US, Qatari and Egyptian mediators have been engaged in weeks of behind-the-scenes talks in efforts to secure a second truce in the war between Israel and Hamas and the release of captives in exchange for Palestinian prisoners being held in Israeli jails.

Israel had said on Friday that the head of its spy agency was to return to Doha for his second trip in a week after talks were restarted following failed efforts to secure a truce before the Muslim holy month of Ramadan, which began last week.

The war began when Hamas launched an unprecedented attack from Gaza in October that left about 1,160 dead in Israel, mostly civilians, according to an AFP tally of official figures.

Israel’s military has waged a retaliatory offensive against Hamas that has killed 32,226 people, most of them women and children, according to Gaza’s health ministry.

Palestinian militants seized about 250 Israeli and foreign hostages during the October 7 attack on Israel, but dozens were released during a week-long truce in November.

Israel believes about 130 remain in Gaza, including 33 who are presumed dead – eight soldiers and 25 civilians.

Meanwhile, Palestinians who fled during an ongoing Israeli raid in and around the Gaza Strip’s main hospital have described days of heavy fighting, mass arrests, forced marches past dead bodies and flattened buildings.

The Israeli military says it has killed over 170 militants and detained some 480 suspects in the raid on Shifa Hospital that began on March 18, portraying it as a heavy blow to Hamas and other armed groups that it says had regrouped in the medical compound.

But the heavy fighting has also highlighted the resilience of Palestinian armed groups in an isolated and heavily destroyed part of Gaza where troops have been forced to return after launching a similar raid back in November.

Canada confirms it will halt arms shipments to Israel, amid Gaza scrutiny

Kareem Ayman Hathat, who lived with his parents and two brothers in a five-storey building about 100 metres from the hospital, said they huddled in the kitchen for days while gunfire and explosions echoed outside, sometimes causing the whole building to shake.

On Saturday, Israeli troops stormed the building and forced them and dozens of other residents to leave. He says the men were forced to strip to their underwear and four were detained. The rest were blindfolded and ordered to follow a tank south, as more blasts thundered around them.

“From time to time, the tank would fire a shell,” he told Associated Press in an interview from another hospital in central Gaza, where he has sought shelter. “It was to terrorise us.”

The head of Israel’s southern command, Major General Yaron Finkelman, said the Shifa raid had been a “daring, tricky and most impressive operation so far”, with “hundreds” of militants apprehend and the acquisition of valuable intelligence.

“We will finish this operation only when the last terrorist is in our hands – alive or dead,” he added in a statement released by the military on Saturday.

Shifa Hospital had largely stopped functioning following the raid in November. After claiming that Hamas maintained an elaborate command centre inside and beneath the hospital, Israeli forces exposed a single tunnel leading to a few underground rooms. They also said they found weapons in parts of the hospital.

Gaza City, where Shifa is located, suffered widespread devastation in the early days of Israel’s offensive. Israeli forces have isolated the city and the rest of northern Gaza since November, and hardly any aid has been delivered in recent weeks.

Experts said last week that famine is imminent in northern Gaza, where over 210,000 people are suffering from catastrophic hunger.

Additional reporting by Associated Press