JERUSALEM (AP) — Defense Secretary Lloyd Austin was expected to press Israel to wind down major combat operations in Gaza on a visit Monday, in the latest test of whether the U.S. can leverage its unwavering support for the offensive to blunt its devastating impact on Palestinian civilians.

France, the U.K. and Germany, some of Israel’s closest allies, joined global calls for a cease-fire over the weekend, and Israeli protesters have demanded the government relaunch talks with the militant group on releasing more hostages after three were mistakenly killed by Israeli troops while waving a white flag.

Prime Minister Benjamin Netanyahu has insisted that Israel will keep fighting until it removes Hamas from power, crushes its still-formidable military capabilities and returns the roughly 129 hostages still held by the group after its Oct. 7 attack, which ignited the war.

The U.S. has vetoed international calls for a cease-fire and rushed munitions to its close ally while pressing it to take greater steps to avoid harming civilians. The 10-week-old war against Hamas has killed over 18,700 Palestinians and transformed much of northern Gaza into a moonscape.

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Some 1.9 million Palestinians — nearly 85% of Gaza’s population — have fled their homes, with most packing into U.N.-run shelters and tent camps in the southern part of the besieged territory.

Austin, who is traveling with Joint Chiefs Chairman Gen. CQ Brown, is expected to press Israeli leaders to transition to a more precise phase, with targeted operations aimed at killing Hamas leaders, destroying tunnels and rescuing hostages.

Under U.S. pressure, Israel provided more precise evacuation instructions as troops moved into the southern city of Khan Younis earlier this month, though Palestinians say nowhere in Gaza is safe as Israel continues to carry out strikes in all parts of the territory.

Israel also reopened its main cargo crossing with Gaza to allow more aid into the territory — another U.S. request. But the amount entering is still less than half of prewar imports, even as needs have soared, and U.N. agencies say the fighting in the south hinders delivery in many areas.

UNPRECEDENTED DEATH AND DESTRUCTION

The war began with an unprecedented surprise attack by Hamas that overwhelmed Israel’s border defenses. Thousands of militants rampaged across southern Israel, killing some 1,200 people, mostly civilians, and abducting around 240 men, women and children.

Hamas and other militants are still holding an estimated 129 captives after most of the rest were freed in return for Israel’s release of 240 Palestinian prisoners during a truce last month. Hamas has said no more hostages will be released until the war ends.

In response to the Oct. 7 attack, Israel launched one of the 21st century’s deadliest air and ground offensives.

More than 18,700 Palestinians have been killed, the Health Ministry in the Hamas-run territory said Thursday in its last update before a communications blackout that only lifted late Sunday. It says thousands more casualties are buried under the rubble. The ministry does not differentiate between civilian and combatant deaths, but has said that most of those killed were women and children.

Israel’s military says 126 of its soldiers have been killed in the Gaza offensive. It says it has killed thousands of militants, without providing evidence.

Israel blames the civilian deaths on Hamas, saying it uses them as human shields when it operates in dense, residential areas. But the military rarely comments on individual strikes, which frequently kill women, children and other civilians.

ISRAEL RAIDS ANOTHER HOSPITAL

Heavy fighting around Gaza’s hospitals, which are overflowing with patients and displaced people, has taken most of them out of service. Israel accuses militants of sheltering in health facilities and has provided evidence in some cases. Health officials deny the allegations and say the army has recklessly endangered civilians.

The World Health Organization said it was “appalled” by an Israeli raid on northern Gaza’s Kamal Adwan Hospital over the last several days. WHO chief Tedros Adhanom Ghebreyesus said late Sunday that at least eight patients had died, including a 9-year-old, and that several had fled on foot because ambulances could not reach the facility.

The military said troops operating “in the area of the hospital” had detained dozens of suspected militants, some of whom had taken part in the Oct. 7 attack, and had seized “numerous” weapons and military tactical equipment. It said the hospital had been used as a command center by Hamas, without providing evidence.

A similar standoff unfolded last month at Shifa Hospital in Gaza City — the territory’s largest — where hundreds of patients and tens of thousands of displaced people were stranded for days with little food, water or medical supplies. Israel said Hamas concealed a major command center inside the hospital, and revealed what appeared to be a militant tunnel beneath the facility before withdrawing days later.

The WHO, which is working to restore services at Shifa and was able to visit on Friday, described its emergency department as a “bloodbath,” with hundreds of wounded patients, some being sutured on the floor with little or no pain medicine. It said tens of thousands of people are sheltering in the medical compound despite severe shortages of food and water.

REGIONAL TENSIONS

Israel and Lebanon’s Hezbollah have traded fire along the border nearly every day since the war began, and other Iran-backed militant groups have attacked U.S. targets in Syria and Iraq. Yemen’s Iran-aligned Houthi rebels have attacked ships in the Red Sea with missiles and drones, portraying it as a blockade of Israel.

Rear Adm. Daniel Hagari, an Israeli military spokesman, warned that Hezbollah was “dragging Lebanon into an unnecessary war that would have devastating consequences.” The sides fought a devastating monthlong war in 2006.

Nearly 300 Palestinians have been killed in the Israeli-occupied West Bank since the start of the war, and this has been the deadliest year for Palestinians there since 2005. Most have been killed during Israeli military raids, which often ignite gunbattles, or during violent demonstrations.

U.S. defense leaders are hoping to prevent the risk of wider regional conflict, both through a sustained high level of U.S. military presence and by urging Israel to scale back operations. President Joe Biden has warned that Israel is losing international support because of its “indiscriminate bombing.”

Israeli Defense Minister Yoav Gallant said last week that his country would continue major combat operations against Hamas for several more months.

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Magdy reported from Cairo.

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