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The city of Baalbek is just a few hours' drive over the mountains from Beirut, nestled in the heart of the Bekaa Valley. This fertile farm country, once the breadbasket of the Roman Empire, is now best known for its vineyards and its hashish growers, and as a bastion of Hizballah. Indeed, the strength of Hizballah in this largely Shi'a city is such that banners threatening "Death to America!" hang over its ancient Roman temples, one of Lebanon's main tourist attractions.

But the Israeli soldiers who landed by helicopter in Baalbek overnight Wednesday were not there to take pictures. Fierce fighting reportedly broke out around the city's Dar al-Hikmah hospital in the course of a raid whose purpose is not yet clear, but which comes as Israel begins to deploy thousands of troops in a large-scale ground offensive inside Lebanon. According to a Lebanese offical, 19 people were killed in Baalbek, 22 wounded, and five captured by the Israelis. "Israel says they are Hizballah, Hizballah says they are civililans," says the official. "But everyone in Baalbek is either Hizballah or Hizballah supporters. Hizballah is entrenched there. The Dar al-Hikmah, he adds, "is a Hizballah hospital and was probably being used as a command center."

The bombings were carried out by Apache helicopters and unmanded drones. "It was a hard battle, a lot of raids and helicopters," a Hizballah fighter from Baalek who calls himself Ali Hussein told TIME. "Ninety percent of the people of Baalbek have already left. We don't have petrol so we can't leave." Hussein says the hospital had been emptied four days ago, with critical cases transferred to other hospitals and remaining patients sent home. "You cannot imagine the situation, but it was really hell," says Hussein. "We leave it to God, but in my heart I feel we will win in the end because we have a cause: the land."

The Bekaa Valley represents a long-time sanctuary for Hizballah, where fighters retreating from an Israeli advance in the south could regroup and easily be resupplied by smugglers traveling over the Anti-Syrian Range, as the mountains separating Lebanon and Syria are known. It was in the Bekaa that Iranian Revolutionary Guards are said to have trained Hizballah fighters in the 1980s, and from the Bekaa, some of Hizballah's rockets can still reach Israel. The Israeli military would not comment on the reported airborne assault on the city.

The Israelis had already softened the city with air strikes on July 17, destroying gas stations, Hizballah offices, and a dairy processing plant. Many residents had fled, and when a TIME reporter visited less than two weeks ago, many of its streets were empty. The residents who remained behind had been expecting an imminent attack. "All of Baalbek is resistance," said Dr. Khaled Rifai, a town official told TIME before the attack. "The city is like a tank."

• Andrew Lee Butters/Beirut
• Residents in the ancient Lebanese city knew an Israeli attack was imminent