U.S. Secretary of State Antony Blinken arrived in Israel on Tuesday on his 11th visit to the region since the outbreak of the Israel-Hamas war, as the U.S. hopes to revive ceasefire efforts after the killing of top Hamas leader Yahya Sinwar.

So far, all the warring parties appear to be digging in.

Israel is still at war with Hamas more than a year after the militant group's Oct. 7 attack, as well as with Hezbollah in Lebanon, where it launched a ground invasion earlier this month. Israel is also expected to strike Iran in response to its ballistic missile attack on Oct. 1.

Blinken landed just hours after Hezbollah launched a barrage of rockets into central Israel, setting off air raid sirens in the country's most populated areas and its international airport, but causing no apparent damage or injuries. 

The Israeli military said it intercepted most of the five projectiles, with one landing in an open area. Another 15 projectiles were fired from Lebanon into northern Israel at around the same time, it said.

Hospitals in Lebanon fear being targeted by Israel

The death toll from Israeli airstrikes late Monday that destroyed several buildings facing one of Beirut's main hospitals climbed to 13. Lebanon's Health Ministry said 57 others were wounded, including seven who were in critical condition.

The Israeli military said it struck a Hezbollah target, without elaborating, and said that it had not targeted the hospital itself.

Associated Press reporters visited the Rafik Hariri University Hospital, the country's largest public hospital, on Tuesday. They saw broken windows in the hospital's pharmacy and dialysis centre, which was full of patients at the time. 

The force of the explosions also destroyed some of the hospital's solar panels. Staff said that in the midst of their own panic, they had to deal with wounded patients streaming into the hospital in the aftermath of the strikes across the street.

Staff at another Beirut hospital feared it would be targeted after Israel alleged that Hezbollah had stashed hundreds of millions of dollars in cash and gold in its basement, without providing evidence.

The director of the Sahel General Hospital denied the allegations and invited journalists to visit the hospital and its two underground floors on Tuesday. AP reporters saw no sign of militants.

The few remaining patients had been evacuated after the Israeli military's announcement the night before. The rest had left earlier because of repeated airstrikes in the surrounding neighborhood.

"We have been living in terror for the last 24 hours," said hospital director Mazen Alame. "There is nothing under the hospital."

Many in Lebanon fear Israel could target its hospitals in the same way it has raided medical facilities across Gaza. The Israeli military has accused Hamas and other militants of using hospitals for military purposes, allegations denied by medical staff. 

Hospitals can lose their protection under international law if they are used for military purposes.

Blinken expected to focus on Gaza

The State Department said ahead of the visit that Blinken would focus on ending the war in Gaza, securing the release of hostages held by Hamas and alleviating the suffering of Palestinian civilians.

State Department spokesman Matthew Miller said Blinken would underscore the need for a dramatic increase in the amount of humanitarian aid reaching Gaza, something that Blinken and Defence Secretary Lloyd Austin made clear in a letter to Israeli officials last week. 

That letter reminded Israel that the Biden administration could be forced by U.S. law to curtail some forms of military aid should the delivery of humanitarian aid continue to be hindered.

Blinken's previous trips have yielded little in the way of ending hostilities, but he has managed to increase aid deliveries to Gaza in the past.

The United States, Egypt and Qatar have brokered months of talks between Israel and Hamas, trying to strike a deal in which the militants would release dozens of hostages in return for an end to the war, a lasting ceasefire and the release of Palestinian prisoners.

But both Israel and Hamas accused each other of making new and unacceptable demands over the summer, and the talks ground to a halt in August. Hamas says its demands have not changed following the killing of Sinwar.

U.S., Iran step up outreach ahead of expected Israeli strike

Blinken is expected to meet with Israeli Prime Minister Benjamin Netanyahu and other top officials, and to visit a number of Arab countries, likely to include Jordan, Saudi Arabia, Qatar and the United Arab Emirates.

Iran's Foreign Minister Abbas Araghchi has been criss-crossing the region in recent days to try and built support ahead of Israel's threatened retaliatory strike. Speaking in Kuwait on Tuesday, he said Gulf Arab countries had assured him they would not allow their territory to be used for any Israeli strike.

"All the neighbours assured us that they will not allow their lands and air to be used against Iran," Araghchi said, according to the state-run IRNA news agency.

The Arab Gulf countries have not publicly offered such assurances. Gulf Arab nations like the UAE and Qatar host major military installations, and there are concerns an all-out regional war could draw them in.

Iran has repeatedly vowed to respond to any Israeli strike.

War rages in Lebanon and northern Gaza

The U.S. has also tried to broker a ceasefire between Israel and Hezbollah, but those efforts fell apart as tensions spiked last month with a series of Israeli strikes that killed the militant group's top leader, Hassan Nasrallah, and most of his senior commanders.

Israel is currently waging another major operation in already-devastated northern Gaza, which has killed hundreds of Palestinians over the last two weeks, according to local health authorities.

In Lebanon, Israel has carried out waves of heavy airstrikes across southern Beirut and the country's south and east, areas where Hezbollah has a strong presence. Hezbollah has fired hundreds of rockets, missiles and drones into Israel, including some that have reached the country's populous centre.