Israeli forces have destroyed the main surgical building at Gaza City’s al-Shifa Hospital, following four days of siege.

The building was blown up on Thursday, as Israel tightened its siege of Gaza’s largest medical complex. Israeli forces ordered people trapped inside to evacuate before they target the entire facility, according to a Middle East Eye correspondent.

“If you leave the building [without the army’s orders], the soldiers will shoot at you.” A video from the hospital shows women and children scrambling to leave, awaiting the army’s next orders, as the men were reportedly taken away by the soldiers.

The Israeli army said it had killed 140 Palestinians since the start of its raid on the hospital in the early hours of Monday, including 50 over the past day, claiming they were all fighters. Hamas denies having any fighters inside the hospital.