November 20, 2023 Israel-Hamas war

By Tara Subramaniam, Jack Guy, Ed Upright, Mike Hayes, Maureen Chowdhury and Amir Vera, CNN

Updated 12:09 a.m. ET, November 21, 2023
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5:54 p.m. ET, November 20, 2023

Hamas is using bunkers built by Israel under Al-Shifa Hospital, former Israeli prime minister says  

From CNN’s Eve Brennan, Andrew Carey and the Amanpour team

Ehud Barak speaks at a campaign event in Kibutz Ein Shemer, Northern Israel, on July 19, 2019.
Ehud Barak speaks at a campaign event in Kibutz Ein Shemer, Northern Israel, on July 19, 2019. Gili Yaari/NurPhoto/Getty Images

Former Prime Minister Ehud Barak said Monday that Israel had built bunkers "decades ago" underneath Al-Shifa Hospital in Gaza City. 

“It’s already [been] known for many years that they have the bunkers that originally [were] built by Israeli constructors underneath Shifa [which] were used as a command post of Hamas. And, a kind of junction of several tunnels are part of this system,” he told CNN’s Christiane Amanpour in an interview.  

“It's probably not the only kind of command post, several others are under other hospitals or in other sensitive places, but it for sure had been used by Hamas even during this conflict,” he added.  

Israel captured Gaza from Egypt in 1967 and held the territory under full military occupation until 2005 when it withdrew its settlers and soldiers in a move known as the ‘disengagement.’ Hamas assumed full control inside the enclave two years later. 

“It was probably five or four decades ago that we helped (the Palestinians) to build these bunkers in order to enable more space for the operation of the hospital within the very limited size of this compound,” Baruk said. 

Some context: Ahead of raiding the hospital complex last week, Israel claimed that it was being used by Hamas as a command center.

The Israel Defense Forces on Saturday showed CNN what it said was “concrete evidence” that Hamas was using the complex above ground as cover for what it called terror infrastructure underneath, including a command and control hub.

The military showed what a commander described as a big tunnel. “This is a big tunnel,” he said. “I have encountered tunnels — in 2014 in [Operation] Protective Edge, I was a company commander — and this tunnel is an order of magnitude bigger than a standard tunnel.”

Read more about the tunnel shaft

3:39 p.m. ET, November 20, 2023

US "would welcome China playing a constructive role in the Middle East," State Department says

From CNN’s Jenny Hansler 

The United States “would welcome China playing a constructive role in the Middle East,” State Department spokesperson Matt Miller said Monday after the Chinese Foreign Minister convened Arab counterparts in Beijing.

Speaking at a briefing, Miller noted that Secretary of State Antony Blinken had “made this clear personally” in conversations with Chinese Foreign Minister Wang Yi. 

Still, Miller stressed that “one of the things that we heard repeatedly from every party with which we engaged on our last trip is the indispensability of the United States in every aspect of this conflict, whether it comes to getting humanitarian assistance and whether it comes to preventing the conflict from widening.”

He noted that it was the US that was able to negotiate an agreement to begin delivering humanitarian assistance to Gaza after October 7, “the United States that was able to push forward and achieve humanitarian pauses” to allow civilians to move about Gaza, and the US that is “the largest humanitarian donor to the Palestinian people.”

On Monday, Wang met counterparts from Saudi Arabia, Jordan, Egypt, the Palestinian National Authority and Indonesia, as well as the head of the Organization of Islamic Cooperation, in Beijing for talks on “de-escalating” the Israel-Hamas conflict.

4:19 p.m. ET, November 20, 2023

Negotiations "getting close to the end" on release of hostages held by Hamas, White House says

From CNN's Samantha Waldenberg

People look at pictures of Israeli hostages in Tel Aviv, on November 11.
People look at pictures of Israeli hostages in Tel Aviv, on November 11. Ahmad Gharabli/AFP/Getty Images

National Security Council spokesperson John Kirby said Monday that negotiators are “getting close to the end” on the release of hostages held by Hamas – but he declined to elaborate on the details of a potential deal.

He also declined to comment on CCTV footage that Israel said shows two hostages being moved through Al-Shifa Hospital in Gaza on October 7. 

“I know that everybody's interested in the numbers and who they're going to be. We're working that through literally in real time with both sides. So, I think it's better if I just don't speculate about what that pool is going to look like. Obviously, we are laser focused on the American citizens that we know are being held hostage and we want them out, all of them, everybody should be out now,” Kirby said, when asked by CNN’s MJ Lee asked if any of those that might be released would be American citizens. 

When asked what level of confidence the White House has that the American hostages are alive, Kirby responded, in part, saying in part: “I would say we have no indication otherwise.”


3:38 p.m. ET, November 20, 2023

28 premature babies moved from Gaza to Egypt, World Health Organization says

From CNN’s Shirin Zia Faqiri in Atlanta

Palestinians queue as they wait to buy bread from a bakery amid food shortages in Khan Younis on November 17.
Palestinians queue as they wait to buy bread from a bakery amid food shortages in Khan Younis on November 17. Ibraheem Abu Mustafa/Reuters

The World Health Organization (WHO) said 28 out of 33 premature babies have been evacuated into Egypt from Gaza.

