Israeli forces fought Hamas militants among ruined buildings in the north of the Gaza Strip yesterday, inching their way closer to two big hospitals as the plight of civilians in the besieged Palestinian territory worsened.

Residents in Gaza City, a Hamas stronghold, said Israeli tanks were stationed around the area. Both sides reported inflicting heavy casualties on one another in intense street battles. Israel, which has vowed to wipe out Hamas, says 33 of its soldiers have been killed in its ground operation as they advanced into the heart of Gaza City.

Israeli troops had secured a Hamas military stronghold called Compound 17 in Jabalya in northern Gaza after 10 hours of combat with Hamas and Islamic Jihad militants above and below the ground, the Israeli military said on Wednesday.

It said troops killed dozens of militants, seized weapons, exposed tunnel shafts and discovered a Hamas weapons manufacturing site in a residential building in the Sheikh Radwan neighbourhood. Israeli military footage showed soldiers walking through rubble into a building where one wall had been blasted away, finding weapons-manufacturing equipment, instruction manuals and a tunnel shaft.

A conference in Paris, attended by Arab nations, Western powers, G20 members and NGO groups such as Doctors Without Borders, discussed measures to alleviate the suffering in Gaza but without a pause in the fighting expectations are low.

President Emmanuel Macron, as he opened the conference, called for a humanitarian pause. “The situation is serious and getting worse each day.”

Palestinian Prime Minister Mohammad Shtayyeh, whose Palestinian Authority has limited self-rule in the Israeli-occupied West Bank but was driven out of Gaza by Hamas in 2007, was present at the conference. Israel was not invited. “How many Palestinians must be killed for the war to stop,” Shtayyeh asked. “Is killing 10,000 people in 30 days enough?”

Palestinians should govern Gaza once Israel ends its war against Hamas, the United States said on Wednesday, pushing back against Prime Minister Benjamin Netanyahu’s idea that Israel would be responsible for security indefinitely.

While a plan has yet to emerge, U.S. Secretary of State Antony Blinken on Wednesday outlined in the most comprehensive comments on the issue to date Washington’s red lines and expectations for the besieged coastal territory.

“No reoccupation of Gaza after the conflict ends. No attempt to blockade or besiege Gaza. No reduction in the territory of Gaza,” Blinken said at a press conference in Tokyo.

Blinken said there may be a need for “some transition period” at the end of the conflict, but that post-crisis governance in Gaza must include Palestinian voices.

“It must include Palestinian-led governance and Gaza unified with the West Bank under the Palestinian Authority.”

On Monday, Netanyahu told ABC News that Israel will “for an indefinite period” have security responsibility of the enclave after the war. His comments appeared at odds with U.S. officials who say Israel does not want to administer Gaza post-Hamas.

“I think Israel will, for an indefinite period, will have the overall security responsibility because we’ve seen what happens when we don’t have that security responsibility,” Netanyahu said.

Israeli officials have since tried to clarify they do not intend to occupy Gaza after the war, but they have yet to articulate how they might ensure security without maintaining a military presence. Israel withdrew its forces from Gaza in 2005.

The Palestinian Authority (PA), which exercises limited self-rule in parts of the Israeli-occupied West Bank, says Gaza, where Hamas has ruled since 2007, is an integral part of what it envisions for a future Palestinian state.

But top officials including Palestinian Authority President Mahmoud Abbas say a PA return to Gaza must be accompanied by a political solution that ends Israel’s occupation of territory it captured in the 1967 Middle East war.

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“(We) are not going to go to Gaza on an Israeli military tank,” PA Prime Minister Mohammad Shtayyeh told PBS this week. “We are going to go to Gaza as part of a solution that deals with the question of Palestine, that deals with occupation.”

Hamas took over Gaza after a brief civil war in 2007 with Abbas’ Fatah party. Years of reconciliation talks between the rivals failed to reach a breakthrough for resuming PA administration of Gaza. The PA still pays for electricity, water and some civil servant salaries in Gaza.

Since Oct. 7, more than 10,000 Palestinians have been killed in a relentless bombardment of the Gaza Strip, home to 2.3 million by Israeli forces, say Palestinian health officials in Gaza. About 40% of those killed are children, they say.

Arab states, which provide the PA with financial aid, have advocated for an immediate ceasefire but have shown reluctance to discuss a post-war status for Gaza. They say the focus should remain on stopping hostilities.

But Blinken said the conversation about the future should take place now. “Because identifying the longer-term objectives and a pathway to get there will help shape our approach to addressing immediate needs,” he said.

Since conflict broke out, the Biden administration has reasserted its support for a solution based on Israeli and Palestinian states side by side but has yet to outline a path to reviving long-stalled peace talks, the last round of which broke down in 2014.

United Nations Secretary-General Antonio Guterres on Wednesday said “best-case scenario” would be a “hopefully re-invigorated” Palestinian Authority assuming some political control over Gaza.

White House spokesperson John Kirby said Washington and its partners were still discussing what a Gaza governance structure might look like. “We believe that the Palestinians should be in charge of their future and they should be the determining voice and factor in their future,” he said.

In another development, a defective drone in Iraq may have helped keep America from being dragged deeper into a widening Middle East conflict.

The drone, which was launched at the Erbil air base by an Iranian-backed militia before sunrise on Oct. 26, penetrated U.S. air defenses and crashed into the second floor of the barracks housing American troops at about 5 a.m, according to two U.S. officials familiar with the matter.

But the device laden with explosives failed to detonate and in the end only one service member suffered a concussion from the impact, said the officials, who asked to remain anonymous to speak freely about the attack. The U.S. had got lucky, they added, as the drone could have caused carnage had it exploded.

The incident was among at least 40 separate drone and rocket attacks that have been launched at U.S. forces by Iranian-backed militias in Iraq and Syria over the past three weeks in response to American support for Israel in the Gaza war, according to Pentagon data and the two U.S. officials.

The bombardment has only caused a few dozen minor injuries so far, with many of the rockets and one-way attack drones intercepted by U.S. air defenses in Iraq and Syria, where a total of 3,400 American troops are based.

David Schenker, a former U.S. assistant secretary of state at the Washington Institute for Near East Policy think-tank, cautioned that while neither Iran and its allied groups nor the U.S. appeared to want a direct confrontation, the risks were growing. The possibility of a major strike that draws America into a conflict is “a very realistic concern,” he said.

“I think they are calibrating the attacks to harass rather than kill en masse U.S. troops,” he said of Iraqi and Syrian militias. “But there’s a lot more they can do.”

It’s unclear how President Joe Biden would respond to a major attack that kills a large number of Americans. Struggling in opinion polls ahead of next year’s presidential election, Biden has so far sought to limit the U.S. role in the conflict mostly to ensuring military aid to Israel.