Doctors at one of Gaza City's last functioning hospitals say they are overwhelmed with casualties from Israeli strikes and are having to carry out operations in filthy conditions with few or no anaesthetics.
One Australian medic volunteering at al-Shifa hospital told the BBC that every day was a mass casualty event, while another described how a baby had been saved from the body of a pregnant woman who had been killed.
Israeli forces are now just 500m (1,640ft) away from the hospital as they expand their ground offensive to fully occupy Gaza City, which Israel's military calls Hamas's main stronghold.
Witnesses say tanks are advancing into the city centre from the south and north-west.
Israeli air and artillery strikes, attacks by quadcopter drones and detonations of remotely driven vehicles laden with explosives continue to drive tens of thousands of Palestinians from their homes each day.
The Israeli military says it is carrying out the offensive in Gaza City to defeat Hamas and secure the release of the hostages still held by the group after 23 months of war.
Warning: Contains graphic descriptions of injuries
Al-Shifa hospital was once the biggest medical complex in the Gaza Strip. It now lies in ruins, pockmarked by craters, with burned-out wards and bullet holes.
But inside medics are working beyond full stretch. Many of the beds do not even have mattresses, medicines are in short supply and the casualties are endless.
It's just a mass murder, a killing, a torture, a nightmare, Dr Nada Abu Alrub, an emergency specialist from Australia volunteering at the hospital, told the BBC in a video call on Tuesday.
She said they were operating on severely wounded patients with minimal to hardly no anaesthesia.
Last week, she said, doctors had to conduct an emergency Caesarean on a nine-month pregnant woman whose head had been blown off. They managed to save her daughter.
Dr Saya Aziz, an Australian anaesthetist, described how a six-year-old boy with a fractured arm and leg had been waiting for three days for an operation.
Every couple of hours there are multiple amputation cases with massive resuscitation. It's life or limb, literally, she told the BBC.
Outside the hospital, Israel's tanks are advancing, as the ground offensive against Hamas in Gaza City continues.
Around one million Palestinians were estimated to be living in Gaza City before Israel announced its plans for the offensive last month. The UN says more than 320,000 have fled southwards since then.
However, witnesses say the coastal al-Rashid road is severely congested and that families are struggling for hours to complete the journey.
Many remain trapped and unable to flee even as the fighting inches closer, fearful of the consequences of remaining or attempting to escape.
