Gaza's Main Hospital: Ground Zero of Israel's Battle against Hamas
Gaza's largest hospital, Al-Shifa, has become a symbol of the ongoing conflict between Israel and Hamas Discover the latest developments, Israel's claims, Palestinian reactions, US statements, the significance of Al-Shifa, and the legal implications of targeting hospitals
Israeli forces conducted a raid on Wednesday at Al-Shifa, the largest hospital in Gaza. The raid was prompted by their accusation that Hamas was using tunnels underneath the extensive complex, a claim that has been denied by both the militant group and hospital officials.
Thousands of Palestinians are thought to be seeking refuge within and near the hospital, identified by the UN as the focal point of the ongoing conflict. This has resulted in the entrapment of defenseless patients, staff, and displaced Palestinians who now face shortages of crucial medical resources and fuel.
Due to the dire circumstances, the primary structure of the hospital has practically halted its operations, compelling physicians to rely on candlelight and resort to wrapping premature infants in foil to sustain their lives. Alarming reports indicate that the conditions prevailing within have escalated to a level of sheer catastrophe.
The hospital has recently become a reflection of the ongoing war and the rhetoric surrounding it. Palestinians use the fighting around Al-Shifa as evidence of Israel's careless disregard for civilian life in Gaza, while Israel highlights the hospital as an instance of Hamas using civilians as human shields.
However, the Israeli forces' choice to enter the hospital signifies a possible escalation in the conflict, which started on October 7. On that day, Hamas militants entered Israel, resulting in the death of over 1,200 individuals and the kidnapping of more than 200 others. This attack stands as the largest of its kind on Israel since the country's establishment in 1948.
A satellite image shows Al-Shifa hospital, amid the ongoing conflict between Israel and the Palestinian Islamist group Hamas, in Gaza on November 7.
According to the Palestinian Ministry of Health in Ramallah, more than 11,000 people have been killed by retaliatory Israeli strikes in Gaza. The figures are sourced from the Hamas-controlled territory.
Heres what we know so far about Al-Shifa and the Wednesday raid.
What happened on Wednesday?
The Israel Defense Forces (IDF) announced on Wednesday morning that they were conducting a targeted operation against Hamas in a specific area of Gaza's Shifa Hospital. Dr. Khaled Abu Samra from the hospital revealed to CNN that they were given a 30-minute warning prior to the commencement of the Israeli operation in the early hours of Wednesday morning.
Smoke rises as displaced Palestinians take shelter at Al Shifa hospital, amid the ongoing conflict between Hamas and Israel, in Gaza City, November 8, 2023. REUTERS/Doaa Rouqa
Doaa Rouqa/Reuters
Israeli troops and tanks raid Gazas Al-Shifa Hospital
He reported that we were instructed to avoid the windows and balconies due to the proximity of the armored vehicles at the complex entrance. Journalist Khader Al Zaanoun informed CNN that Israeli tanks and military vehicles were present in the hospital courtyard. He further stated that Israeli soldiers were conducting intense search and interrogation operations with young men inside the hospital, accompanied by violent gunfire. They were using megaphones to call upon young men to surrender by raising their hands and coming out.
CNN is unable to authenticate Israel's assertions about Hamas operating from the hospital. Israeli army representative Peter Lerner informed CNN on Wednesday that the IDF had notified hospital administrators, patients, and civilians present to seek protection. This was done with the intention of carrying out a military operation to discern and separate the civilians from the terrorists.
Ambulances carrying victims of Israeli strikes crowd the entrance to the emergency ward of the Al-Shifa hospital in Gaza City on October 15.
Dawood Nemer/AFP/Getty Images
What is Israel claiming?
Israel has continuously alleged that Hamas is utilizing the hospital complex for military activities. During a media presentation last month, Israeli military spokesperson Daniel Hagari accused Hamas of orchestrating rocket attacks and commanding operations from bunkers beneath the hospital structure. He further stated that this hospital was connected to the network of tunnels that Hamas has constructed underneath Gaza City.
At the time, Hagari provided only one piece of evidence: a telephone conversation allegedly discussing the existence of Hamas headquarters at the Al-Shifa hospital between two individuals from Gaza. CNN was unable to independently verify the credibility of the recording.
During the presentation, Hagari claimed that other hospitals inside Gaza were also utilized by Hamas in a similar manner. He supported his statement with aerial photos, graphics, and voice recordings. Additionally, the IDF released an "intelligence-based" illustrated video showcasing the supposed layout of the Hamas headquarters under Al-Shifa. The video demonstrated a 3D diagram of the hospital, which seamlessly transitioned to reveal an animated network of tunnels and operation rooms.
Israel has made additional attempts to raise awareness about what it claims is evidence of Hamas operations taking place beneath hospitals. The IDF extended an invitation to the media on Monday, allowing them to visit Gaza City's Al Rantisi children's hospital. Hagari asserted that certain sections of the basement served as a Hamas "command and control center" and potentially functioned as a holding facility for hostages.
An aerial view shows the compound of Al-Shifa hospital in Gaza City on November 7.
Bashar Taleb/AFP/Getty Images
CNN reporters were embedded with the IDF and granted access to a room beneath the hospital, where guns and explosives were displayed. This room was referred to as an "armory" by Hagari.
