Israel urged to halt attacks on healthcare workers – Jurist.org

Introduction: A Crisis Within a Crisis

In the throes of the devastating conflict engulfing Gaza and Israel, a secondary and profoundly alarming crisis is unfolding—one that strikes at the very heart of humanitarian principles. A chorus of international voices, including leading human rights organizations, United Nations agencies, and medical charities, has issued an urgent and unified plea to Israel: halt the relentless attacks on healthcare workers, facilities, and transport. This is not merely a call for restraint but a desperate demand for adherence to the most fundamental laws of war, which grant special protection to those dedicated to saving lives. The systematic dismantling of Gaza’s healthcare infrastructure and the targeting of its medical personnel represent a catastrophic failure to distinguish between combatant and civilian, threatening to erase the last vestiges of sanctuary for the sick and wounded in a territory already besieged by unparalleled destruction and loss.

The situation has transcended a series of isolated, tragic incidents, evolving into what many observers describe as a pattern of deliberate action that has crippled the capacity to provide even the most basic medical care. Doctors, nurses, paramedics, and ambulance drivers—individuals who under international law are to be respected and protected in all circumstances—have found themselves on the front lines, not only of a medical emergency but of a military campaign that increasingly fails to recognize their protected status. This article delves into the specific allegations, the legal framework that governs conduct in conflict, Israel’s stated justifications, and the catastrophic human cost of a war that is systematically consuming its own healers.

An Urgent Global Plea: The Call to Protect Medical Personnel

The appeals directed at the Israeli government and its military forces are coming from the highest echelons of the global community. The World Health Organization (WHO), the International Committee of the Red Cross (ICRC), Doctors Without Borders (Médecins Sans Frontières – MSF), and numerous UN Special Rapporteurs have been relentless in their documentation and condemnation of the violence. Their reports paint a harrowing picture: hundreds of healthcare workers killed, hundreds more injured or detained, and dozens of hospitals and clinics rendered non-functional through direct strikes or siege.

Dr. Tedros Adhanom Ghebreyesus, Director-General of the WHO, has repeatedly described the situation as a “catastrophe,” stating that the organization has documented hundreds of attacks on healthcare facilities since the conflict began. He has emphasized that “hospitals are not battlegrounds” and that the “deconfliction” mechanism—a system designed to notify warring parties of the locations of humanitarian sites to prevent them from being targeted—has demonstrably failed to provide protection. Similarly, MSF has provided excruciating first-hand accounts from its staff on the ground, describing harrowing evacuations under fire and the horror of treating colleagues wounded in attacks on the very hospitals where they worked. These organizations are not distant observers; they are active participants whose own staff members have been killed, injured, and endangered. Their pleas are grounded in the daily reality of attempting to practice medicine in an active war zone where the traditional symbols of neutrality, the red cross and red crescent, have become targets rather than shields.

The Grim Reality on the Ground: Documented Incidents and Testimonies

The general statistics, while staggering, only tell part of the story. The true scale of the crisis is found in the specific, documented incidents that have systematically dismantled Gaza’s healthcare system piece by piece.

Systematic Attacks on Hospitals and Clinics

Virtually no major hospital in the Gaza Strip has been spared. The attacks on facilities like Al-Shifa Hospital, the territory’s largest medical complex, have been a focal point of international scrutiny. Israeli forces besieged and raided the hospital, claiming it housed a significant Hamas command center. While the Israel Defense Forces (IDF) presented evidence of tunnels and weapons found on the premises, the scale of the military operation, which led to the hospital’s complete incapacitation and the deaths of numerous patients due to lack of care, has drawn widespread condemnation.

Other major facilities, including the Al-Ahli Arab Hospital, Nasser Medical Complex in Khan Younis, and Kamal Adwan Hospital in the north, have suffered similar fates. They have been hit by direct airstrikes, shelled during ground operations, or surrounded for extended periods, cutting off access for patients, staff, and essential supplies like fuel, medicine, and food. Reports from inside these besieged hospitals described doctors performing surgery without anesthesia, using vinegar as an antiseptic, and watching patients die from treatable infections. The destruction is not just structural; it is the obliteration of hope and the last refuge for a terrified civilian population.

The Targeting of Ambulances and Paramedics

The Palestine Red Crescent Society (PRCS) has issued daily reports detailing attacks on its ambulances and the killing of its paramedics. Convoys attempting to evacuate the wounded have come under fire, in direct violation of international norms that mandate safe passage for medical transport. In one widely reported incident, an ambulance convoy outside Al-Shifa hospital was struck, resulting in multiple deaths and injuries. The IDF stated it had targeted the ambulance because it was being used by a Hamas terrorist cell, a claim vehemently denied by health officials in Gaza and the PRCS.

