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AOAV: all our reportsHealth and explosive violenceExplosive violence in Gaza

Gaza healthcare crisis: urgent action required to address alleged unlawful Israeli attacks

The situation in Gaza has reached a critical juncture as Human Rights Watch (HRW) presents evidence of repeated, apparently unlawful attacks on medical facilities, personnel, and transport by the Israeli military. These actions have severely compromised Gaza’s healthcare system, resulting in a grave healthcare crisis that demands swift international intervention.

As the conflict in Gaza escalates, the healthcare system faces unprecedented challenges. The latest findings from HRW highlight the alarming frequency of Israeli attacks on medical facilities, staff, and ambulances. These actions have not only strained an already fragile healthcare system but have also raised concerns of potential war crimes.

Escalating Crisis in Gaza’s Healthcare System
The World Health Organization (WHO) reports that as of November 12, at least 521 people, including 16 medical workers, have lost their lives in 137 “attacks on health care” in Gaza. These attacks, coupled with Israel’s decisions to cut off electricity and water and block humanitarian aid, have created dire conditions. Hospitals are struggling to function, lacking essential medicines, basic equipment, and even electricity. Medical professionals are being forced to operate without anesthesia, and vinegar is being used as an antiseptic.

The Impact of Attacks on Medical Facilities
HRW’s investigation specifically examined attacks on several medical facilities, including the Indonesian Hospital, al-Ahli Hospital, the International Eye Care Center, the Turkish-Palestinian Friendship Hospital, and the al-Quds Hospital between October 7 and November 7. These facilities, which are meant to provide essential care to civilians, have been targeted with devastating consequences.

The Indonesian Hospital, a critical healthcare institution, was struck multiple times between October 7 and October 28, resulting in the loss of civilian lives. Similarly, the International Eye Care Center was completely destroyed after an airstrike on October 10 or 11. The Turkish-Palestinian Friendship Hospital suffered strikes on October 30 and 31, forcing its closure on November 1 due to damage and a lack of fuel for generators. The al-Quds Hospital also faced repeated Israeli strikes, causing injuries to patients and staff.

These attacks are not isolated incidents; WHO reported that as of November 10, 18 out of 36 hospitals and 46 out of 72 primary care clinics had to shut down. The closures are a result of damage from attacks and a lack of essential resources like electricity and fuel. The ongoing attacks are pushing healthcare facilities in Gaza to the brink of collapse, making it increasingly challenging to provide care to the injured and those in need of medical attention.

Impact on Health Workers and Patients
The attacks have put healthcare workers in an untenable position, with many dealing with an overwhelming number of injured patients while facing severe shortages of essential supplies. Thousands of internally displaced people who have sought refuge in hospitals are now at risk due to shortages of food and medicine. Gaza’s hospitals are running with inadequate medical staff, as some have been killed or injured outside of their work.

Medical professionals in Gaza are operating in dire conditions, with limited resources and equipment. A doctor at Nasser Medical Center explained the challenges: “At 3 a.m. I dealt with a 60-year-old woman with a cut wound in her head. I can’t make a suture to heal her wound—no gloves, no equipment—so we have to use unsterile techniques.”

International Humanitarian Law Violations
It is crucial to emphasise that hospitals and medical facilities have special protections under international humanitarian law. These protections are in place to ensure that civilians, including patients and medical staff, are safeguarded during armed conflicts. Hospitals may lose their protected status if they are used for military purposes, but even in such cases, certain protocols must be followed.

All warring parties must exercise constant care to minimize harm to civilians. Attacks on hospitals can be considered unlawful if they are indiscriminate or disproportionate. The use of explosive weapons in densely populated areas increases the risk of indiscriminate attacks. The Israeli military’s actions must be evaluated in terms of the anticipated loss of civilian life and property compared to the concrete and direct military gain.

Israeli Claims and Contestations
The Israeli government has claimed that Hamas is using hospitals for military purposes. However, HRW has not been able to corroborate these claims or find any information that would justify attacks on Gaza hospitals. Even if such claims were accurate, Israel has not demonstrated that the resulting attacks were proportionate.

Israel’s broad evacuation order on October 13 to 22 hospitals in northern Gaza was problematic as it did not account for the specific requirements of hospitals, including patient and medical personnel safety. The sweeping nature of the order and the lack of a reliably secure way to evacuate raised concerns about its true intent.

Urgent Calls for Action
HRW urges the international community to take immediate action to address the crisis in Gaza’s healthcare system. The Israeli government should cease unlawful attacks on hospitals, ambulances, and other civilian objects. The blockade of Gaza, which amounts to collective punishment, should also end. Palestinian armed groups must take all possible precautions to protect civilians under their control and refrain from using them as “human shields.”

The Independent International Commission of Inquiry on the Occupied Palestinian Territory and Israel should conduct a thorough investigation into the apparently unlawful Israeli attacks on healthcare infrastructure in Gaza. Furthermore, the International Criminal Court prosecutor has jurisdiction over the current hostilities between Israel and Palestinian armed groups, and all parties involved should cooperate with the commission and the ICC.

Several countries, including the United States, United Kingdom, Canada, Germany, and others, should suspend military assistance and arms sales to Israel as long as such actions continue. All governments should demand that Israel restores the flow of essential resources, including electricity, water, fuel, and humanitarian aid to Gaza, ensuring that these vital supplies reach the civilian population.

In conclusion, the healthcare crisis in Gaza is reaching a breaking point, with healthcare facilities struggling to function and patients in dire need of care. Immediate action is essential to address the unlawful attacks on Gaza’s healthcare infrastructure, protect civilians, and ensure that medical professionals can provide care to those who need it most.

Conclusion
The situation in Gaza is dire, with its healthcare system on the brink of collapse due to repeated Israeli attacks on medical facilities, personnel, and transport. Urgent international action is required to address this crisis, investigate potential war crimes, and protect the civilian population in Gaza.

Dr. Iain Overton, the Executive Director of AOAV (Action on Armed Violence), says of HRW’s report: “The findings of Human Rights Watch raise deep concerns over the ongoing armed violence and unlawful attacks on healthcare facilities in Gaza. These actions are not only devastating for the people of Gaza but also a violation of international humanitarian law. It is imperative that all parties involved prioritize the protection of civilians, healthcare workers, and medical facilities, and that those responsible for these violations are held accountable for their actions.”