WHO’s Senior Emergency Officer Rob Holden said two of the 33 neonatal babies died over the weekend, and three other babies were reunited with their families.

The remaining 28 babies were evacuated into Egypt where an “appropriate level of care was initiated,” Holden said during a United Nations briefing on Monday.

Looking ahead, Dr. Michael Ryan, the WHO’s executive director, said that more than 5,000 women will be giving birth in the next month in Gaza. Of those, 15% will need a cesarean section and 25% of their children will be born preterm, he said.

“That’s thousands of babies. That’s not 31 … that is literally thousands of babies will be born. Who will be preterm and who’ll need those incubators, will need that kangaroo care, will need their mother with them to provide that. Some will need incubation, some will need mechanical ventilation,” Ryan said. 

The WHO recommends that skin-to-skin contact, known as kangaroo mother care, be provided to a preterm infant immediately after birth, without any initial time spent in an incubator.

Ryan also said that a combination of large crowds gathered in one place combined with decreasing temperatures in Gaza is “a public health risk,” and could result in an “epidemic.” 

“We're seeing large numbers of people packed into refuges, packed into (United Nations Relief and Works Agency) UNWRA schools, packed into various other kinds of centers. This is creating a concentration of people, which is driving epidemic risks and the rains over the last 24 hours have really added to that,” Ryan said.

He noted that the risks aren't limited to diarrhea or disease. "The sudden drop in temperature is going to create a problem with pneumonia in children…This is an absolute recipe for a large-scale epidemic amongst this population.” 

The “heavy rain” over the past 24 hours has “flooded a lot of makeshift camps,” accelerating those risks, he said.

Ryan added that "nutrition is the baseline for health, nutrition is the baseline for child development, and right now the caloric intake of the quality of that for children particularly has reduced below a critical level.”

4:55 p.m. ET, November 20, 2023

"We must get answers," families of Israeli hostages say ahead of meeting with Netanyahu

 From Tamar Michaelis in Tel Aviv and Sugam Pokharel in London 

Family members of some of the Israeli hostages taken by Hamas say they want answers ahead of their Monday meeting with Israeli Prime Minister Benjamin Netanyahu and his war cabinet. 

“I demand their commitment that everyone is returning home. All the hostages. We must get answers, and a commitment,” Shai Wenkert, who son is held hostage by Hamas, said.  “I would like to receive (the commitment) in a written form,” he added. 

The families came to meet the prime minister and the war cabinet to “receive answers,” Meirav Leshem Gonen, whose daughter is held hostage by Hamas, said. 

“We have very concrete questions that we expect them to answer. Every deal or any stage in this path ... doesn’t excuse anyone from their responsibility to return all the hostages home,” she continued. 

Meanwhile, the United States and Qatar have given upbeat assessments on the negotiations surrounding hostages held by Hamas. A deal freeing dozens of civilians could be reached within days, sources told CNN.

1:10 p.m. ET, November 20, 2023

German president will visit Israel for talks with Israeli counterpart next week

From CNN’s Inke Kappeler in Berlin 

German President Frank-Walter Steinmeier will travel to Israel on November 26 and 27 to hold “political talks” with his Israeli counterpart Isaac Herzog, according to a statement from the president’s office.   

During his visit, Steinmeier is also planning to hold meetings in southern Israel and east Jerusalem. 

The president will then travel Oman and Qatar, the statement said.

12:48 p.m. ET, November 20, 2023

Here's what we know about what Israel says it has found at Al-Shifa Hospital

From CNN's Sophie Tanno, Hamdi Alkhshali and Oren Liebermann

The exterior of Al-Shifa hospital is seen Gaza City on November 10.
The exterior of Al-Shifa hospital is seen Gaza City on November 10. Stringer/AFP/Getty Images

Gaza’s largest hospital, Al-Shifa, has become a flashpoint in Israel’s war against Hamas, which began when gunmen from the militant group crossed the border into Israel on October 7, killing around 1,200 people.

Palestinians and humanitarian agencies say the current fighting in and around Al-Shifa is proof of Israel’s wanton disregard for civilian life in Gaza, while Israel accuses Hamas of using the medical center as a shield for its operations. On top of providing medical care, the Al-Shifa Hospital had recently become a key shelter for thousands of Palestinian civilians fleeing Israeli bombardment.

Since launching its operation at the hospital on November 15, the Israel Defense Forces (IDF) have shown images of a tunnel shaft and military equipment, but have yet to show conclusive proof of the large-scale command and control center it alleges is there.

Hamas, the Gaza Health Ministry and hospital officials have denied Israel’s claims, saying that hospitals in the Strip have only been used to treat patients. Doctors in Al-Shifa have also sounded the alarm about deteriorating conditions inside the medical facility, which is struggling to meet patients’ needs amid supply shortages and the presence of Israeli troops.

