BEIRUT — An Israeli airstrike killed an elite Hezbollah commander Monday in southern Lebanon, the latest in an escalating exchange of strikes across 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 unit that operates along the border, according to a Lebanese security official who spoke on condition of anonymity in keeping with regulations. The commander, Wissam al-Tawil, was a veteran of the Iranian-backed Lebanese force who took part in the 2006 cross-border kidnapping of two Israeli soldiers that triggered the last war between Israel and Hezbollah, an official in the group said.

He is the most senior Hezbollah militant 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.

In other developments, Israel said it has largely wrapped up major operations in northern Gaza, though fighting and bombardment there continue. Israeli forces are now focusing 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.

Medics, patients and displaced people fled from central Gaza’s main hospital as 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, saying it was too dangerous amid Israeli bombardment, drone strikes and sniper fire. That spread panic among people sheltering there. Thousands left, joining the hundreds of thousands who have fled further south, said a hospital staffer, Omar al-Darawi.

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

The Al-Aqsa hospital was struck multiple times in recent days, al-Darawi said. After the pullout, large numbers of patients who cannot be moved were concentrated on one floor to be treated by remaining doctors. “They need special care, which is unavailable,” he said.

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,” WHO chief Tedros Adhanom Ghebreyesus said. “The bloodbath in Gaza must end.”

More dead and wounded arrive at the hospital each day as Israeli forces advance in central Gaza, backed by heavy airstrikes. The military said Monday it had uncovered a large Hamas site for building rockets in the nearby Bureij refugee camp.

Thousands have been fleeing the area, heading south. Fifteen members of the Ayash family crammed into a van with their belongings for the journey. “Along the way there was banging, missiles, bombing, and planes,” said Khawla Ayash.

Reaching Muwasi, a coastal area outside Rafah, they unloaded bags, blankets and thin mattresses and began setting up tents alongside other relatives.

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

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

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 shortages of food and water. The WHO said Sunday it has been unable to deliver supplies to northern Gaza for 12 days because of bombardment and the inability to guarantee safe passage with the Israeli military.

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 operate in the north.

Since the war began, more than 23,000 Palestinians have been killed, about two-thirds of them women and children, and more than 58,000 have been wounded, 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.

Blinken focused on preventing the war from spreading as he held talks in Gulf countries and Jordan over the past two days.

For the past three months, both Israel and Hezbollah have sought to limit their cross-border exchanges. Hezbollah appears wary of risking an all-out war that would bring massive destruction to Lebanon.

But last week’s killing of Hamas’ deputy political leader, Saleh Arouri, in Beirut threatens to throw the two sides into an escalating spiral.

A Hezbollah rocket barrage hit a sensitive air traffic base Saturday in northern Israel in one of the group’s biggest attacks of the war — an “initial response” to Arouri’s killing, Hezbollah said.

Israeli leaders say their patience with Hezbollah rocket fire is wearing thin and that if diplomacy doesn’t stop it, 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 return security to the north.

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

Hezbollah began firing rockets shortly after Hamas’ Oct. 7 attack, saying it aimed to ease pressure on Gaza. Hamas and other militants killed about 1,200 people in southern Israel that day, mostly civilians, and took some 250 people hostage, over 130 of whom remain in captivity.

In the cross-border, exchanges nearly 200 people have been killed on the Lebanese side, mostly fighters but also 20 civilians. On the Israeli side, five civilians and 12 soldiers have been killed and more than 150 injured. Tens of thousands of people in both countries have been driven from homes near the border.

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Shurafa reported from Deir al-Balah, Gaza Strip, and Jeffery from Cairo. Associated Press writers Kareem Chehayeb in Beirut and Samy Magdy in Cairo contributed.

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Find more of AP’s coverage at: https://apnews.com/hub/israel-hamas-war

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