Israeli tanks continue to advance amid a systematic destruction of Gaza City from land, air and sea, but for doctors at the major urban centre’s al-Shifa Hospital, leaving patients is not an option.

The hospital was once the largest medical complex in the Gaza Strip, but most of it now lies in ruins after several rounds of intense Israeli ground and air sieges since the start of the war in October 2023. Palestinians still view it as a symbol of strength and resilience.

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What remains of the building of a former clinic has now been turned into an emergency ward that is forced to treat an overwhelming number of Palestinians wounded by Israel. Part of the bombed surgery department has been transformed into intensive care for bedridden patients.

Many displaced Palestinians are also surviving famine and Israeli attacks in the area of the hospital.

A volunteer Australian doctor currently working at the embattled Gaza City hospital said the medical staff are operating in horrible conditions.

“The amount of resilience I saw in these doctors, they’re literally heroes,” she told Al Jazeera, adding that doctors, nurses and medical students are living and working at the hospital.

“We’ve been here only for two weeks, and we just cannot understand the amount of trauma and hard work. I don’t think any human being can stay alive and tolerate what we’re going through.”

The director of the hospital, Dr Muhammad Abu Salmiya, is trying to lead by example despite the horrifying conditions.

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He spent more than seven months in Israeli prison after being arrested based on unproven claims that Hamas was using al-Shifa as a base for “terrorism”. He recounted torture and humiliation in Israeli military detention after being released without any formal charges levelled against him.

On Saturday, an Israeli air attack on his family home killed at least five people. Abu Salmiya saw the bodies of his brother, his sister-in-law and the couple’s children at al-Shifa.

“Our medical crews are still carrying out their humanitarian mission in this hospital complex under heavy pressure,” Abu Salmiya told Al Jazeera’s Ibrahim al-Khalili in Gaza City.

“Their message continues: We serve patients and the injured to the best of our abilities.”

Al-Shifa is just one of the many medical facilities that suffered near-total destruction at the hands of Israeli forces in Gaza, who have reduced most of the infrastructure in the besieged enclave to rubble.

Dr Ahmed al-Farra, director of paediatrics at Nasser Hospital in southern Gaza’s Khan Younis, said he feels for all medical teams across the enclave who are facing the same terrible conditions.

“Since the beginning of this war, [Israel] has been attacking and targeting medical teams, even by putting them in jail and targeting their families,” he told Al Jazeera, adding that a record number of healthcare workers and first responders have been killed.

“If you are in Gaza, you are being killed in every possible way.”