Fresh Air

Thanks to Hamas and its fellow terrorist organisation Palestinian Islamic Jihad (PIJ), Gaza’s al-Shifa Hospital complex now lies in ruins. Having turned the extensive hospital complex into a military base, thereby removing its protected status under the Geneva Conventions, Hamas then opted to violate a long-standing ceasefire with Israel to launch its October 7 invasion and mass slaughter and kidnapping.

The hospital as it existed until Hamas caused its destruction this year was actually a product of Israel’s occupation of the Gaza Strip from 1967-2005. It was renovated and massively expanded by Israel in the 1980s as part of a project to improve living conditions in Gaza. These renovations included Israeli-built bunkers under the hospital to expand the hospital’s functional space to deal with the medical needs of Palestinians.

By 2007, two years after the Israeli withdrawal from all of Gaza, Hamas had taken over al-Shifa, which is why it was attacked by the Palestinian Authority during its brief civil war with Hamas that year. Human Rights Watch reported that “Fatah gunmen began firing mortars and rocket-propelled grenades at Shifa Hospital in Gaza City, drawing Hamas fire from inside the building, killing one Hamas and one Fatah fighter.”

In December 2008, the New York Times reported that armed Hamas gunmen in civilian clothing were going room to room in Shifa, executing suspected collaborators. In early 2009, following Operation Cast Lead, the Palestinian Authority said Hamas had taken over hospitals in Gaza, including al-Shifa, to use them “as stations for summons, interrogation, torture and detention.” This was later confirmed by Amnesty International in 2015, which said that during Operation Protective Edge in 2014, Palestinians abducted by Hamas on suspicion of being collaborators “were interrogated and tortured or otherwise ill-treated in a disused outpatient’s clinic within the grounds of Gaza City’s main al-Shifa hospital.”

During the 2008-2009 war, then-Shin Bet chief Yuval Diskin and other Israeli intelligence officials claimed senior Hamas officials were hiding in the basement and bunkers of the hospital. Then-Israeli Public Security Minister and former intelligence chief Avi Dichter said, “Shifa Hospital has long ago ceased to be just a hospital. It is somewhat of an open secret that Hamas commanders walk around the hospital, in some instances wearing doctor’s robes.” A Gazan doctor interviewed contemporaneously and anonymously by PBS’s Wide Angle also said he suspected Hamas leaders were hiding under the hospital.

It was during the 2014 war that the Washington Post reported that Shifa had become “a de facto headquarters for Hamas leaders, who can be seen in the hallways and offices.” Dave Harden, a former United States Agency for International Development (USAID) mission director in the West Bank and Gaza, posted on X (formerly Twitter) in November 2023, “It was broadly suspected/understood as far back as 2014 that Hamas used the Shifa Hospital complex as a command center and base for operations. I didn’t have direct evidence, but it was recognized by both trusted Palestinians and Israelis in my network.” The hospital complex was used to fire rockets during the 2014 war, as well.

A British doctor who once worked at the hospital told France24, “When I was first asked to work there [at Shifa], I was told there was a part of the hospital I was not to go near, and if I did, I’d be in danger of being shot.”

Anonymous Palestinians interviewed for the Voices from Gaza project by the Free Press and Center for Peace Communications also testified that Shifa was an open Hamas base. One claimed, “When I went to Shifa hospital, I found Qassam fighters all around us… Every Palestinian knows Shifa is full of them, but nobody can talk.” Another asserted, “[Hamas] exploited the fact there were so many people [at Al-Shifa]. To be candid, their ammunition depot was in Shifa Hospital.”

During Israel’s first raid against Hamas and PIJ in Al-Shifa Hospital in mid-November, US National Security Council spokesperson John Kirby told reporters:

Hamas and [PIJ] use some hospitals in the Gaza Strip, including Al-Shifa, and tunnels underneath them to conceal and to support their military operations and to hold hostages. Hamas and [PIJ] members operate a command-and-control node from Al-Shifa in Gaza City. They have stored weapons there.

The initial Israeli raid in November uncovered weapons and explosives in the hospital as well as an extensive tunnel system underneath. The New York Times, citing classified Israeli intelligence documents and images it had examined, reported that the tunnel under al-Shifa was more than 213 metres in length and that the IDF found “underground bunkers, living quarters and a room that appeared to be wired for computers and communications equipment along a part of the tunnel beyond the hospital.” The evidence, it said, “suggests Hamas used the hospital for cover, stored weapons inside it and maintained a hardened tunnel beneath the complex that was supplied with water, power and air-conditioning.”

US intelligence independently corroborated Israeli claims, partially based on communications intercepts, about the use of al-Shifa by Hamas and PIJ “for a variety of purposes related to its campaign against Israel.” In January, the New York Times reported that:

A senior U.S. intelligence official said on Tuesday that the American government continued to believe that Hamas used the hospital complex and sites beneath it to exercise command and control activities, store weapons and hold “at least a few hostages.” American intelligence agencies obtained information that Hamas fighters had evacuated the complex days before the multiday operation, destroying documents and electronics as they left.

However, following the Israeli withdrawal from the complex, senior Hamas and PIJ commanders and hundreds of fighters slowly reinfiltrated the hospital complex. Israel launched a surprise attack on this grouping beginning March 18, killing and detaining several top Hamas and PIJ commanders, capturing at least 500 members of both organisations and killing at least 200 terrorist operatives (for more on this, see Ahron Shapiro’s factsheet, published last week.)

That Israel had captured and killed senior leaders of Hamas and PIJ was confirmed by a Hamas official to the Hezbollah-linked Al-Akhbar paper in Lebanon, who said, “Nobody should underestimate the size of the infiltration carried out by the enemy army at Al-Shifa Hospital, nor underestimate the importance of the figures who were arrested or executed.”

IDF Spokesman Rear Adm. Daniel Hagari said during the operation, “Hamas is destroying Shifa Hospital. Hamas is firing from inside the Shifa emergency room and maternity ward and throwing explosive devices from the Shifa burn ward. Terrorists hiding around the hospital fired mortars at our forces, causing extensive damage to the hospital buildings.” Israel withdrew on April 1.

The IDF claims no civilians were killed in the hospital complex itself as a direct result of its operations, though there are claims that several died in unspecified circumstances during the raid. Both Hamas and Fatah’s Al-Aqsa Martyrs Brigade released videos or statements about targeting the IDF with artillery and rockets inside the compound, confirming Israel’s version of events in terms of responsibility for the fighting at the hospital.

And that is the sad story of al-Shifa Hospital. What began as an Israeli endeavour to improve the lives of Palestinians by building a state-of-the-art hospital complex in Gaza in the 1980s and 1990s was ended by a coalition of genocidal terrorist organisations that could not care less about Palestinian well-being.