INTERVIEW: Israel’s war on Gaza hospitals

Amira Howeidy , Wednesday 22 Nov 2023

Human Rights Watch’s Omar Shakir explains how Israel’s targeting of Gaza’s hospitals has been allowed to continue, in an interview with Al-Ahram Weekly.



Director for Palestine-Israel at the international NGO Human Rights Watch (HRW) Omar Shakir said in an interview with Al-Ahram Weekly this week that Israel’s repeated and unlawful attacks on medical facilities in Gaza should be investigated as war crimes.

Despite the Israeli army’s claims of Hamas’ “cynical use” of hospitals for military purposes, it has not put forward any evidence justifying depriving hospitals and ambulances in Gaza of their protected status under international humanitarian law, the group said in a report issued last week.

The report investigated Israeli attacks on five hospitals between 7 October and 7 November that killed and injured hundreds and damaged parts of these medical facilities. The attacks, as well as the lack of fuel and electricity, have forced 18 out of Gaza’s 36 hospitals, including its biggest and most important medical complex the Al-Shifa Hospital, to shut down, as Gaza’s collapsing healthcare system grapples with an unprecedented number of injured patients.

Because hospitals are protected under international law during conflicts, thousands of Palestinians had sought shelter in them after Israel’s assault on the Strip began on 7 October. While Israel has repeatedly accused the Palestinian resistance of using hospitals for military operations or as human shields, it has failed to provide any evidence to substantiate these claims.

As the Weekly went to press this week, the Israeli occupation forces in northern Gaza had laid siege to the Indonesian Hospital in addition to bombing the Al-Awda Hospital, killing dozens of patients and medical staff.

In a telephone interview with the Weekly on Monday, HRW’s Shakir explained that Israel’s attacks on hospitals are rooted in decades of impunity and have also been enabled by the cover provided by its Western allies to violate and undermine international law during its war on Gaza.


The missile strike on the Al-Ahli Baptist Hospital on 17 October in Gaza City that killed hundreds was so shocking that the Israeli military felt compelled to deny its responsibility and even blame it on the Islamic Jihad group. But what we’ve seen during the past few weeks is a targeted military campaign on Gaza’s hospitals in the absence of an international outcry. How did we arrive at normalising such gross violations of international law?

The reality is that international law is very clear that hospitals have special protection and that doctors, medical workers, and ambulances must always be protected and allowed to do their work. There must be an effort by warring parties to ensure that medical facilities are allowed to continue in operation. There is a very narrow specific provision under the law in which it is permissible to carry out attacks on hospitals, and as is often the case, warring parties, especially the Israeli government, have sought to take that really narrow condition and use it as the basis for systematic attacks very broadly across Gaza on hospitals. Human Rights Watch has investigated several of these attacks on hospitals and found that the Israeli government has put forward no evidence that would justify attacking Gazan hospitals.

I think we’ve got to this point precisely because there have been decades of unlawful attacks by Israeli forces, as well as by Palestinian armed groups, that have taken place with impunity, which creates an attitude in which basic notions of international humanitarian law can be quickly set aside and a callous disregard for human life takes their place. I think it’s rooted in this impunity based on years of unlawful attacks and Israeli apartheid against Palestinians, and that’s what’s led to this situation in which hospitals have been deprived of medical supplies, water, and fuel that runs their electricity, making it impossible for them to operate, and they have also been under relentless attack.


What kind of dynamics have contributed to the shift in the international condemnation of the attack on the Baptist Hospital almost a month ago and the current daily targeting of hospitals and even refugee centres by the Israeli forces? The escalation came soon after US President Joe Biden’s solidarity visit to Israel on 18 October, in addition to the three visits to Israel by US Secretary of State Antony Blinken. Both made public endorsements supporting Israel.  

I certainly believe that the attitude of governments in Europe and the US are a big part of providing Israel with the sense that it can continue with its aerial campaign. We know that the bombing of hospitals has been condemned in places like Syria, by Syrian or Russian forces or in other contexts, and yet we have far too often not seen leaders in Europe and the US unequivocally condemn Israeli war crimes and its unlawful attacks. It took days for many Western leaders to even reiterate the need to respect international humanitarian law. We do not see condemnation of war crimes, and we don’t hear calls for investigations and accountability including at the International Criminal Court (ICC), which has jurisdiction over the matter.

I think that when the US issued its statement for example regarding the Al-Shifa Hospital, that was read by many Israeli officials as providing a green light for the attack on that particular hospital. And I think we shouldn’t lose sight of the fact that beyond the airstrikes and other direct attacks on hospitals, you have the blocking of the entry of life-saving aid and medical supplies, which is a war crime under international law, as is collective punishment.

