This gives us more strength to continue the campaign until complete victory.”

On Monday, Mr Biden said the US hopes to have a ceasefire between Israel and Hamas in Gaza “by next Monday.”

The US president also suggested later on that Israel could “lose support from around the world” if it “keeps up with this incredibly conservative government they have”.

Another poll, from the Associated Press and Norc, found that about half of US adults in January believed Israel had “gone too far” – up from 40% in November.

White House and State Department officials on Tuesday confirmed that negotiations on a temporary ceasefire were continuing, but declined to give details on the substance of the talks or potential timelines.

John Kirby, the White House’s National Security Council spokesperson, said that “significant progress” had been made towards a deal last week to allow hostages to leave Gaza and let humanitarian assistance in.

“We’re building on that progress this week and the president and his team remain engaged around the clock with multiple partners in the region,” Mr Kirby added.

“But as the president said just in the last 24 hours or so there’s no deal as of yet. And there’s a lot more work to do.”

The ceasefire, Mr Kirby said, would “hopefully” allow for a six-week pause, significantly longer than previous pauses in the fight.

“Maybe that could lead to something more in terms of a better approach to end the conflict,” he said.

At the State Department, spokesman Matthew Miller said that US diplomats – working with Qatar, Egypt and Israel – are “trying to push this deal over the finish line”, but that “ultimately, we would need Hamas to say yes.”

A Hamas official had earlier told BBC News the group’s priorities were on ending hostilities, rather than the release of hostages.

Israel launched a large-scale air and ground offensive in Gaza after Hamas gunmen killed about 1,200 people in southern Israel and took 253 hostages, some of whom have since been released.

The Hamas-run health ministry in the Gaza Strip says at least 29,878 people have been killed in the territory since then – including 96 deaths in the past 24 hours – in addition to 70,215 who have been wounded.

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The start of the pause will be announced in the next 24 hours – if successful it will be the first break in fighting since 7 October

On Wednesday morning, Israel confirmed its ground and air operation in Gaza is continuing, before the pause starts

Hamas says 150 Palestinian women and teenagers will be released from Israeli jails under the deal

The group adds that hundreds of lorries of humanitarian aid, medical supplies and fuel will be allowed into Gaza

Israel’s government insists that this isn’t the end of the war, reiterating its commitment to “complete the elimination of Hamas”

Israel began attacking Gaza after Hamas fighters crossed the border on 7 October, killing 1,200 people and taking about 240 others hostage

Gaza’s Hamas-run health ministry says more than 14,000 people – including more than 5,000 children – have been killed in Israel’s campaign

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At a news conference on Thursday, a former leader of a pro-Palestine campus group played a voicemail she received which included a racial slur.

The university’s Muslim Student Association said it received an email mocking dead Palestinians, as well.

The messages were reported to campus and state police and the FBI.

The University of Connecticut, also known as UConn, “unequivocally condemns Islamophobia, just as it condemns antisemitism and all forms of hatred”, a school spokesperson said.

Both Muslim and Jewish groups in the US have recorded spikes in incidents of hate and harassment since the 7 October attacks by Hamas that ignited a war where thousands have been killed.

Lena Maarouf said she graduated from UConn in 2022 but her phone number was still listed on the website for a group that she formerly led, Students for Justice in Palestine.

The man who left the voicemail message called her a “terrorist”, used a racial slur and said: “I can’t wait to see you dead.”

The call came from an Oklahoma area code, and the threatening email came from a Yahoo email domain, the students said.

“The Muslim community does not feel supported, the Palestinian community does not feel supported,” Ms Maarouf said during the news conference on the UConn campus in Storrs, Connecticut. “UConn needs to step up.”

Muslim student leaders and the state chapter of the Council on American-Islamic Relations (Cair), a Muslim civil rights group, called on the university to provide educational programmes about the conflict and about Islam, and to provide security assurances for Muslim students.

“No young person seeking an education should feel threatened because of their race, religion, background or political views,” said Farhan Memon, chairperson of Cair’s Connecticut chapter.

In a statement, UConn spokesperson Stephanie Reitz said the school recognises the concern about the messages, and that a teach-in on the conflict was held on campus last week.

“We recognize the concern generated by the messages, and we join others in condemning the hateful sentiments in the strongest terms,” Ms Reitz said.

The BBC has contacted the FBI’s Connecticut office for comment.

Connecticut Governor Ned Lamont said last week that he is organising a meeting of university security officials on dealing with hate crime on college campuses across the state.

Spike in hate

On Thursday, Cair said it received 1,283 complaints in the month after the Hamas assault on Israel on 7 October, compared to 63 reports in the month of August. The incidents included threats, use of weapons, and a knife attack outside Chicago which killed a six-year-old boy and seriously injured his mother.

Last month the Anti-Defamation League, a Jewish civil rights organisation, said that it had recorded 30 incidents of anti-Semitic harassment, vandalism and assault in the weeks after the 7 October Hamas attacks, an increase of nearly 400% over the same period last year.

Last month a student at Cornell University in New York State was arrested after allegedly posting violent threats against Jewish students.

Prosecutors say Patrick Dai, 21, made threats to bring a gun to the Cornell University campus and rape Jewish women and “behead any Jewish babies”.

National Security spokesperson John Kirby made the comments on Monday, suggesting instead “pauses” to allow aid to be delivered inside Gaza.

Currently, supplies of food, water, fuel, and medicines for Gaza’s 2.2 million residents are dangerously low.

But Israel has vowed there will be no ceasefire until Hamas is dismantled.

