As Israeli troops pushed into Gaza overnight, intense tank fire shook parts of Khan Yunis, sending a flood of patients into the southern city's Nasser hospital.The shells smashed into buildings near the border with Israel, prompting thousands to flee their homes under the cover of darkness, only missiles lighting up the sky.
At Nasser hospital, doctors and nurses working 24-hour shifts were on alert for the wave of patients who began arriving in the early hours.
"The situation is very, very difficult," said doctor Kamel Zaqzuq.
"This is much, much more difficult than the last war," he said, referring to the previous major conflict between Israel and Hamas militants in November 2012.
"At night, it's one constant emergency."