Gaza: Unlawful Israeli Hospital Strikes Worsen Health Crisis

Injured Palestinians being treated using flash light at the Indonesian Hsopital in North Gaza on Nov 10 2023. Anas al-Shareef - Reiters - via HRW

• The Israeli military’s repeated, apparently unlawful attacks on medical facilities, personnel, and transport are further destroying Gaza’s healthcare system and should be investigated as war crimes.

• Concerns about disproportionate attacks are magnified for hospitals. Even the threat of an attack or minor damage can have massive life-or-death implications for patients and caregivers.

• The Israeli government should end attacks on hospitals. The Independent International Commission of Inquiry on the Occupied Palestinian Territory and the ICC should investigate.

(Jerusalem) – The Israeli military’s repeated, apparently unlawful attacks on medical facilities, personnel, and transport are further destroying the Gaza Strip’s healthcare system and should be investigated as war crimes, Human Rights Watch said today. Despite the Israeli military’s claims on November 5, 2023, of “Hamas’s cynical use of hospitals,” no evidence put forward would justify depriving hospitals and ambulances of their protected status under international humanitarian law.

Map showing locations of four attacks on health facilities documented by Human Rights Watch between October 7 and November 7, 2023. © 2023 Human Rights Watch

The World Health Organization (WHO) has reported that at least 521 people, including 16 medical workers, have been killed in 137 “attacks on health care” in Gaza as of November 12. These attacks, alongside Israel’s decisions to cut off electricity and water and block humanitarian aid to Gaza, have severely impeded health care access. The United Nations found as of November 10 that two-thirds of primary care facilities and half of all hospitals in Gaza are not functioning at a time when medical personnel are dealing with unprecedented numbers of severely injured patients. Hospitals have run out of medicine and basic equipment, and doctors told Human Rights Watch that they were forced to operate without anesthesia and to use vinegar as an antiseptic.

“Israel’s repeated attacks damaging hospitals and harming healthcare workers, already hard hit by an unlawful blockade, have devastated Gaza’s healthcare infrastructure,” said A. Kayum Ahmed, special adviser on the right to health at Human Rights Watch. “The strikes on hospitals have killed hundreds of people and put many patients at grave risk because they’re unable to receive proper medical care.”

Human Rights Watch investigated attacks on or near the Indonesian Hospital, al-Ahli Hospital, the International Eye Care Center, the Turkish-Palestinian Friendship Hospital, and the al-Quds Hospital between October 7 and November 7. Human Rights Watch spoke by phone with two displaced people sheltering in hospitals and 16 healthcare workers and hospital officials in Gaza and analyzed and verified open-source data, including videos posted to social media and satellite imagery, as well as WHO databases.

Israeli forces struck the Indonesian Hospital multiple times between October 7 and October 28, killing at least two civilians. The International Eye Care Center was struck repeatedly and completely destroyed after a strike on October 10 or 11. Strikes hit the compound and vicinity of the Turkish-Palestinian Friendship Hospital on October 30 and 31. Damage to the hospital as well as a lack of fuel for hospital generators resulted in its closure on November 1. Repeated Israeli strikes damaged the al-Quds Hospital and injured a man and child out front. Israeli forces on several occasions struck well-marked ambulances, killing and wounding at least a dozen people in one incident on November 3, including children, outside al-Shifa hospital.

These ongoing attacks are not isolated. Israeli forces have also carried out scores of strikes damaging several other hospitals across Gaza. WHO reported that as of November 10, 18 out of 36 hospitals and 46 out of 72 primary care clinics were forced to shut down. The forced closure of these facilities stems from damage caused by attacks as well as the lack of electricity and fuel.

Health workers at Gaza’s hospitals told Human Rights Watch they are dealing with unprecedented numbers of injured patients. Additionally, thousands of internally displaced people sheltering at hospitals have been put at risk, facing shortages of food and medicine. Gaza’s hospitals have been forced to address these issues with shortages of medical staff, some of whom have been killed or injured outside their work.

A doctor at Nasser Medical Center said: “At 3 a.m. I dealt with a 60-year-old woman with a cut wound in her head. I can’t make a suture to heal her wound—no gloves, no equipment—so we have to use unsterile techniques.”