Wednesday briefing: Why Israeli forces are raiding Gaza’s biggest hospital
Good Wednesday #GoodWednesday
Good morning. In the last few hours, Israeli soldiers have stormed Gaza’s Al-Shifa hospital. Israel says that the raid, which is still underway, is a “precise and targeted operation against Hamas”, which it accuses of operating a command centre beneath the medical facility, a claim Hamas denies.
The attack at al-Shifa is militarily significant – but it is also taking place in the arena of an unfolding humanitarian catastrophe that has drawn huge global attention, with conditions rapidly deteriorating on the site since the Israel Defence Forces (IDF) surrounded it last week. And so whether Israel is able to carry out the pinpoint attack it has promised is likely to be a critical test of the international community’s view of its conduct of the war.
Israel says that it will do everything in its power to protect patients, medical staff, and others sheltering on the site. But there have already been claims of civilians coming under fire as they sought to flee. For the very latest, head to the live blog. Today’s newsletter, which comes a little late as the situation develops, takes you through what you need to know. Here are the headlines.
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In depth: How a hospital became the focus of the conflictA wounded infant receives treatment at al-Shifa Hospital. Photograph: APAImages/Shutterstock
The Dar al-Shifa (House of Healing) hospital is the most advanced in the Hamas-controlled Gaza Strip. There are about 600 patients and somewhere between 200 and 700 medics and administrators on site; figures have varied widely on the number of displaced people there, from 1,500 to 15,000, with an estimate from a doctor on Wednesday morning that 2-3,000 were sheltering at the facility.
Israel claims that since it pulled out of Gaza in 2005, Hamas has expanded existing basements under the complex of buildings into a sprawling command centre as part of a broader strategy of using civilians to shield its forces from Israeli attack. Hamas denies this.
Since Friday, when Israeli tanks and snipers encircled the facility, an already dire situation has worsened. On Saturday, the hospital said that its last generator ran out of fuel, and yesterday, a health ministry spokesperson said that mass graves were being dug on site to deal with about 100 decomposing bodies. A key question about this morning’s attack is whether it will put those civilians on site in still greater danger, or end the situation rapidly and allow them to escape or get the medical supplies they need.
What do we know about the attack so far?
At about 1am local time, Israel told officials in Gaza that it intended to raid the hospital complex in “the coming minutes”. Later, the IDF confirmed that an attack was underway and said that it was strictly targeted on an area of the hospital where it said Hamas was operating. It said that its forces had undergone special training for the “complex and sensitive environment” and that medical teams and Arabic speakers had gone in as part of the operation.
Dr Munir al-Bursh, director-general of the Gaza health ministry, told Al Jazeera that Israeli forces had raided the western side of the site. There were also reports of tanks inside the complex. A Gaza health ministry spokesperson said that the IDF had reached the basement and was “shooting and carrying out bombings”, while an eyewitness told the BBC that they had seen soldiers entering a specialised surgical department. None of these claims have been independently verified by the Guardian.
What impact has the situation had on patients?
Before the attack began, the UN said that 32 patients had died so far, as well as three nurses. Those physically able to leave were already frightened to do so: healthcare worker Goudhat Samy al-Madhoun told AP that Israeli Defense Forces (IDF) fired on a group of about 50 who were attempting to flee the facility on Monday despite promises of safe passage. Al-Madhoun said Israeli forces fired on the group several times, wounding one man, who had to be left behind.
Without the fuel needed to keep crucial equipment running, the humanitarian situation has been deteriorating rapidly. Munir al-Boursh, a doctor and Palestinian health ministry undersecretary who spoke to the Guardian’s Ruth Michaelson, said that there were no oxygen supplies or light to conduct surgery, and that six operating theatres were out of action.
Meanwhile, photographs from Reuters published on Monday showed premature babies weighing less than 1.5kg, who had been removed from incubators, lying huddled together on ordinary beds in an operating theatre. “Yesterday I had 39 babies and today they have become 36,” Dr Mohamed Tabasha, head of the paediatric department, said then. “I cannot say how long they can last.”
The IDF has said that it is arranging the transfer of incubators from Israel; Gaza health ministry spokesperson Ashraf al-Qidra said that no such plan was in place before the raid. Israel also says that it left 300 litres of fuel at the entrance to the complex on Sunday but that Hamas stopped the hospital from taking it.