In response to Israel's allegations, the director of hospitals at the Hamas-controlled ministry of health denied the claims. He stated that the basement of Rantisi hospital was utilized as a shelter for women and children, rather than a storage area for Hamas weapons or a place where hostages were held.
How have Palestinians responded?
Hamas, Palestinian health officials and medical workers have also vehemently denied Israels claims about Al-Shifa, and condemned Wednesdays raid.
Dr. Medhat Abbas, the director general of the Gaza health ministry, informed CNN that the hospitals in Gaza solely serve to treat patients and not as a hiding place for anyone.
Dr. Mai Al-Kaila, the Palestinian Authority Health Minister, denounced the raid as a fresh act of inhumanity against medical personnel and patients. She also cautioned that such actions could have disastrous implications for patients and medical staff.
Hamas attributed responsibility for the raid to both Israel and the US in a statement released on Wednesday. They claimed that the US had provided Israel with permission to carry out further massacres against civilians by accepting Israel's fabricated account of Al-Shifa serving as a command center. Additionally, the statement criticized the United Nations for its inability to protect the Palestinians.
Wounded Palestinians sit in Al-Shifa hospital in Gaza City, after arriving from Al-Ahli hospital following an explosion there on October 17.
Abed Khaled/AP
What has the United States said?
On Tuesday, the White House supported Israel's allegations, stating that Hamas was using the al-Shifa hospital in Gaza as a base for storing weapons and operating a command center. US intelligence was cited as the source of this information. John Kirby, a spokesperson for the US National Security Council, conveyed this message to reporters accompanying President Joe Biden, however, no evidence was provided to substantiate Kirby's claim.
But Biden also said Monday that hospitals in Gaza "must be protected" and that his "hope and expectation is that there will be less intrusive action" around them.
Why is Al-Shifa so important?
The extensive Al-Shifa medical facility in the western part of Gaza City was established in 1946 during British rule. It has been widely regarded as the primary healthcare provider in the besieged Gaza Strip and has experienced damage during previous conflicts between Hamas and Israel. Following Israel's initial conflict with Hamas in 2008-2009, claims were made that Hamas fighters sought refuge in mosques, hospitals, and other civilian locations to evade Israeli attacks.
A premature Palestinian baby lies in an incubator at the maternity ward of Shifa Hospital in Gaza on October 22, 2023.
Mohammed Al-Masri/Reuters
Doctors race to save newborns as Israel says its battling Hamas around Gazas largest hospital
In 2009, Avi Dichter, the former Minister of Internal Security and Shin Bet director, stated that Palestinians living in Gaza were well aware that Hamas uses Al-Shifa for its operations, despite Hamas' repeated denials. Nine years later, during the 2014 Israel-Gaza war, the hospital was targeted. This attack, condemned by aid and medical organizations, sparked a dispute between Palestinians and Israel, as Palestinians accused Israel while Israel claimed it was unintentional due to a failed Hamas rocket launch.
The hospital garnered media attention a year later following the release of a scathing report by Amnesty International, which accused Hamas of interrogating and subjecting individuals to torture at a clinic located in Al-Shifa.
What does international law say about targeting hospitals?
International humanitarian law (IHL) regulates the conduct of warfare and aims to minimize the impact of conflict. Its primary objective is to safeguard civilians, along with their medical personnel and facilities.
However, this protection is not absolute. Cordula Droege, the chief legal officer of the International Committee of the Red Cross, highlighted in a video on Tuesday that such safeguards can be forfeited if civilian objects, such as hospitals, are exploited to carry out hostile actions against the enemy. Consequently, it is essential to refrain from utilizing these structures to accommodate combatants and weaponry, as doing so legitimizes their targeting for military purposes.
Once a hospital loses its protected status, an attack may be deemed acceptable, but the attacking party must issue a warning prior to launching the strike. The purpose of such a warning is to provide an opportunity for those who are misusing the hospital to cease their harmful actions towards the enemy. If these actions persist, the warning also allows for the safe evacuation of patients and medical staff. However, it is important to acknowledge that this may not always be possible in conflict situations.
In a statement released on Wednesday, the IDF emphasized that it had been warning for weeks about Hamas's continuous military use of the Shifa hospital, which jeopardized its protected status. Furthermore, the IDF notified the relevant authorities on Tuesday that all military activities within the hospital must cease within a 12-hour timeframe.
However, according to Droege, this does not grant permission for indiscriminate attacks. All strikes must adhere to the principle of proportionality, meaning the attacking party must ensure that the anticipated harm to civilians is not excessive in relation to the expected military advantage. Additionally, all parties involved are required to take measures to minimize harm to civilians.
Determining proportionality, however, is a challenging task. Michael Schmiit, a law professor at the University of Reading and a former targeting officer in the US Air Force, stated that this calculation is the most difficult decision a commander can make on the battlefield, as there is no clear-cut criterion.
Legal experts are divided on whether Israel's actions violate International Humanitarian Law (IHL), although the horror of such attacks is universally acknowledged. This report includes contributions from CNN's Tamar Michaelis, Jo Shelley, Abeer Salman, Andrew Carey, Nic Robertson, Kareem Khadder, Celine Alkhaldi, Manveena Suri, and Aimee Look.
