As the conflict between Israel and Gaza enters its 40th day, these are the main developments.

Here is the situation on Wednesday, November 15, 2023:

Latest on human impact and fighting

• Ambulances and rescue services are no longer operational in Gaza City, according to a report by the United Nations Office for the Coordination of Humanitarian Affairs (UN OCHA) on Tuesday.
• At least 11,078 Palestinians have been killed in the Israeli bombardment of Gaza since October 7, according to the last available toll from November 10. An additional 2,700 people – including an estimated 1,500 children – are believed to be trapped under rubble, either dead or awaiting rescue, according to UN OCHA.
• Israel’s far-right finance minister, Bezalel Smotrich has touted the “voluntary migration” of Palestinians in Gaza as the “right humanitarian solution” for the besieged enclave and region in a Facebook post on Tuesday. The remark comes amid hundreds of thousands of people being forcibly displaced in Gaza since October 7, and comments from other Israeli officials that Arab nations should take them in.
• On Tuesday, the United States and the United Kingdom announced a new round of sanctions on Hamas and some of its leaders to restrict their funding channels.
• Yemen’s Houthi group launched ballistic missiles on Israeli targets, a spokesperson of the group said on Tuesday. Israel’s military has not confirmed a Houthi attack but said its “Arrow” aerial defence system intercepted a missile near the Red Sea on Tuesday.
• After reporting a $6bn deficit in October, Israeli Prime Minister Benjamin Netanyahu has approved an amended state budget for 2023 in response to the Israel-Hamas war.
• A “children for children” captive release is under negotiation, according to Israeli television station, Kan.

The situation at Gaza’s hospitals

• Israeli troops have entered al-Shifa Hospital’s surgical and emergency units. Tanks have been surrounding the hospital, Israeli soldiers searched the basement and also opened fire inside the hospital on Wednesday, medical sources told Al Jazeera.
• The White House said on Tuesday that it does “not support striking a hospital from the air”, and does not want to see civilians and patients there get caught in crossfire, according to Reuters, citing an unnamed spokesperson for the White House National Security Council.
• Earlier on Tuesday, hours before Israeli forces stormed the hospital, national security spokesperson John Kirby told reporters that the White House had intelligence indicating Hamas tunnels under al-Shifa. Hamas rejected these claims in a statement on Wednesday, and said that the US’s adoption of this narrative is responsible for the attack on al-Shifa Hospital.
• Human Rights Watch has called for Israel’s attacks on Gaza hospitals to be investigated as war crimes, in a statement released on Tuesday.

Diplomacy

• Netanyahu slammed Canadian Prime Minister Justin Trudeau for calling on Israel “to exercise maximum restraint” and saying that the killing of women and children needs to stop. “It is not Israel that is deliberately targeting civilians but Hamas,” Netanyahu wrote in a social media post directed at Trudeau on Wednesday.
• Netanyahu and US President Joe Biden discussed the latest developments in Gaza during a phone call on Tuesday. The White House readout of the call did not mention hospital attacks as a point of discussion and stated that the two spoke “at length” about securing captives.
• Meanwhile, thousands of protesters gathered in San Francisco to protest against Israel’s war on Gaza and get world leaders to push for a ceasefire ahead of a meeting between President Biden and Chinese President Xi Jinping on the sidelines of the Asia Pacific Economic Cooperation summit.
• The US has been ramping up its weapons transfer to Israel with increased arsenals and new equipment, Bloomberg reported on Tuesday citing an internal defence department list. Some of the items delivered include cannon ammunition, bunker-buster munitions, and night-vision devices.
• Indonesia and Malaysia’s defence ministers called for a ceasefire in Gaza during a regional meeting of the Association of Southeast Asian Nations on Wednesday.

Attacks in the occupied West Bank

• Eleven Palestinians were arrested in Israeli raids across the West Bank on Wednesday, according to Wafa news agency.
• Israeli forces demolished a Palestinian family’s house in Shuqba village, west of Ramallah, at dawn on Wednesday under the pretext of building without a permit. The family was informed about the demolition decision via a phone call one week ago, according to Wafa.