At least six health workers have been killed in Israeli attacks in southern Lebanon as Israel has bombarded areas around the ancient eastern Lebanese city of Baalbek for a second day after issuing forced evacuation orders.

“Enemy aircraft launched four strikes on the village of Douris and the surroundings of the city of Baalbek,” Lebanon’s National News Agency (NNA) reported on Thursday.

Lebanon’s Ministry of Health said the six medics were killed and four others were wounded in multiple Israeli attacks. It said Israeli forces hit a gathering point for civil defence workers, killing four medics. Two other medics were killed in two more separate incidents.

There was another attack in the town of Salaa, which destroyed an ambulance, but the paramedic operating it “miraculously survived”, it said.

A view shows a site damaged in the aftermath of Israeli strikes on Hadath Baalbek [Mohamed Azakir/Reuters]

“The international community’s silence regarding this brutality is unjustified at a time when voices must be raised to restore humanitarian laws and put an end to the machine of brutality that continues to kill front-line personnel,” the ministry said in a statement carried by the NNA.

The number of paramedics killed since the beginning of Israel’s attacks on Lebanon has risen to 178, with 279 wounded, and 246 vehicles hit, it said.

Israel also carried out air strikes in the al-Housh area of Tyre, southern Lebanon, the NNA reported. Al Jazeera’s verification agency, Sanad, has confirmed footage posted online showing the moment of the bombing and dense smoke rising from multiple raids in the area.

Hezbollah attacks

The Lebanese armed group Hezbollah also fired rockets towards Israel on Thursday. An attack on northern Israel’s Metula killed five people including an Israeli farmer and four foreign workers, Israel’s Channel 12 said.

Israeli emergency services said a rocket launched from Lebanon towards Haifa killed two people in northern Israel.

Medics “treated and attempted resuscitation on a 30-year-old male and a 60-year-old female, who were then pronounced dead”, the Magen David Adom first responders said in a statement.

The Lebanese group also said it had launched several rocket and artillery attacks against Israeli forces near the southern town of Khiam. It marked the fourth straight day of fighting in and around the strategic hilltop town.

Israeli forces launched a ground invasion in southern Lebanon on October 1.

Ceasefire talks

Meanwhile, United States envoys and Israeli officials held talks in Israel to discuss efforts towards a ceasefire in both Lebanon and the besieged Gaza Strip.

Israeli Prime Minister Benjamin Netanyahu told visiting US envoy Amos Hochstein and US Middle East adviser Brett McGurk that any ceasefire deal with Hezbollah would have to guarantee Israeli security.

“The prime minister specified that the main issue is not paperwork for this or that deal, but Israel’s determination and capacity to ensure the deal’s application and to prevent any threat to its security from Lebanon,” Netanyahu’s office said.

Israeli Defence Minister Yoav Gallant also took part in the discussion, which he said in a statement focused on “security arrangements as these relate to the northern arena and Lebanon, and efforts to ensure the return of 101 hostages still held by Hamas in Gaza”.

Evacuation orders a ‘war crime’

Also on Thursday, Lebanon’s caretaker Prime Minister Najib Mikati said Israel’s evacuation orders are a “war crime”.

“The threats issued by the Israeli enemy against Lebanese civilians to evacuate entire cities and displace them from their areas and homes is an additional war crime, added to the series of crimes committed by the Israeli enemy, including killing, destruction and sabotage,” he said, according to NNA.

Mikati said he has conveyed this position to all diplomatic bodies, calling for intensifying political pressure to stop the deadly Israeli aggression. He also met with US Ambassador Lisa Johnson and Egyptian envoy Alaa Moussa as part of his efforts to reach a ceasefire for Lebanon.

Al Jazeera’s Dorsa Jabbari, reporting from Beirut, said with Mikati’s latest remarks, it is “very difficult to see an agreement coming together in the near future”.

“He believes these continuing Israeli escalations do not inspire optimism,” Jabbari said. “He said the intense air strikes have to stop in order for negotiations to begin.”

According to Jabbari, this is a major sticking point in negotiations.

“The Israeli military has said in the past weeks that they are going to negotiate under fire, and that is something that the Lebanese government and Hezbollah have said they are not willing to do.”

Just a day earlier, Mikati expressed optimism about a ceasefire in “the coming hours or days”, while Hezbollah’s new leader Naim Qassem said on Wednesday that the group would accept a truce under certain conditions.

According to Israeli media reports citing government sources, the proposed plan brokered by the US team would see Hezbollah forces retreat around 30 kilometres (20 miles) from the border, north of the Litani River.

Israeli forces would withdraw from Lebanon and the Lebanese army would then take charge of the border, alongside UN peacekeepers.

Lebanon would be responsible for preventing Hezbollah from rearming itself.