Israel committed war crimes during Gaza hospital occupations: Human Rights Watch
Israeli forces committed war crimes against sick patients while occupying hospitals in the Gaza Strip, Human Rights Watch (HRW) said on Thursday.
The rights watchdog said the army "caused deaths and unnecessary suffering" of some 84 Palestinian patients while occupying medical facilities, through the denial of electricity, water, food and medicines.
Witnesses at three hospitals also reported that soldiers targeted civilians with gunfire, mistreated and forcibly displaced health workers and patients. They also said the soldiers deliberately targeted medical facilities and equipment - acts that HRW concluded are tantamount to war crimes.
The report is based on interviews with nine patients and two healthcare workers who witnessed the Israeli raids and occupations of al-Shifa medical complex in Gaza City in November 2023 and March 2024, Kamal Adwan hospital in Beit Lahia in January 2024, and the Nasser medical complex in Khan Younis in February 2024.
Medical staff reported that Israeli forces' blockade of the hospitals, which barred access to ambulances and medical supplies, hampered treatment and directly contributed to the deaths of wounded and chronically ill patients, including children on dialysis.
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Dr Khalif Abu Samra, a healthcare worker at al-Shifa, told HRW that he witnessed staff detaching a patient from a ventilator due to a lack of electricity.
Israeli forces also forcibly evacuated hospitals, rarely facilitating transfer to other facilities, with no assistance offered to those on stretchers and wheelchairs, and fired at fleeing patients and ambulances.
No safe routes
On 13 October 2023, the Israeli military issued an expulsion order for northern Gaza which included al-Shifa, the largest medical facility in Palestine, where 50,000 displaced people were sheltering.
The order was issued despite there being no reliably safe route to leave the complex.
When the hospital attempted evacuations Israeli air strikes targeted the ambulances carrying patients away from the complex. One attack left at least 21 people dead or wounded, including five children.
Ridana Zukhra, 23, reported that she was fired at by an Israeli tank as she attempted to flee the complex with her children, brother and cousin. Her five-year-old daughter was so badly wounded in the attack, her leg had to be amputated.
On 12 November, Israeli forces blockaded the hospital, which was sheltering around 600 patients at the time, including premature babies and dialysis patients. Israel severed access and power supplies to the facility, resulting in the deaths of some 40 patients between 11 and 17 November 2023.
On 15 November troops stormed the facility. Shahad al-Qutaiti was receiving treatment at the time for wounds sustained in a strike on her apartment building in Gaza City on 11 October that killed her husband and mother-in-law. Qutaiti had delivered a stillborn baby girl days before the raid.
She recalled that Israeli forces fired “a sound [flash-bang] grenade and a smoke grenade through the windows to force people to go downstairs".
Israeli soldiers ordered patients and staff to evacuate on 17 November. According to Dr Abu Samra, around 150 patients could not move, including those in comas, double amputees and premature babies.
According to media reports and UN agencies, five premature babies died at the hospital between 11 and 19 November. Abu Samra reported that at least 10 patients on dialysis machines "refused to leave", and that he had "no idea" what happened to them.
Another doctor reported that a maternity patient died after being transferred to another facility that lacked adequate intensive care.
When Israeli forces withdrew from al-Shifa in early April 2024 after a second deadly two-week siege on the hospital, the buildings were reduced to rubble, with piles of corpses strewn across the complex.
With limited access to cemeteries and morgues overwhelmed with the dead, families were forced to dig temporary graves in the hospital courtyards. Some victims were buried in mass graves by Israeli troops during their assault.
Earlier this month, amid the now defunct ceasefire, Gaza's civil defence teams began relocating the bodies from the hospital courtyards to the city's cemeteries.
'Centers of death and mistreatment'
The Israeli military has repeatedly justified its assaults on Gaza's medical facilities with claims that the hospitals are used by Palestinian armed groups as "military command centres", but have failed to provide any verifiable evidence for these allegations.
HRW stressed that the targeting of hospitals and medical staff is a breach of international humanitarian law.
'Those responsible for these horrific abuses, including senior officials, should be held to account'
- Bill Van Esveld, Human Rights Watch
While the watchdog acknowledged that medical facilities may be subject to attack if "they are used to commit acts harmful to the enemy", it said that "the presence of wounded or sick combatants and their small arms does not make hospitals subject to attack".
"While Israeli forces exercised effective control over hospitals, they were also obligated under international human rights law to respect, protect, and fulfill the right to the highest attainable standard of health," the report said.
Bill Van Esveld, HRW's associate children’s rights director, said: “The Israeli military’s occupation of Gaza’s hospitals has transformed sites for healing and recovery into centers of death and mistreatment.”
“Those responsible for these horrific abuses, including senior officials, should be held to account,” he added.
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