When science and religion work synergistically
Civilian populations face dire consequences of the systematic erosion of international humanitarian norms. For instance, the increased frequency of targeting hospitals and medical personnel is part of broader strategies to demoralize and control local populations. These measures violate the Geneva Conventions, which mandate the protection of civilian medical infrastructure, even during wartime. What happens to public health when there is reduced access to medical care? What occurs when the integrity of humanitarian law is challenged? And how can protection measures for healthcare facilities be strengthened? Click on for these answers and more.
In October 2024, Israel launched an airstrike on Al-Aqsa Martyrs Hospital in Deir al-Balah, Gaza. There were thousands sheltering in tents outside the hospital. At least four people were killed, with many left injured. Two people, a mother and son, were burned alive as their tent set on fire and they were unable to escape.
This is merely one of many attacks that have damaged or destroyed Gaza’s healthcare facilities. According to a Washington Post article examining Gaza’s healthcare sector, of 36 hospitals in Gaza, by May 2024, only four had not gone out of service. At that time, there were 90 documented incidents of hospital attacks in Gaza.
In October 2024, Israeli forces raided Gaza's Kamal Adwan Hospital, the last operating hospital in northern Gaza. The Israeli military also set various parts on fire, destroying hospital entrances and some surrounding infrastructure. There were approximately 600 displaced people sheltering at the hospital.
The Israeli military arrested all of Kamal Adwan’s medical staff (69 staff members), except for one doctor, accusing hospital staff of being Hamas operatives. Israeli forces also killed, injured, and/or arrested many patients and their families. No evidence was provided for the claims made by Israeli forces.
The conditions in Northern Gaza are completely deteriorating. A full evacuation of the area has been ordered by the Israeli military, but many people have nowhere to go. Airstrikes and raids have increased in the area, leading to hundreds of deaths just in October 2024, many being children.
Ambulances are also frequently targeted en route to hospitals or in attempts to retrieve the wounded or killed. The Israeli army accuses ambulances of transporting militants to their respective missions. There has been no evidence of such occurrences.
The UN Human Rights Council conducted a fact-finding mission in October 2024 to investigate war crimes in Gaza. They consider the Israeli targeting of hospitals to be “the war crimes of willful killing, mistreatment, and the crime against humanity of extermination."
Under international humanitarian law, anyone that is wounded or ill, regardless if they are civilians or military personnel, has the right to be respected, protected, and cared for.
International humanitarian law also extends specific protections to those working in medical functions, medical units, and hospitals. The only time this protection is questioned is when medical sites are used as places to launch an attack.
This is an accusation that Israel has used several times. It accuses hospitals of functioning as military bases, hostage holding spots, as weapons depots, and as sites where combatants blend with civilians. In Gaza and in Lebanon, the reasoning has been the same. But they have not provided evidence of such claims.
Hamas, other militant groups, and hospital staff have continuously denied the use of hospitals as military bases or otherwise. As foreign journalists and media outlets are not permitted to enter Gaza, confirming claims made by the Israeli government is nearly impossible.
For example, a video posted by the Israeli Defense Forces claimed that they had found weapons and technology at the Al-Rantisi Children's Hospital in Gaza. In the video, they show a paper on the wall with Arabic written on it, claiming that it was a list that showed which terrorists were guarding Israeli hostages, supposedly held under the hospital.
The video was widely circulated. The handwritten chart with several highlighted bits made its rounds on social media. The supposed list of terrorists turned out to be a calendar, with no names actually written on there, just the days of the week.
The attempt to utilize exceptions in human rights law without providing verified evidence is a tactic frequently employed by the Israeli military. Using the language of international law, while committing atrocities, offers a unique challenge.
Attacks on healthcare systems are not unique to the war in Gaza. In Ukraine, a monitoring website called Attacks on Healthcare in Ukraine has registered over 770 attacks on hospitals and clinics since February 2022.
In July 2024, a Russian airstrike hit Okhmatdyt Children’s Hospital in Kyiv, leaving 27 dead and 117 injured. Its toxicology department was completely destroyed and its intensive care unit and surgical and oncology wards were severely damaged.