But the hospital needs 10,000 litres of fuel a day. Hospital director Mohammad Abu Salmiya told CNN that the Israeli offer would be enough to power the facility for half an hour, and that staff had been too scared to retrieve the fuel given how small a difference it would make. Hospital officials have called for any delivery to be made by a neutral body like the International Committee of the Red Cross.
Why is Israel targeting the hospital?
An aerial view shows the compound of Al-Shifa hospital in Gaza City on 7 November 2023. Photograph: Bashar Taleb/AFP/Getty Images
It says that since the 7 October attacks that killed 1,200 Israelis, senior Hamas leaders have been based there. Israeli army spokesperson Lt Col Peter Lerner told CNN the hospital and compound were for Hamas “a central hub of their operations, perhaps even the beating heart and maybe even a centre of gravity”.
Israeli officials quoted in the New York Times claimed that Al-Shifa was spared during past operations in Gaza out of deference to civilian patients and staff but that it was now a key Israeli target.
In an analysis piece on Sunday, Jason Burke wrote that Israel intends to dismantle Hamas’s ability to govern Gaza, and quoted Prof Kobi Michael of the Institute of National Security Studies in Tel Aviv, who said: “In this war we have to dismantle the elements of Hamas that will prevent Hamas from becoming a military threat again or a government again.”
What is the evidence for claims that Hamas is headquartered under the hospital?
The IDF has released footage which it says is of two interrogations of Hamas militants who allegedly confirm that the organisation has a command centre hidden at al-Shifa. It has also released audio recordings said to capture other militants discussing the command centre, and claims to have further intelligence supporting its case. (The authenticity of other audio recordings released as evidence by Israel has been disputed.)
The US said on Tuesday that its own intelligence supported Israel’s conclusions – a move which Hamas said this morning had given a “green light” for the raid.
Hamas, and medical staff on site including the hospital director, deny that there is any Hamas presence there. The NGO Human Rights Watch has also said it is unable to corroborate the allegation. The health ministry in Gaza has invited an independent inspection, but others have dismissed that suggestion as impractical in the current circumstances.
Is Israel entitled to take military action at the hospital?
Regardless of the truth of the claim, Israel has been urged to spare the hospital and the civilians there. Joe Biden said on Monday that “the hospital must be protected”, and others including the World Health Organization and Unicef have called for an end to all attacks on hospitals. After the operation was announced, a White House spokesperson said that the US did not wish to see a firefight in the hospital “where innocent people, helpless people, sick people trying to get medical care they deserve are caught in the crossfire”.
The Geneva convention provides special protection for civilian hospitals, saying that they should “in no circumstances be the object of attack”. But it adds that such protection can be rescinded if a hospital is used for “acts harmful to the enemy”, like concealing fighters or weapons. If so, there is still a requirement for due warning and a “reasonable time limit” for the acts to stop.
Cordula Droege, chief legal officer of the ICRC, said that the law also prohibits any action that prevents hospitals from treating the sick. There was no “free licence to attack”, she said. “Every attack is subject to the principles of proportionality and precaution. This means that the party to the conflict has to do everything feasible to avoid or at least minimise harm to patients and medical staff.”
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Using civilians as human shields, as Hamas is repeatedly accused of doing, is itself a war crime, as Peter Beaumont explains in this piece. But under international law, that fact does not in its own right justify an attack on a hospital unless all possible measures have been taken to protect the civilians in the firing line.
That is why Israel insists there is “no siege” at al-Shifa, that it has provided evacuation routes for civilians, and that it gave Hamas authorities 12 hours notice that any military operation inside the facility must cease before the operation. began. And it is why such close scrutiny will now be applied to whether the IDF does everything in its power to protect the civilians who are still in the hospital as the battle rages.
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A bit of good news to remind you that the world’s not all bad
‘No-kill’ caviar produced by John Addey in Yorkshire. Photograph: Courtesy of KC Caviar
For a long time, the only way most people extracted eggs from sturgeons to make caviar was by beating the fish on the head to death before cutting its belly open. When polar and marine scientist Angela Köhler saw this happen, she knew she had to figure out a way to produce “no kill caviar”.
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