BEIRUT — An Israeli airstrike killed an elite Hezbollah commander Monday in southern Lebanon, the latest in an escalating exchange of strikes along the border that have raised fears of another Mideast war even as the fighting in Gaza exacts a mounting toll on civilians.

The strike on an SUV killed a commander in a secretive Hezbollah force that operates along the border, according to a Lebanese security official who spoke on condition of anonymity in keeping with regulations. Hezbollah identified the slain fighter as Wissam al-Tawil without providing details.

He is the most senior militant in the armed group killed since Hamas’ Oct. 7 attack into southern Israel triggered all-out war in Gaza and lower-intensity fighting between Israel and Hezbollah, which has escalated since an Israeli strike killed a senior Hamas leader last week in Beirut.

U.S. Secretary of State Antony Blinken, who is back in the region this week, appears to be trying to head off a wider conflict.

Fighting continued in northern Gaza, even after Israel said it has largely wrapped up major operations there to now focus on the central region and the southern city of Khan Younis, where thousands more Palestinians fled.

Israeli officials say the fighting will continue for many more months as the army seeks to dismantle Hamas and return scores of hostages taken during the militants’ Oct. 7 attack.

The offensive has already killed over 23,000 Palestinians, devastated vast swaths of the Gaza Strip, displaced nearly 85% of its population of 2.3 million and left a quarter of its residents facing starvation.

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‘Sickening Scenes in Gaza’s Overwhelmed Hospitals’

Medics, patients, and displaced people fled from the main hospital in central Gaza as the fighting drew closer, witnesses said Monday. Losing the facility would be another major blow to a health system shattered by three months of war.

Doctors Without Borders and other aid groups withdrew from Al-Aqsa Martyrs Hospital in Deir al-Balah in recent days, saying it was too dangerous. That spread panic among people sheltering there, causing many to join the hundreds of thousands who have fled to the south of the besieged territory.

Tens of thousands of people have sought shelter in Gaza’s hospitals, which are struggling to treat dozens of people wounded each day in Israeli strikes. Only 13 of Gaza’s 36 hospitals are even partially functioning, according to the U.N. humanitarian office.

Omar al-Darawi, an employee at the Al-Aqsa hospital, said the facility has been struck multiple times in recent days. He said thousands of people left after the aid groups pulled out, while patients have been concentrated on one floor to be treated by the remaining doctors.

“We have large numbers of wounded who can’t move,” he said. “They need special care, which is unavailable.”

More dead and wounded arrive each day as Israeli forces advance in central Gaza, backed by heavy airstrikes. Gaza’s Health Ministry said Monday that 249 Palestinians have been killed and 510 others were wounded across the territory in the last 24 hours.

World Health Organization staff who visited Sunday saw “sickening scenes of people of all ages being treated on blood-streaked floors and in chaotic corridors,” Tedros Adhanom Ghebreyesus, the head of the U.N. agency, said in a statement. “The bloodbath in Gaza must end.”

Thousands more Palestinians fled Deir al-Balah and refugee camps in central Gaza, heading south along the coastal road to an area known as Muwasi, on the outskirts of Rafah at Gaza’s southern end, where already more than 1 million people have crowded.

The U.N. children’s agency UNICEF warned that 90% of Gaza’s children under 2 were consuming only bread and milk, and that cases of diarrhea were skyrocketing.

“As the threat of famine intensifies, hundreds of thousands more young children could soon be severely malnourished, with some at risk of death. We cannot allow that to happen,” said Catherine Russell, UNICEF’s executive director.

Dire Conditions in the Isolated North

The situation is even more dire in northern Gaza, which Israeli forces cut off from the rest of the territory in late October.

Entire neighborhoods have been demolished, and most of the population has fled. Tens of thousands who remain face severe shortages of food and water. The WHO said late Sunday it has been unable to deliver supplies to northern Gaza in 12 days because of heavy bombardment and the inability to guarantee safe passage with the Israeli military.

Even there, Israel still battles what it describes as pockets of militants.

An airstrike early Sunday flattened a four-story home filled with displaced people in the urban Jabaliya refugee camp, killing at least 70, including women and children, according to Mahmoud Bassal, a spokesman for Gaza’s civil defense. There was no immediate confirmation from the Health Ministry, which has struggled to maintain its operations in the north.

Search efforts were still underway Monday. Civil defense officials circulated a graphic video showing the aftermath, with several bodies scattered amid the rubble.

Jabaliya, which was built for Palestinian refugees from the 1948 war surrounding Israel’s creation and is now a dense, built-up neighborhood, has seen weeks of heavy fighting.

More than 23,000 Palestinians have been killed, about two-thirds of them women and children, and more than 58,000 wounded, since the war began, according to the Health Ministry in Hamas-run Gaza. The death toll does not distinguish between combatants and civilians.

Israel blames Hamas for civilian casualties because the group operates in populated residential areas, but the military almost never comments on the intended target in strikes that kill large numbers of civilians. The military says it has killed some 8,000 militants, without providing evidence, and says 176 of its own soldiers have been killed in the offensive.

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Seeking to Head Off a Wider War

Blinken, who was meeting leaders in the United Arab Emirates and Saudi Arabia on Monday after talks in Jordan and Qatar, once again spoke of the need for Israel to adjust its military operations to minimize harm to civilians and allow more aid into the territory.

But his main focus appeared to be preventing the war from spreading.

A Hezbollah rocket barrage hit a sensitive air traffic base in northern Israel on Saturday in one of the biggest attacks in three months of fighting. The militant group said was an “initial response” to the killing of Hamas’ deputy political leader Saleh Arouri in Beirut last week.

So far, both sides have sought to limit the fighting.

Hezbollah appears wary of risking an all-out war that would bring massive destruction to Lebanon. Israeli leaders say their patience is wearing thin and that if the tensions cannot be resolved through diplomacy, they are prepared to go to war. They have expressed particular concern about the Radwan Force, the elite Hezbollah unit in which al-Tawil was a commander, which operates along the border.

Prime Minister Benjamin Netanyahu, visiting troops near the border, vowed to “do everything” possible to return “security to the north.”

“We prefer that this be done without a wider campaign, but that won’t stop us,” he said.