Gaza - Patients and staff at the al-Quds hospital in the Gaza Strip were still under gunfire Thursday afternoon, hours after a shell hit the building causing a large fire.

"We are a civilian hospital and we are under siege," said Regis Garrigue, a doctor from France who was volunteering at the hospital, which was marked with Red Crescent flags.

Fire brigades, escorting by the International Red Cross in coordination with the Israeli military, were after a few hours able to extinguish the fire, which ravaged one wing of the hospital.

Other parts of the complex suffered "extensive damage" due to shelling and gunfire.

He said some members of the surgical teams, including war surgeons with his charity, Help Doctors, were conducting operations even as fighting went on outside, but he stressed the shortage of medicines.

"We are lacking anaesthetics. We lack food. The doctors are not eating, (or have been) eating very little, for two days now," Garrigue said.

Most patients have been evacuated to the ground level of the building, but getting them to a different location remained impossible, he said.

"We are scared to go out. The shooting is heavy."

In addition, three patients in the intensive care unit with gunshot wounds to the head, including a woman and a child, could not be moved without equipment that was not available.

There are about 150 people at the hospital, including medics and patients as well as local residents who sought refuge from the fighting.

The fire broke out at about 11:45 am (0945 GMT) in the nine-storey wing of the hospital.

The Israeli military said it coordinated the fire trucks but had no further comment on the incident. (dpa)