Gaza has lost its largest hospital.
Al Shifa has been the beating heart of the strip's medical infrastructure for almost eight decades, but now is "basically not functioning", according to the World Health Organisation (WHO).
The WHO's findings pose some very difficult questions for Israel and its military campaign in Gaza.
Under the rules of war, hospitals are protected from military activity unless it can be proven the enemy is using them to pose a threat.
Israel claims it has found a Hamas command and control centre in the hospital and that beneath it is a complex of Hamas built tunnels.
But it has not produced the evidence to back that up - just footage claiming to show a tunnel entrance nearby, some assault rifles, some grenades, and laptops described as "technological assets".
Hospital turned into 'death zone'
As the normally pro-Israeli government Jerusalem Post has put it, Israel has presented a much weaker case to the world about Hamas's presence at the hospital than expected.
The WHO's report is profoundly worrying. It says Gaza's biggest hospital is now a "death zone".
Most of the patients have left. Footage over the weekend has shown patients emerging under white flags while Israeli tanks prowl the area.
Left behind are the severely ill who cannot be moved and 32 babies in an extremely critical condition.
Israel holds itself to higher standards than Hamas
Under international humanitarian law, parties to an armed conflict have a duty to meet the basic needs of a population under its control.
Hamas has comprehensively failed to meet that standard, firing rockets from within residential areas and from schools and other civilian buildings.
But Israel as a modern democracy holds itself to higher standards. It does not appear to be following up its military operation in northern Gaza with a large-scale humanitarian mission.
Israeli officials have disputed its responsibilities under the rules of war. They have told Sky News that D-Day was not followed immediately by a Marshall Plan.
But as allied troops moved through northern France in 1945, measures were put in place to feed and shelter civilians.
Israel is arguably not doing the same on the scale required, and now its operation has effectively shut down the biggest hospital in Gaza just as the humanitarian disaster is deepening.