Al Ahli Arab Hospital, a ministry of the Episcopal Diocese of Jerusalem that serves patients in Gaza, was hit Oct. 17 by an apparent airstrike, adding to an already volatile situation in the Palestinian territory as Israeli soldiers prepare for an expected ground assault on the militant group Hamas.

The Palestinian Health Ministry put the initial death toll at 500 or more people, though it wasn’t clear how it reached that estimate. The ministry is run by Hamas, which has controlled the territory since 2007.

Diana Branton, a spokeswoman for the United States-based American Friends of the Episcopal Diocese of Jerusalem, or AFEDJ, told Episcopal News Service that the hospital’s courtyard was hit, but little other information was immediately available. “We have confirmation that Ahli was struck. We do not have a confirmation of actual casualty counts,” Branton said. The hospital’s courtyard “is where many of the [Palestinian] refugees were staying.”

Israeli airstrikes have been a regular threat in the Palestinian territory since Oct. 7 in response to a surprise attack by Hamas, in which gunmen massacred hundreds of Israelis in a coordinated land, sea and air attack on Israeli soil. Hamas also has fired its own rockets into Israel.

The Ahli hospital is one of 22 hospitals in the northern region of Gaza struggling to remain open to treat patients after Israel tightened its blockade of the territory, ordered an evacuation to the southern end of the Gaza Strip and deployed soldiers to Gaza’s northern border. Gaza, with about 2.3 million people confined to about 140 square miles, is one of the most densely populated places in the world, and many of its residents had been sheltering around the hospitals seeking safety from Israeli airstrikes.

Al Ahli Arab Hospital has been ministering as a Christian witness in Gaza City since 1882. The institution was founded by the Church of England’s Church Mission Society and was later run as a medical mission by the Southern Baptist Conference from 1954 to 1982. It then returned to the Anglican Church. Photo: Mary Frances Schjonberg/Episcopal News Service

Photos of the Ahli hospital on Oct. 17 showed its facilities engulfed in flames and scattered with broken glass and body parts, according to an Associated Press report. It quoted an Israeli military spokesman who had only preliminary information. “We will get the details and update the public,” Rear Adm. Daniel Hagari said. “I don’t know to say whether it was an Israeli airstrike.”

The New York Times later quoted an Israeli military statement that blamed the airstrike on an errant rocket fired by Islamic Jihad, a Hamas ally, not an Israeli rocket.

The initial Oct. 7 attack by Hamas and subsequent airstrikes by the militant group and the Israeli military reportedly have killed thousands of Israelis and Palestinians so far. The damage to the Ahli hospital occurred on a global day of prayer and fasting that was called by the heads of the 13 Christian denominations in the Holy Land, including the Anglican province that includes the Diocese of Jerusalem.

Episcopal leaders also are encouraging Episcopalians to donate to American Friends of the Episcopal Diocese of Jerusalem, which supports the Ahli hospital.

The Ahli hospital sustained damages from a previous strike, which hit its cancer unit. Four staff members were injured in the Oct. 14 strike, which damaged two upper floors, according to AFEDJ. An earlier strike destroyed the house of the hospital’s medical director.