This pattern of attacks has created an impossible dilemma for emergency responders. To answer a call for help is to risk their own lives, yet to remain behind means abandoning the wounded. This has had a chilling effect on emergency medical services, leaving countless injured individuals without a chance of reaching a medical facility, effectively sentencing them to death in the rubble of their homes.

Detention and Mistreatment of Medical Staff

Beyond the physical attacks, there is a growing body of evidence concerning the systematic detention and alleged mistreatment of Palestinian healthcare workers. Senior doctors, nurses, and hospital administrators have been forcibly taken from their workplaces by Israeli forces during hospital raids. Testimonies from released medical personnel describe being stripped, blindfolded, and subjected to harsh interrogations, humiliation, and in some cases, physical abuse. The director of Al-Shifa Hospital, Dr. Muhammad Abu Salmiya, was detained by Israeli forces for weeks. Such actions not only remove critical medical expertise from an already collapsing system but also instill a deep sense of fear among the remaining staff, further hampering their ability to work.

The Legal Framework: International Humanitarian Law and the Sanctity of Healthcare

The repeated calls for Israel to halt its attacks are firmly rooted in a comprehensive and long-established body of international law designed specifically to mitigate the horrors of war. This framework, known as International Humanitarian Law (IHL) or the Laws of Armed Conflict, is not ambiguous on the matter of healthcare.

The Geneva Conventions: Bedrock of Protection

The four Geneva Conventions of 1949 and their Additional Protocols form the cornerstone of IHL. The First Geneva Convention provides explicit protection for wounded and sick soldiers, as well as for the medical personnel, units, and transport dedicated to their care. The Fourth Geneva Convention extends these protections to civilians in times of war. Under these treaties, hospitals and mobile medical units are protected objects. They may not be attacked under any circumstances. Medical personnel, recognizable by the distinctive emblems of the Red Cross, Red Crescent, or Red Crystal, are granted protected status and must be respected and spared from harm.

This protection is absolute unless a medical facility is used for “acts harmful to the enemy.” Even in such a case, the protection does not cease immediately. A warning must be issued, setting a reasonable time limit for the harmful acts to cease. Only if the warning goes unheeded can the facility’s protected status be revoked and an attack be considered lawful, and even then, the principles of distinction, proportionality, and precaution must be strictly observed to minimize harm to civilians and patients.

The Special, Protected Status of Medical Personnel

The special status afforded to healthcare workers is a recognition of their neutral, humanitarian function. Their sole purpose is to provide care to the wounded and sick, regardless of which side they belong to. Attacking them is not just an attack on individuals; it is an attack on the principle of humanity itself. This is why such acts are considered particularly egregious under IHL. The law demands that warring parties do everything feasible to facilitate their work, not hinder or target it. This includes ensuring access to the wounded, allowing the passage of medical supplies, and respecting their physical and psychological integrity.

Navigating the Allegations of War Crimes

Given the scale and nature of the attacks, numerous legal experts and human rights bodies have stated that some of Israel’s actions may amount to war crimes. Intentionally directing attacks against hospitals, medical units, and transport displaying the distinctive emblems is listed as a grave breach of the Geneva Conventions. The widespread and systematic nature of these attacks has also led to accusations of crimes against humanity. The Office of the Prosecutor of the International Criminal Court (ICC) has confirmed that its ongoing investigation into the situation in Palestine includes events since the start of this conflict, and the issue of attacks on healthcare is likely to be a central component of that inquiry.

Israel’s Position: Security Imperatives vs. International Obligations

The Israeli government and the IDF have consistently defended their actions, framing them as necessary components of their stated mission to dismantle Hamas and secure the release of hostages. They contend that they are operating within the bounds of international law in an exceptionally complex combat environment.

The “Human Shields” and Military Use Argument

The central pillar of Israel’s justification is the claim that Hamas systematically uses civilian infrastructure, including hospitals, for military purposes. The IDF has released media and intelligence reports purporting to show Hamas tunnels beneath hospitals, weapons stored within medical facilities, and fighters operating from their grounds. According to Israel, this military use causes the hospitals to lose their protected status under IHL, making them legitimate military targets.

Officials argue that by embedding its military assets within the civilian population, Hamas is guilty of the war crime of using “human shields” and bears ultimate responsibility for the resulting harm to civilians and civilian objects. From this perspective, the destruction of a hospital, while tragic, is a direct consequence of Hamas’s strategy. However, critics and human rights lawyers argue that even if military use is proven, Israel’s obligations under the principles of proportionality and precaution remain. The expected military advantage from an attack must not be excessive in relation to the incidental loss of civilian life and damage to civilian objects.

