The head of orthopaedic surgery at Al-Ahli al-Arabi Hospital in Gaza, Fadel Naim, had just finished a procedure when he heard a huge explosion and his department filled with people screaming for help.
"People came running into the surgery department screaming help us, help us, there are people killed and wounded inside the hospital," he said.
"The hospital was full of dead and wounded, dismembered bodies," he said. "We tried to save whoever could be saved but the number was too great for the hospital team."
Tuesday's explosion killed hundreds of Palestinians and derailed a diplomatic mission by U.S. President Joe Biden, who arrived in Israel on Wednesday to calm the region but was snubbed by Arab leaders who called off an emergency summit.
Palestinian officials blamed an Israeli air strike for the blast. Israel said the blast was caused by a failed rocket launch by the Palestinian Islamic Jihad militant group, which denied blame.
Doctor Ibrahim Al-Naqa was proud of the 100-year-old baptist hospital. In a region of conflict, it welcomed all faiths and offered patients a church and a mosque.
On Tuesday, people seeking shelter from the fiercest fighting between the Israeli military and the Palestinian militant group Hamas in decades walked into the hospital to their deaths.
Blood stained the walls and the ground in what was normally a peaceful place that helped patients recover.
"This place created a safe haven for women and children, those who escaped the Israeli bombing into this hospital, those who saw this place as a safe haven," said Naqa.
"Without warning this hospital was targeted. We don't know what the shell is called but we saw the results of it when it targeted children and ripped their bodies into pieces."
REGION IN CRISIS
The death toll from the hospital explosion was by far the highest of any single incident in Gaza during the current violence, and saw protests erupt in the occupied West Bank and the wider region, including in Jordan and Turkey.
British-Palestinian doctor Ghassan Abusittah said the hospital had been shaking all day because of bombing. He said he heard the sound of a missile just before a huge explosion and then the operating room ceiling collapsed on top of him and other physicians. In the courtyard he could see bodies and limbs everywhere. He treated a man whose legs were blown off.
Abusittah said Gaza's medical system had collapsed, with doctors scrambling for even basic resources. "We are exhausted. The number of patients just keeps getting bigger," he said.
The blast inflamed a region in crisis after Hamas, which controls the Gaza Strip, carried out a cross-border rampage against communities in southern Israel on Oct. 7 in which at least 1,300 people were killed and hostages were taken.
Israel responded with the heaviest ever air strikes on the blockaded Gaza Strip and has massed troops and tanks on its border.
Before Tuesday's blast, health authorities in Gaza said at least 3,000 people had died in 11 days of Israeli bombardment.
The scenes of destruction from the hospital were horrific even by the standards of the past 12 days, which have confronted the world with relentless images, first of Israelis killed in their homes and then of Palestinian families buried under rubble from Israel's retaliatory strikes.
Gaza's health ministry spokesman, Ashraf Al-Qidra, said 471 Palestinians were killed and more than 314 wounded at the hospital.
"The massacre carried out by the Israeli occupation at the Baptist Hospital is the massacre of the 21st century and it is a continuation of its crimes since the Nakba of our people in 1948," said Salama Marouf, head of the Hamas government media office.