The World Health Organization (WHO) has verified nearly 1,900 attacks on healthcare facilities, staff, patients, supplies, and transport units since February 2022. The WHO has repeatedly warned Russia that the intentional attacks against hospitals and medical facilities is a war crime.
In October 2024, Russia launched several attacks on the city of Kharkiv. In addition to damaging residential buildings and UNESCO-protected heritage sites, the attacks were also directed toward a hospital. In Kryvyi Rih, another hospital was subjected to ballistic missiles.
Russia’s attacks on hospitals and medical facilities are not limited to its war on Ukraine. In Syria, Russian involvement in the destruction of civilian infrastructure has also been well documented.
Russia has been consistently collaborating with Assad forces in Syria throughout the country’s civil war. In 2015, Russia escalated its efforts, committing several war crimes directed at hospitals.
In May 2024, a victim’s family member and a Syrian humanitarian organization called Hand in Hand for Aid and Development filed a complaint to the UN Human Rights Committee regarding a series of airstrikes in 2019 on Kafr Nobol Surgical Hospital in Idlib, which killed two civilians.
Kafr Nobol was not the only hospital to be attacked that day. At least three other facilities were also attacked. Physicians for Human Rights reported 566 attacks on medical facilities in Syria from 2011-2019, which led to the loss of 900 medical workers. Approximately 90% of these incidents were perpetrated by the Syrian government and its allies.
In Sudan, the horrid violence of its civil war has left Khartoum North, one of the three cities that make up Sudan’s capital Khartoum, with only one functioning hospital. The WHO reports that there have been over 100 attacks registered on health facilities since April 2023.
In addition to the constant attacks on medical facilities, the displacement of over 11 million people has affected access to medical staff. The security situation has also resulted in critically low access to medical supplies.
In October 2024, the shelling of Al-Saudi Maternity Hospital in Al Fasher, the capital city of North Darfur State, injured 10 medical staff members and destroyed multiple departments, including the emergency department. The hospital’s water and energy systems also suffered damage.
Al-Fasher had eight functioning hospitals before the war began. Bombardments have left only one functioning facility left, the Al-Saudi Maternity Hospital, which is now only partially functional.
During Yemen’s ongoing civil war, hospitals have not been sparred. Airstrikes by the Saudi-Emirate coalition, which have targeted civilian infrastructure, including hospitals, have killed thousands of civilians.
The Yemen Archive, a database project, reported over 130 attacks on medical facilities by 2019. One hospital alone in the city of Hodeida has been attacked on three separate occasions, resulting in the destruction of medical equipment and a massive fire that almost completely destroyed one of the hospital’s floors.
If an attack on a hospital or medical facility is seen as justified from an international law perspective, the provisions state that a warning must be provided to allow for the evacuation of the wounded and sick
Attacks must still be limited to the rules of war, which includes proportionality, to avoid harm to patients and medical personnel. Regulations also include measures that would allow for the rapid restoration of a facility following an attack.
Sources: (Al Jazeera) (Human Rights Watch) (AP News) (Open Society Foundations) (International Committee of the Red Cross) (Politico) (NBC News) (The Washington Post) (France 24) (OCHA) (Attacks on Healthcare in Ukraine) (United Nations) (World Health Organization) (The Century Foundation) (Physicians for Human Rights)
See also: Enforced disappearances—a tool of political repression
Under siege: Targeting hospitals in conflict
We have seen an increased frequency of attacks on healthcare facilities in war zones
LIFESTYLE War
Civilian populations face dire consequences of the systematic erosion of international humanitarian norms. For instance, the increased frequency of targeting hospitals and medical personnel is part of broader strategies to demoralize and control local populations. These measures violate the Geneva Conventions, which mandate the protection of civilian medical infrastructure, even during wartime. What happens to public health when there is reduced access to medical care? What occurs when the integrity of humanitarian law is challenged? And how can protection measures for healthcare facilities be strengthened? Click on for these answers and more.