The IDF is now under pressure to prove Israel’s long-standing assertion with its promise of “concrete evidence.” Its ability to continue its operation in Gaza, and the credibility of Israel, could be at stake as the number killed in Gaza surpasses 12,000, according to authorities in the Hamas-controlled Strip.

Here’s what we know so far:

  • What does Israel say: For weeks, the IDF said Hamas has been using Gaza’s largest hospital as cover for what it calls terror infrastructure below ground. IDF spokesperson Rear Admiral Daniel Hagari said Hamas had a command and control center or headquarters underneath the hospital complex grounds, which other senior Israeli officials have also insisted on.
  • What evidence has Israel provided: Over the weekend, the IDF took CNN and other news organizations to a newly exposed tunnel shaft on the grounds of the Al-Shifa hospital complex that it says was used by Hamas. The structure appeared to be substantial, with the remains of a ladder hanging over the opening and a pole that looked like a hub for a spiral staircase running through the middle of the shaft.
  • The IDF also released a video: Filmed on Friday from inside the shaft, the video shows a staircase leading down into a concrete tunnel that the military said was 55 meters long and located 10 meters underground. At the end of the tunnel is a metal door with a small window, according to the video, which the IDF said it had not yet opened to the possibility that Hamas had booby-trapped it.
  • How has Hamas responded: Israel’s allegations have been vehemently denied by Hamas, the Gaza Health Ministry, and hospital officials. The director general of the Hamas-controlled health ministry, Dr. Medhat Abbas, told CNN that hospitals in the enclave “are used to treat patients only” and are not being used “to hide anyone.”

Read more about what Israel found at Gaza's largest hospital, Al-Shifa.

4:56 p.m. ET, November 20, 2023

Israel and Hezbollah continue to exchange fire across Lebanon-Israel border

From CNN’s Sarah Sirgany and Ben Wedeman in Beirut and Amir Tal in Jerusalem and Tamar Michaelis in Tel Aviv

The Israel Defense Forces (IDF) and Hezbollah say they exchanged more fire across the Israel-Lebanon border on Monday, including Hezbollah's use of powerful Borkan missiles against Israel.

Lebanon’s National News Agency (NNA) said there have been 10 Hezbollah strikes on Israeli positions since midnight local time, and Israel carried out 15 individual strikes, including artillery, drone and helicopters in south Lebanon on Hezbollah targets. NNA said among the strikes, two were in the eastern sector of south Lebanon, an Israeli drone strike on a house in Al-Khiyam and Israeli artillery shelling on Mays Al-Jabal.

Neither NNA nor the IDF said if there were any casualties during these cross-border attacks.

Hezbollah fired four Borkan missiles at the Braneit barracks Monday morning, saying it is the command center of the IDF’s 91st Division. In his last speech, Hezbollah’s leader Hassan Nasrallah said the Borkan missile carries between 300 to 500 kilograms (about 661 to 1,102 pounds) of explosives.

In addition, Hezbollah said it used three attack drones and artillery to target a gathering of Israeli soldiers west of Kiryat Shmona. The group also said it fired rockets and artillery to target Israeli military infantry in Mothalath al-Tayhat, and that it attacked several Israeli military posts in the eastern, central and western sectors of the border.

In a statement released on Monday, the IDF said, “a terrorist cell attempted to launch anti-tank missiles in the area of Marwahin in Lebanon. The IDF struck the cell. Additionally, in response to the launches toward Israeli territory earlier today, IDF tanks, a fighter jet, and a helicopter struck Hezbollah terror infrastructure in Lebanon.”

The IDF added, “25 launches were identified from Lebanon toward several locations adjacent to the border. The IDF Aerial Defense Array intercepted a number of the launches and the rest fell in open areas. Moreover, three UAVs were identified striking adjacent to an IDF post. No injuries were reported.”

The IDF said it struck the sources of the Hezbollah launches.

Some background: The first cross-border strikes between Hezbollah and Israel were carried out by Hezbollah on October 8. Strikes, and counter strikes, have continued daily since then. 

11:47 a.m. ET, November 20, 2023

World Health Organization "appalled" by attack on Indonesia Hospital in Gaza, director-general says

The head of the World Health Organization has condemned the attack on the Indonesian Hospital in Gaza which killed 12 people, including patients. 

In a post on X, Director-General of the WHO, Tedros Adhanom Ghebreyesus said, "WHO is appalled by an attack on the Indonesian Hospital in #Gaza."

"Health workers and civilians should never have to be exposed to such horror, and especially when inside a hospital," he added.

Israel said on Monday it was responding to enemy fire targeting their troops from within the hospital and that, "in response, IDF troops directly targeted the specific source of enemy fire. No shells were fired toward the hospital."

Twelve people died after Israeli tank fire hit the Indonesian Hospital in northern Gaza, health authorities in the Hamas-run strip said earlier on Monday. Among the dead are patients who were being treated at the hospital and a member of medical staff, health officials said.