Israel’s military has claimed Hamas operates at al-Shifa, which the armed group and hospital officials have denied.

Israel’s military struck a yard at the al-Shifa Hospital complex, where thousands of displaced Palestinians are sheltering, Health Ministry spokesperson Ashraf al-Qudra said on Friday.

“Israel is now undertaking these dangerous steps against the hospitals to put them completely out of commission and subsequently displace the people sheltering in them, as well as the patients and medics,” al-Qudra told Al Jazeera.

Israel’s military has said that Hamas operates a command centre at the site of the hospital, including entrances to its extensive tunnel network, which Hamas and hospital officials have denied.

Israeli officials did not immediately comment on reports of the latest strikes.

Mohammad Abu Salmiya, director general of al-Shifa Hospital, said the strike hit civilians located next to a number of journalists in the yard, wounding four, including two critically.

“This led to a lot of casualties, including critical injuries. It could have been a massacre in this place because of the number of people in this complex,” Abu Salmiya told Al Jazeera.

“Before that, they bombed a building very close to the hospital. And now, there are heavy clashes and heavy bombing next to the hospital.”

Abu Salmiya said that medics and patients were in a state of fear due to near-constant explosions near the facility.

“Not a second goes by without bombing close to the hospital. Many of the hospital’s windows have been broken, and there is fear and anxiety amongst the medics and the patients and the displaced people,” he said.

“This is a war against the hospitals and a war against all the [Palestinian] citizens.”

Video of the apparent aftermath of the attack showed several people screaming and scrambling for cover, and an injured man lying on the pavement in a pool of blood.

Al-Qudra said that two children’s hospitals, Al-Rantisi and Al-Nasr, had also been hit by “direct attacks and bombardments” on Friday.

Omar Shakir, Human Rights Watch’s Israel and Palestine director, said on social media that medical facilities must be protected and that “no area is a free-fire zone”.

The attack on al-Shifa is the latest in a series of reported strikes on or near the Gaza City hospital in recent days.

Last week, Israel’s military bombed an ambulance outside the hospital, killing 15 people, according to Palestinian officials.

On Monday, Al Jazeera and Palestinian media reported that Israeli forces had struck solar panels providing electricity to the medical complex, prompting denials by Israeli officials.

Israeli military officials have released pictures, illustrated maps and audio recordings that they say show that Hamas is using the facility to plan operations and hide its fighters.

“Hamas terrorists operate inside and under [al-Shifa] Hospital and other hospitals in Gaza,” spokesperson Rear Admiral Daniel Hagari said last month.

Hamas, health authorities and al-Shifa Hospital officials have denied that the armed group is hiding in or under the complex.

Israel’s military has repeatedly ordered the hospital to evacuate in recent weeks, drawing condemnation from humanitarian groups that say medical facilities must be spared from fighting.