Operational Challenges in Asymmetric Urban Warfare

Israeli military spokespersons have also highlighted the immense challenges of fighting in the dense urban landscape of Gaza. They maintain that the IDF takes extensive measures to avoid civilian casualties, including issuing warnings through leaflets, phone calls, and “roof-knocking” (dropping a small, non-explosive device on a roof before a larger strike). They argue that in a war against a non-state actor that does not wear uniforms and deliberately blends in with the civilian population, distinguishing between combatant and non-combatant is incredibly difficult. However, the sheer scale of the destruction of the healthcare system has led many to question whether these precautionary measures are sufficient or are being genuinely applied in all cases.

The Human Cost: A Healthcare System on the Brink of Collapse

Beyond the legal and military arguments, the undeniable reality on the ground is a humanitarian catastrophe of historic proportions, directly fueled by the collapse of the healthcare system.

Devastating Impact on the Civilian Population

With the vast majority of Gaza’s hospitals no longer functioning, the impact on the civilian population is immeasurable. The wounded from airstrikes and fighting often have nowhere to go. Those who reach one of the few remaining, overwhelmed field hospitals face dire conditions, with shortages of everything from basic antibiotics to surgical equipment. But the crisis extends far beyond trauma care. Patients with chronic diseases like cancer, diabetes, and kidney disease are dying from a lack of treatment. Pregnant women are forced to give birth in unsanitary and unsafe conditions, leading to a spike in maternal and infant mortality. The spread of infectious diseases like cholera and dysentery is rampant due to the collapse of sanitation systems, with no functioning healthcare infrastructure to manage the outbreaks. The destruction of the healthcare system is, in effect, a force multiplier for death and suffering throughout the territory.

The Unseen Scars: The Psychological Toll on Healthcare Workers

For the healthcare workers who have survived and continue to work, the psychological toll is immense. They are grappling with mass casualty events on a daily basis, making impossible triage decisions, and operating on friends, neighbors, and even their own family members. They do so while enduring personal loss, displacement, and the constant fear for their own safety. Many are suffering from extreme exhaustion, anxiety, and post-traumatic stress disorder. These medical professionals are the last line of defense for their community, but they are also victims, bearing witness to a level of human suffering that will leave deep and lasting scars.

The International Response and Broader Implications

The global reaction to the targeting of healthcare in Gaza has been one of outrage and alarm, accompanied by calls for action and accountability that have so far failed to change the reality on the ground.

Intensifying Calls for Independent Investigations

There is a growing international consensus on the need for a thorough and independent investigation into all alleged violations of IHL by all parties to the conflict. The ICC’s investigation is a formal legal process that could potentially lead to arrest warrants for individuals deemed responsible for war crimes. The UN Human Rights Council has also established commissions of inquiry. The primary challenge for these bodies is access to the conflict zone and the cooperation of the warring parties, but the pressure for accountability is mounting and is unlikely to dissipate once the fighting stops.

The Critical Role of the UN, WHO, and NGOs

International organizations like the UN, WHO, ICRC, and MSF have played a vital role. They have not only provided what little aid can get through but have also served as the world’s eyes and ears on the ground. Their meticulous documentation, press briefings, and advocacy are essential for building a record of events and for keeping international pressure on the parties to the conflict. They are the primary source of credible information on the humanitarian situation, countering disinformation and ensuring that the plight of civilians and healthcare workers is not forgotten.

The Dangerous Erosion of International Norms

Perhaps the most significant long-term consequence of the systematic attacks on healthcare in Gaza is the erosion of one of the most sacred norms of international law. The principle of medical neutrality is a cornerstone of the entire humanitarian project. If hospitals can be considered battlegrounds and doctors can be considered targets, it sets a dangerous precedent for all future conflicts. It signals that the established rules of war are optional, undermining the very framework designed to preserve a sliver of humanity in the midst of organized violence. The failure to protect healthcare in Gaza is not just a tragedy for Palestinians; it is a threat to the legal and ethical architecture that protects civilians everywhere.

Conclusion: A Crossroads for Humanity and International Law

The urgent pleas for Israel to halt attacks on healthcare workers are a desperate attempt to salvage a foundational principle of international law and human decency. The conflict in Gaza has laid bare the fragility of these norms in the face of modern warfare and intense political division. While the complexities of the conflict and the security concerns raised by Israel cannot be dismissed, they cannot be used to justify the wholesale destruction of a territory’s ability to care for its sick and wounded. The protection of healthcare is not a concession; it is an obligation.

The international community stands at a critical crossroads. Upholding the law requires more than condemnation; it demands meaningful action to ensure protection, facilitate humanitarian aid, and secure accountability for all violations. Failure to do so will not only result in more preventable deaths in Gaza but will also leave the world a more dangerous place, where the red cross and red crescent no longer offer sanctuary, but simply mark the next target. The fate of Gaza’s healthcare workers is a litmus test for the world’s commitment to the laws it so painstakingly built from the ashes of past wars.