I think even the aspect of condemning collective punishment as a war crime also hasn’t been forthcoming, so certainly the attitude of countries, especially the US and other allies of Israel in Europe, has certainly been a part of emboldening Israeli officials to follow up on their pretty clear and unequivocal statement of the intention to punish the population in Gaza and to commit atrocities.


The much-delayed 15 November UN Security Council Resolution calling for a humanitarian pause and establishing human corridors in Gaza was rejected by Israel, which seemed to respond by raiding the Al-Shifa Hospital and evacuating it. How much has this slow action by the Security Council – 40 days into the war and not even calling for a ceasefire – enabled Israel to pursue its war on Gaza’s hospitals?

I think the US has paralysed the Security Council from being able to carry out its essential function, especially during times of hostilities and armed conflict. In essence, it was rendered for the first five weeks basically incapacitated from taking action. The resolution last week is binding, and it signalled to the Israeli government that there is grave concern, including from the US. But that concern should have been forthcoming sooner, and I think the slow pace certainly has contributed to giving cover to the Israeli government to continue its campaign and its unlawful blockade on Gaza.

So, much more is needed, and at HRW we have been clear for weeks that we’re witnessing mass atrocities taking place on the ground and that world leaders must not only be much clearer in their statements, but they must take concrete action to prevent further mass atrocities.  


What would the legal repercussions of Israel’s rejection of a binding UN Security Council Resolution be?  

The Security Council has the mandate to ensure that its resolutions are followed, and it should continue to monitor and take action. Although it abstained, the US made it clear that it agreed with many provisions in that statement, so there must be much more concrete action that can take many different forms.

There needs to be calls for accountability, including at the International Criminal Court (ICC) to provide support for its office to do its job, and there must be a look at all forms of potential complicity in war crimes. HRW has called for an arms embargo to be imposed on the Israeli government given the grave risk that these weapons and military systems will be used in the commission of grave crimes. I think that states need to activate their atrocity prevention mechanisms. The UN can do the same thing in order to look at all sorts of different ways in which it can take forms of action and help prevent further atrocities from taking place in Gaza.


After raiding and evacuating the Al-Shifa Hospital, the Israeli military presented what it claimed to be new evidence of Hamas’ misuse of that Hospital. We saw footage of what Israel claimed to be an underground tunnel, but no evidence yet of a military command centre run by Hamas. Do you think Israel has now established that hospitals are indeed legitimate targets, and should we expect further attacks against others?

Any time allegations of hospitals being misused are made, they should be taken seriously. We’re not in a position to corroborate the Israeli government’s claims, but when we have looked into these claims, we have found that the numbers of strikes on hospitals were unlawful and should be investigated as war crimes, and we found in those situations that the evidence they put forward did not justify attacking hospitals.

Let’s remember that the heightened protection of hospitals means that they can only be attacked if acts harmful to the enemy have taken place from there. We did not find that in the cases we documented. In addition, even if actions harmful to the enemy have taken place, attacks on hospitals can take place only when there is provision of safe evacuation and medical representation, and that’s not possible in Gaza given that there’s no safe place to go and no reliably secure way to get anywhere.

In addition, let’s remember that international law continues to prohibit unlawfully indiscriminate or disproportionate attacks. And the risk of disproportionality is heightened in hospitals precisely because even a relatively minor invasion can have life-altering consequences for patients in urgent need of medical care. So, Israel cannot treat hospitals as free-fire zones, even if the burden was met to show that they’re being used to commit acts harmful to the enemy.


On the 45th day of the war, are we at a point of genocide fatigue and desensitisation to the mass atrocities live-streamed daily over such a long period?  

I hope nobody is ever desensitised to the piling up of hundreds of bodies everyday, and more than 4,500 children killed, to entire parts of neighbourhoods being reduced to rubble, to hospitals, schools, refugee camps, being struck by Israeli airstrikes. We should never be desensitised to that, and I think across the world, including in the West, we’ve seen people that are not desensitised that continue to call for the greater protection of civilians and an end to unlawful attacks.

These calls are just not yet fully reflected in the statements of the US and some other governments: there’s a disconnect there. But ultimately, we’re seeing the fundamental principles of international law that grew out of the ashes of World War II being put to the test; we’re seeing the core institutions of international order from the UN to the ICC being tested by the current dynamics on the ground.

Right now, humanity is not meeting those tests, and the consequences will reverberate far beyond Israel-Palestine if these institutions continue to fail to rise to the occasion.


* A version of this article appears in print in the 23 November, 2023 edition of Al-Ahram Weekly

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