/ 15 November 2023

Israel’s war on hospitals

Palestinians Taking Shelter Around Nasser Hospital Live Under Difficult Conditions In Gaza
KHAN YUNIS, GAZA - NOVEMBER 13: Palestinians, who were displaced from their homes due to Israeli attacks, take shelter at Nasser Hospital to protect themselves from Israeli airstrike in Khan Yunis, Gaza on November 13, 2023. (Photo by Abed Zagout/Anadolu via Getty Images)

There have been no attacks on hospitals in the Gaza Strip, that Israeli Defence Force (IDF), has solemnly assured the world. 

Tell that to the doctors at Al-Shifa Hospital in Gaza City, whose solar panels — its last energy source — were knocked out by an Israeli airstrike on November 6.

That means no light for surgery, which as one medic pointed out, cannot be conducted by the light of a cell phone, and no incubators for babies. 

America’s National Public Radio, which has done a good job of tracking the horrifying fallout of the invasion, quotes health ministry officials as saying that 18 of Gaza’s 35 hospitals are out of commission and 71% of its primary health facilities have been crippled by damage or fuel shortages.

Some attacks are clearly intimidatory, such as the two rockets that detonated 50m from the gates of the hospital of Al-Quds (“The Holy One”, the Arab name for Jerusalem). But health officials say Rantissi and Nasser hospitals have been hit by direct strikes.

Regional directors of the World Health Organisation and the United Nations have recorded 137 attacks on health care facilities, in which 521 people have been killed, including 16 staff members, and 686 injured.

The IDF is dedicated to the Afrikaner nationalist philosophy of “kragdadigheid” — the ever more ruthless application of repressive might in response to resistance — but this incursion is markedly different from those in 2008 and 2014.

The aim then was limited to degrading Hamas as a fighting force. Now it is to eradicate the militants root and branch and demolish their infrastructure, particularly the network of tunnels under Gaza City, and drive home to the Gaza citizenry the cost in blood of supporting Hamas.

The IDF could, of course, bomb Al-Shifa, Gaza’s largest hospital, to rubble in its hunt for the Hamas fighters it says are hiding in it. It has chosen to drive out the bedridden and thousands of displaced non-combatants sheltering ther, by blocking medical care, food, water and electricity, in a supposed display of the “purity of arms” principle enshrined in the IDF Code of Conduct.

This is about the optics of the war, not its substance. Although the vast majority of the war dead have been civilians — 40% of them children — the Israelis were curiously adamant that they were not behind the missile explosion at the Al-Ahli Hospital in central Gaza City on 18 October, which killed hundreds of refugees. The IDF blamed the blast on an abortive launch by Islamic Jihad, explaining that this had been proved by an “analysis of our operational systems”.

Likewise, it insisted that an ambulance convoy struck on 10 November, killing 15, was being used to transport terrorists and weapons. It provided no evidence.

Former Pentagon intelligence officer Marc Garlasco argues that the Israelis now appear to be dropping older, non-precision bombs and making “dynamic” operational decisions involving less warning to non-combatants.

And the choice of targets seems more indiscriminate: officials report that 52 mosques and two churches have been damaged, while the United Nations Relief and Works Agency for Palestine Refugees, UNRWA, reports that 50 of its installations have been hit by shelling or from the air.

Health officials say that 117 000 desperate displaced people are sheltering in the remaining operational facilities.  Satellite images indicate that up to a third of the buildings in northern Gaza have been damaged or destroyed.

In part, one is witnessing the vengeful flailing of an army and government caught napping by the Hamas cross-border raid on 7 October. Embarrassed and politically damaged, the unpopular Israeli leader, Benjamin Netanyahu, initially tried to shift the onus for the intelligence failure onto his generals. 

The lopsided response — 11 000 Palestinian dead in exchange for the revised toll of 1 200 Israelis — may also stem from sheer frustrated fury that Israel’s 16-year policy of “malign neglect” and blockade, punctuated by periodic IDF smash-ups when the militants become too troublesome, has not cowed Gaza into exhausted surrender.

The UN human rights office has raised “serious concerns” about the proportionality of strikes on refugee camps, while long-serving UN secretary general António Guterres has described Gaza as “the graveyard of children”. One writer points out that under international humanitarian law attacks on even legitimate military targets are prohibited if civilian casualties or damage are likely to be “excessive in relation to the concrete and direct military advantage anticipated”.

Both Israel and the US have ruled out a ceasefire in Gaza on grounds that the Israelis must be allowed to defend themselves. Israel’s UN ambassador, Gilan Erdan, has reacted to UN strictures by calling for Guterres’s resignation. The procedure is an old one: when in moral doubt, accuse the accuser.

Israel’s ruthless indifference to civilian suffering extends to the division of the Strip into north and south Gaza and what amounts to the attempted removal of a million people in densely populated Gaza City and surrounds.

As the IDF prepared to move in at the end of October it dropped leaflets calling on residents to evacuate to south of the Wadi Gazi, a wetland that roughly cuts the Gaza Strip in two, within 24 hours. Then it encircled and isolated northern Gaza in a three-pronged invasion.

The purpose seemed to be fourfold: to punish the citizenry; to force the release of hostages taken during the Hamas raid; to clear the battlefield and facilitate a full-scale drive on alleged Hamas “command posts” in and around hospitals; and perhaps to prepare for the permanent demilitarisation of the north under Israeli security control.

This is not the long-term plan favoured by the US, which has warned against Israel’s reoccupation of Gaza, ceded in 2005. Netanyahu has long been at the forefront of the Israeli ultra-right’s rejection of a Palestinian state and claim that the whole of Israel/Palestine is theirs by divine fiat.

The International Federation of the Red Cross/Red Crescent Movement pointed out the dire implications of this unprecedented “cleansing” operation. The Al-Quds Hospital “is caring for hundreds of injured people and bedridden, long-term patients”, it noted, “evacuating patients, including those in intensive care, on life support and babies in incubators is close to, if not impossible, in the present situation.

“Civilian lives must be protected. Hospitals, doctors and nurses must be protected. We must preserve humanity.”

NBC News reports doctors at Al-Shifa saying that despite promises of an evacuation effort by Israeli forces, no one is leaving the hospital.

Neurosurgeon Nidal Abu Hadrus said people could not leave with the noise of bombing and gunfire in what the IDF said are “intense battles” surrounding the facility. The claim is that Hamas fighters are using the patients and hundreds of refugees trapped in the hospital as human shields.

“It is not safe to move out. It is not safe to stay. We don’t know what to do,” Abu Hadras was quoted as saying. “Please help us.”

Meanwhile, health facilities south of the evacuation border have been overwhelmed by the tide of human misery from the north.

In a heartbreaking interview with CNN, a recently evacuated American nurse working for Doctors Without Borders (MSF), Emily Callahan, described children with burns “on their faces and down their necks”, partial amputations and open wounds wandering around the camps to which they were prematurely discharged. Parents had besieged the MSF staff with pleas: “Help us! Help us!”

Fifty thousand refugees had no running water and access to just four toilets. 

Callahan described the violent execration of America and Israel among the displaced. It was this that forced her and other MSF staff to evacuate. In 26 days they had been relocated five times — “nowhere is safe in Gaza”. 

Time is longer than rope, commented the South African anatomist of apartheid, Eddie Roux. Can the Israelis not understand that with every round of pitiless brutality against the Palestinians, they are sowing a new crop of implacable hatred for the years ahead?

Drew Forrest is a former political editor and deputy editor of the Mail & Guardian.