Human Rights Watch (HRW) released a report on Tuesday saying that Israel is executing repeated and unlawful attacks on healthcare facilities, personnel and transport and that these attacks should be investigated as war crimes.
HRW also expressed concern about Israel cutting off access to electricity, water and humanitarian aid, saying the country’s actions were “further destroying Gaza’s healthcare system.” The report urges Israel to end these attacks and calls on the Independent International Commission of Inquiry on the Occupied Palestinian Territory and International Criminal Court (ICC) to open formal investigations.
HRW investigated attacks between October 7 and November 7 on or near five healthcare facilities: Indonesian Hospital, al-Ahli Hospital, the International Eye Care Center, the Turkish-Palestinian Friendship Hospital and the al-Quds Hospital. It conducted its investigation by speaking with displaced people at the hospitals and healthcare workers and analyzing verified open-source data like social media, satellite images and World Health Organization (WHO) databases. They also specifically pointed to an Israeli strike on an ambulance near the Al-Shifa Hospital that killed 15 people.
HRW said its investigation showed the Israeli military had attacked medical facilities and the area around them on multiple occasions across the Gaza Strip, and that Israel’s broader siege of the territory (including limits on humanitarian aid, water and fuel) was having graving effects on Gaza’s healthcare system. The UN Office for the Coordination of Humanitarian Affairs (OCHA) and WHO have previously said that Gaza’s hospitals are “on the brink of collapse due to the shortage of electricity, medicine, equipment and specialized personnel.”
“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 HRW. “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.”
International humanitarian law gives healthcare facilities and workers specific protection from military activity. This rule prohibits attacks on healthcare facilities, healthcare workers, people who are wounded and health-related transports. These protections can be lost if facilities are used to commit an “act harmful to the enemy.” International law does not define what constitutes an “act harmful to the enemy,” but it’s generally understood to mean acts of war or aggression. Acts that do not qualify include: using light weapons in self-defense or defense of wounded and sick, guarding a medical facility, or the presence of sick or wounded combatants no longer taking part in hostilities. To lawfully attack a medical facility where an “act harmful to the enemy” is being committed, a party must give advance warning with a time limit and take all possible precautions to minimize harm to civilians.
Israel has long maintained that Hamas operates out of Gaza’s hospitals and uses civilian patients as human shields. This week, they raided Al-Shifa Hospital, Gaza’s largest hospital, saying that Hamas uses it as a military command center. Hamas has denied this. Fighting engulfed the area around the hospital for days, with WHO expressing concern about patient wellbeing. Military officials claim they found evidence of Hamas operations, and BBC reporters brought into the hospital say they were shown weaponry, military publications and military uniforms found in the complex. The BBC reporters were not shown the basement, where Israel says Hamas operates out of tunnels, and were not able to speak with patients or healthcare workers.
The report comes more than 40 days into the current war between Israel and Hamas, which started when Hamas launched attacks into Israel on October 7. More than 11,000 Palestinians and 1,200 Israelis have been killed so far, mostly civilians. Israel has been accused of several war crimes, with Palestinian rights groups filing an ICC complaint alleging genocide. Hamas has been the subject of its own war crimes accusations, with families of victims of the October 7 attack also filing an ICC complaint alleging genocide. UN Secretary-General António Guterres has called for a humanitarian ceasefire to prevent further atrocities, saying:
The way forward is clear. A humanitarian ceasefire. Now. All parties respecting all their obligations under international humanitarian law. Now. This means the unconditional release of the hostages in Gaza. Now. The protection of civilians, hospitals, UN facilities, shelters, and schools. Now. Unfettered access to deliver supplies to all people in need in Gaza. Now. And the end of the use of civilians as human shields. Now. None of these appeals should be conditional on the others.