The head of surgery at Gaza’s largest hospital, Dr. Marwan Abu Sada, raised concerns about the safety of patients and staff at Shifa Hospital as fighting continued to rage around it. Shells were hitting the hospital and Israeli soldiers and Hamas militants were engaged in close-quarters combat. The Israeli military denied launching direct strikes on the hospital or placing it under siege.
Hospitals in the main combat zone of northern Gaza have increasingly become targets during the Israel-Hamas war. Israel claims that Hamas militants are using hospitals as shields for fighters, but no evidence has been provided to support this claim. Palestinians and rights groups, on the other hand, accuse Israel of recklessly harming civilians seeking shelter.
The battles around Shifa Hospital have raised questions about when medical facilities lose their special protection under international humanitarian law. Israel claims that Hamas operates its command headquarters beneath the hospital complex, but Hamas and the hospital director deny this.
Throughout the war, Palestinian families have sought refuge in medical compounds, believing them to be safer than other alternatives. However, hospitals have become targets of Israeli airstrikes, leading to a blackout at Shifa Hospital that resulted in the deaths of several patients, including a newborn in an incubator.
Palestinian medical workers accuse Israel of launching an all-out attack on infrastructure to punish the population. The ongoing Israeli bombardment has destroyed ambulances and rendered hospitals inoperable. According to the Health Ministry in Gaza, 190 medical workers have been killed since the start of the war.
International humanitarian law provides special protections for hospitals during war, but they can lose their protections if combatants use them to hide fighters or store weapons. However, there must be sufficient warning before attacks to allow for the safe evacuation of patients and medical workers.
Even if Israel can prove that Hamas is using Shifa Hospital as a command center, international law still requires steps to be taken to protect innocent civilians. If the harm to civilians is disproportionate to the military objective, the attack is considered illegal under international law.
In an editorial, the International Criminal Court prosecutor warned combatants that the burden of proof is on them if they claim hospitals have lost their protected status due to military use. The bar for evidence is set very high, and if there is doubt, the attacker must assume that the object is protected.
