Fresh Air

In one of the largest arrest operations since the start of ground operations in Gaza following Hamas’ October 7, 2023, attack, the IDF recently raided the Kamal Adwan Hospital in northern Gaza, which it called “Hamas’s last bastion in Jabalia.” This was the third time since December 2023 that Israel had raided the hospital.

Prior to the latest operation, hundreds of Hamas and Palestinian Islamic Jihad (PIJ) operatives had reportedly sought shelter there from intensive Israeli strikes in the Jabalia area, and established fighting positions – some booby-trapped – in the hospital grounds and planted explosive devices in the general area.

According to the IDF, after evacuating patients, staff and those sheltering at the hospital to another nearby hospital and bringing the necessary supplies from Kamal Adwan, it detained about 240 suspected operatives of Hamas and PIJ. These included at least 15 individuals implicated in the October 7 attacks, as well as senior commanders and other fighters. The hospital’s director, Hussam Abu Safiya – a Hamas colonel, according to Israel, Palestinian media outlets and Gaza’s own Hamas-run medical services – was among those detained.

Some of the Hamas fighters allegedly tried to flee in ambulances and stretchers by pretending to be staff or patients. In addition, two Hamas cells were also reportedly struck by drones trying to flee the hospital premises. The IDF claimed it killed 19 operatives in the fighting and is unaware of any civilian casualties resulting from the operation. It also says it never fired directly at the hospital.

One IDF investigator told Israeli news outlet N12 that the “hospital” was more of a Hamas base than a medical facility:

Every Hamas terrorist we interrogated confirmed that the Kamal Adwan Hospital is their military base: it’s where they regroup, store their weapons, and manage the intelligence they gather. Some of the hospital rooms have been converted into Hamas operational rooms. Kamal Adwan Hospital is a Hamas operations and organization base, including [for] the preparation of explosives, ammunition, and weapons. Every issue related to hostages has passed through this hospital at various times. Hamas set up operational rooms inside the hospital, and no civilian ever entered those rooms. It was made to look like a hospital, and patients were brought there just for appearances. In reality, there are entire sections meant solely for the entry of Hamas terrorists.

If this whole saga seems like déjà vu, it is because in late December 2023, the IDF launched its first raid on the Kamal Adwan Hospital and detained nearly 100 suspected terrorist group members inside. The hospital’s then-director Ahmed al-Kahlout, who admitted he’d been a Hamas lieutenant colonel since 2010, told interrogators that 16 members of the staff were members of Hamas’ military while others fought for PIJ, and the hospital was a base for operational activity. Someone with the same name, though described as the Kamal Adwan’s ICU director, was reportedly killed in a drone strike approximately a year later. During that first raid, the IDF claimed to have found weapons, including in neonatal incubators, as well as intelligence documents and tactical communication devices elsewhere in the hospital.

Another short raid took place in late October 2024.

Dr Baxtiyar Baram, a Kurdish physician who was volunteering in northern Gaza in two hospitals, Al-Awda and Kamal Adwan, told the Kurdish news website Rudaw, “I saw that hospitals had been used for hiding Hamas leaders,” among other abuses.

These three Kamal Adwan raids are emblematic of an ongoing and systemic issue in Gaza; namely, Hamas’ abuse of hospitals and medical facilities “to commit acts harmful to the enemy”, a somewhat undefined yet expansive phrase  in international humanitarian law (IHL) describing the conditions that strip such facilities of their usual protection from military action, with caveats and within the bounds of other IHL principles.

Hamas’ actions have forced the IDF to fight in or around hospitals across Gaza carefully, and to evacuate patients, staff and those sheltering on hospital grounds, as has happened in this case and numerous others where the IDF had to raid a hospital used as a base.

Indeed, several hospitals and medical facilities throughout Gaza have had to be raided – or have been or are currently battle zones – multiple times since October 7, 2023, because Hamas, PIJ and other terrorist group activities are centred inside them, something AIJAC has documented extensively.

That documentation is not only based on IDF claims and interrogations, but also on independently corroborated US intelligence, Palestinian Authority assertions, documentation by mainstream international media outlets and human rights NGOs and the claims and footage of Hamas and other terrorist groups themselves. Terrorist groups using hospitals, medical facilities, ambulances and other related infrastructure “to commit acts harmful to the enemy” is not a theoretical or unverifiable assertion by the IDF, but a fact backed up by mountains of publicly available evidence.

But you wouldn’t know that from reading the latest thematic report by the Office of the United Nations High Commissioner for Human Rights (OHCHR), which implies in paragraph 43 that any such allegations are merely unverified Israeli claims for which there is no evidence:

If Palestinian armed groups have used hospitals and other medical units outside their humanitarian function for acts harmful to the enemy, or in an attempt to shield military objectives from attack, such conduct would constitute serious violations of international humanitarian law…The IDF has regularly alleged that the hospitals it has attacked have been used by “Hamas” or “terrorist organizations”, or that operatives were in close proximity to the hospital. If verified, this would raise serious concerns that Palestinian armed groups were using the presence of civilians to intentionally shield themselves from attack, which would amount to a war crime. Independent and credible investigations are required in this regard [emphasis added].

Among the many other laughable flaws of this report are its “legal analysis” section, particularly paragraphs 37-39, which demand a virtually impossible standard of military conduct for Israel. The report even suggests in paragraph 39 that Hamas leaders hiding inside hospitals or using them as bases of operations “would not make hospitals military objectives and raise serious concerns of violations of the principle of distinction and of the special protection of hospitals.”

That’s right, the report effectively argues that, contrary to the text and practice of IHL, while Hamas is not allowed to use hospitals as military bases, if they do, Israel is not allowed to do anything about it.

Additionally, despite a plethora of incontrovertible information that the infamous Al Ahli hospital parking lot explosion on October 17, 2023, was caused by a misfired Palestinian rocket, the report refuses to attribute responsibility, instead implying it may have been part of a pattern of Israel targeting hospitals. This is the calibre of “analysis” one expects nowadays from anti-Israel activists masquerading as UN legal experts and officials.

This is a pity, because there are genuine legal and ethical discussions to be had in terms of IHL, IDF conduct and medical units and facilities in Gaza being abused by Hamas. Unfortunately, judging from this OHCHR report and similar documents and statements by human rights NGOs and UN officials, few are interested in engaging in them – only in finding ways to condemn Israeli conduct in ever more apocalyptic terms.

What is the effect of fatuous reports lamenting the tragic destruction of healthcare infrastructure in Gaza without directly blaming Hamas and PIJ for utilising this “to commit acts harmful to the enemy”; pretending that there’s no way to know why the IDF is constantly having to fight in and around hospitals in the first place; and trying to rewrite international law to falsely claim all such operations are illegal in any case? Incentivising Hamas to continue abusing hospitals, thus guaranteeing that it will be much harder for Gazans to get the medical care they need, as these medical facilities are inevitably turned into conflict zones, medical resources are diverted or destroyed and some facilities have to be shut down.