By Nidal al-Mughrabi and Bassam Masoud
CAIRO/GAZA (Reuters) -Israeli forces pounded the shattered Gaza Strip on Tuesday while Yemen's Houthis vowed to defy a U.S.-led naval mission and keep targeting Red Sea shipping in support of the Palestinian enclave's ruling Hamas movement.
Israel's campaign to eradicate Hamas militants behind an Oct. 7 massacre has left the coastal enclave in ruins, brought widespread hunger and homelessness, and killed nearly 20,000 Gazans, according to the Palestinian enclave's health ministry.
Under foreign pressure to avoid killing innocents, Israel's Prime Minister Benjamin Netanyahu says the war will not stop until a remaining 129 hostages are freed and Hamas is obliterated after its fighters' slaying of 1,200 Israelis.
The conflict has spread beyond Gaza, including into the Red Sea where Iran-aligned Houthi forces have been attacking vessels with missiles and drones. That has prompted the creation of a multinational naval operation to protect commerce in the area, but the Houthis said they would carry on anyway, possibly with a sea operation every 12 hours.
"Our position will not change in the direction of the Palestinian issue, whether a naval alliance is established or not," Houthi official Mohammed Abdulsalam told Reuters, saying only Israeli ships or those going to Israel would be targeted.
"Our position in support of Palestine and the Gaza Strip will remain until the end of the siege, the entry of food and medicine, and our support for the oppressed Palestinian people will remain continuous."
Announcing the naval operation, U.S. Defense Secretary Lloyd Austin said in Bahrain that joint patrols would be held in the southern Red Sea and Gulf of Aden, which encompass a major East-West global shipping route.
"This is an international challenge that demands collective action," Austin said.
British maritime security firm Ambrey said on Tuesday it received information of a potential boarding attempt west of Yemen's Aden port city, adding that the attack was unsuccessful and all crew were safe.
Some shippers are re-routing around Africa.
DEATHS MOUNT
In Gaza, Israeli latest missiles hit the southern Rafah area, where hundreds of thousands of Palestinian refugees have amassed in recent weeks, killing at least 20 people and wounding dozens as they slept at home, local health officials said.
Residents said they had to dig in the rubble with bare hands. "This is a barbarian act," said Mohammed Zurub, whose family lost 11 people in the attack.
In the north, another strike killed 13 people and wounded about 75 in the Jabalia refugee camp, the health ministry said.
Local Palestinians reported intensifying Israeli aerial and tank bombardment of Jabalia as darkness descended later on Tuesday.
Israel says it warns of strikes in advance so civilians can escape, and accuses Hamas fighters of hunkering down in residential areas and using hospitals and schools as cover, which the Islamist group denies.
Israeli military officials told reporters in a briefing on Tuesday that heavy civilian casualties are the cost of Israel's intense campaign to destroy Hamas and the militants' urban warfare strategy, despite global alarm at the huge human toll.
One official, a military legal adviser, said the air force was carrying out "thousands and thousands of attacks and often attacks that require heavy firepower" to break through Hamas' underground tunnel network.
U.S. Defense Secretary Lloyd Austin had told Israeli leaders on a visit on Monday that protecting civilians in Gaza was both "a moral duty and a strategic imperative", warning that excessive violence bred resentment that would benefit Hamas and make peaceful coexistence even harder in the long term.
OVER 90% OF POPULATION HOMELESS
The U.N. agency for Palestinian refugees UNRWA said more than 60% of Gaza's infrastructure was destroyed or damaged, with more than 90% of the 2.3 million population uprooted.
In the ground war, where Israel has lost 132 soldiers, tanks advanced further into the southern city of Khan Younis and shelled a market area but met heavy resistance, residents said.
Thousands of Hamas fighters, based in tunnels, are waging guerrilla-style war against Israeli forces.
"The IDF (Israel Defense Forces) is continuing to operate against Hamas terrorist infrastructure and operatives in the Gaza Strip," the military said in a statement.
Israeli President Isaac Herzog signalled readiness on the part of the country on Tuesday to enter another foreign-mediated "humanitarian pause" in fighting to recover more hostages held by Hamas and enable more aid to reach besieged Gaza.
A truce in late November mediated by Qatari and U.S. diplomats lasted for a week before collapsing and yielded the release of 110 hostages by Hamas in exchange for 240 Palestinian women and children from Israeli prisons.
Basem Naem, a senior Hamas official based outside Gaza, ruled out further negotiations on exchanging prisoners while the war continued, but said Hamas was open to any initiative to end it and bring relief to Gaza Palestinians.
A source briefed on diplomatic efforts told Reuters on Tuesday that Qatar's prime minister and the heads of the U.S. and Israeli intelligence services had held "positive" talks in Warsaw, Poland to explore ways of reviving negotiations. But a deal was not expected imminently, the source added.
CHILD AMPUTEES KILLED IN HOSPITALS, UN SAYS
The Gaza health ministry said on Tuesday that 19,667 Palestinians had been killed and 52,586 wounded since Oct. 7.
U.N. officials voiced outrage about the plight of Gaza's hospitals, which lack supplies and safety.
"I'm furious that children who are recovering from amputations in hospitals are then killed in those hospitals," said James Elder, spokesperson for the U.N. children's agency UNICEF, saying Nasser Hospital, the largest operational one left in the enclave, had been shelled twice in the past 48 hours.
One of the dead in the paediatric ward was a 13-year-old amputee named Dina who had survived a strike on her home that killed her family.