“Calls for a ceasefire are calls for Israel to surrender to Hamas, to surrender to terrorism… this will not happen,” Israel’s Prime Minister Benjamin Netanyahu said.

Speaking at a press briefing, Mr Kirby said he was confident more aid trucks would be able to enter Gaza via Egypt.

He said the US had spoken to the Israeli government about increasing the number of lorries crossing the border each day to around 100.

About 45 trucks had entered Gaza through Egypt’s Rafah Crossing on Sunday, Mr Kirby said. But, he conceded more would be needed.

“We know that even that, which is a dramatic improvement over where we are right now, is still not going to be enough,” he told the press briefing.

Philippe Lazzarini, the commissioner-general of UN relief agency UNRWA, previously told the BBC that about 500 trucks a day had entered Gaza before the war started.

Israel has been bombing Gaza since the 7 October Hamas attacks that killed 1,400 people in Israel and saw 229 people taken hostage by Hamas.

More than 8,300 people in Gaza have been killed since Israel’s retaliatory bombing began, according to the Hamas-run health ministry.

Yinam Cohen, Israel’s consul general to the Midwest, said on Monday that one woman held hostage by Hamas; Natalie Raanan, had returned home to Chicago.

Last week, the UN General Assembly overwhelmingly called for an immediate humanitarian truce between Israel and Hamas, which was angrily dismissed by Israel.

On Monday, Mr Lazzarini said the system to provide aid would “fail unless there is political will to make the flow of supplies meaningful, matching the unprecedented humanitarian needs”.

Israel began what Mr Netanyahu called the “second stage” of a war intended to destroy Hamas on Monday, with ground forces expanding their operations inside Gaza after three weeks of intense bombardment.

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She was happily sharing pictures of her heavily pregnant belly, waiting to put her birthing plan into action.

She knew she was going to have a girl, her husband was excited, her hospital bag was packed and her four-year-old daughter Tulin couldn’t wait to meet her baby sister.

Then everything changed.

Hamas killed more than 1,400 people in Israel and took more than 200 people hostage in an attack on 7 October. Israel launched retaliatory air strikes on Gaza which – the Hamas-run health ministry says – have killed almost 7,000 people.

“I was scared,” Jumana told the BBC. “I was in labour among continuous shelling.”

The 25-year-old freelance journalist followed Israeli orders to leave her home in the north. She left Gaza City two days after Israeli strikes began and headed south.

Afraid and nine months pregnant, Jumana took her daughter to a relative’s house. She took only a single piece of clothing, a box of milk and a small bag for her daughter.

“The situation was tough,” she explained in a voice message.

“We didn’t sleep at night. There was a lot of shelling and we had to go to another place. Pregnant women like me should be going out for walks but because of the war we are not able to go out even to buy food,” she explained in another message.

Jumana repeatedly spoke of power outages, internet interruptions and water shortages, in addition to her fear and anxiety over giving birth in such difficult circumstances.

On Friday 13 October, Jumana went into labour.

She had originally planned to go to Al-Shifa Hospital in Gaza City, which is a big hospital, but she was told it was under immense pressure. Instead, Jumana went to Al-Awda Hospital in Nuseirat, a smaller hospital in the middle of the Gaza Strip.

But even getting there was hard. In pain and in labour Jumana struggled to find someone to take her. “Taxi drivers are afraid, and ambulances don’t have time for a woman about to give birth,” she explained.

She described the hours of labour as hard and terrifying. “There was intense shelling in a house next to the hospital, the sound was so loud that I thought the shelling had reached the hospital itself. Injured people kept arriving. I could hear screams from every direction. I was also thinking about my first daughter. I was worried about her because she was far away from me.

“All I thought about was I want to deliver my baby no matter what.”

Jumana described her feeling of shock when hours later that evening, she gave birth to a baby girl, who she decided to name Talia.

“Her crying meant we were all still alive,” she recalls.

There was no bed available for Jumana immediately after childbirth. In pain and bleeding, she had to wait until a bed was found and squeezed into a small room.

“I was lucky to have one, other women lay on couches and on the floor in the hospital corridor immediately after giving birth,” she says.

The United Nations Population Fund (UNFPA) estimates that there are about 50,000 pregnant women in Gaza with 5,500 of them expected to give birth in the next 30 days. It says hospitals are overwhelmed and are running out of medicine and basic supplies.

The day after she gave birth, Jumana sent a video of herself holding her baby daughter in a taxi, wrapped in a white blanket.

She had left the hospital to join her family but says even that was an ordeal.

“The lift stopped working due to a power issue,” she says. So Jumana, on the fourth floor of the hospital, in pain after giving birth and with her newborn in her arms, had to walk down several flights of stairs to get to the exit.

Once out of the hospital, she was faced with trying to get transport back to the place where she was staying.

“We spent an hour looking for a taxi, and none of the drivers agreed to take us. They were scared after a nearby shelling in the morning. In the end, we found one, but he asked for a higher fare and didn’t drop us off in front of the house.”

Jumana says childbirth in such hard circumstances has taken its toll. “I am worn out mentally. I no longer have the desire to do anything,” she admits.

But she tells me Baby Talia is doing well: “She is a mix of my features, her sister’s and her father’s.

“If it wasn’t for the war, I would have wanted to celebrate a beautiful event one week after the birth. I would have invited all my family members and held an Aqiqah [a traditional Islamic celebration] for her,” Jumana trails off.

She says she does not know what the future holds for her family but is grateful for their new arrival saying: “She is my hope in this life of war and death.”

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