Al-Shifa Hospital was a government-run hospital in Gaza City, Palestine; most of the staff are employees of the Palestinian Authority in the West Bank. During the Gaza war, Israel and the United States stated that several complexes existed under al-Shifa Hospital, and that it was being used by Hamas as its "main operations base," a claim that Hamas and hospital administrators denied. International law prohibits the targeting of hospitals unless there is evidence it is used for a military purpose that is "harmful to the enemy", and it prohibits the use of human shields for combatants; both constitute war crimes.
Following Israel's release of video showing a Hamas tunnel with two small rooms under the hospital on 22 November, multiple news agencies concluded that the evidence did not demonstrate the use by Hamas of a command center. Amnesty International said on 23 November 2023 that they have "so far not seen any credible evidence to support Israel's claim that al-Shifa is housing a military command centre" and that "the Israeli military has so far failed to provide credible evidence" for the allegation. Izzat al-Risheq, a Hamas official, denied that the group used the hospital as a shield for its underground military structures, saying there was no truth to the claims. A later report in February 2024 by The New York Times said that the evidence provided by the Israeli intelligence suggested that Hamas did use the hospital as cover and stored weapons inside it, however the tunnel did not match the Israeli description of a Hamas command center.
Israel has been accused of waging a propaganda war to detract from accusations that its actions at al-Shifa constitute violations of international law. Medical staff at al-Shifa have accused Israel of directly causing the deaths of civilians being treated at al-Shifa, including prematurely born babies. The head of the World Health Organization called the November raid on the hospital "totally unacceptable".
Following the end of the Al-Shifa Hospital siege, United Nations High Commissioner for Human Rights Volker Türk called for an independent investigation, stating: "This is precisely where you need an independent international investigation, because we have different narratives, you cannot use ... hospitals, for any military purposes. But you also cannot attack a hospital in the absence of clear evidence." A raid in March 2024 saw Israeli and Hamas forces engaged in crossfire at the hospital.
Background
Government funded healthcare in the Gaza Strip
Al-Shifa Hospital is a government-run hospital in Gaza City, Palestine. But, despite the Hamas government controlling most government activities in the Gaza Strip (such as police and law enforcement), the staff at Al-Shifa hospital are employed by the Ramallah-based Palestinian Authority in the West Bank, which is currently run by Mahmoud Abbas's Fatah government. The Hamas government in the Gaza Strip have sporadically funded individual health initiatives such as IVF treatments for infertile couples. IVF funding was widely popular and won massive public support, despite only being made available to a very limited number of couples on a lottery system. In 2017 The Guardian described this as a, "goodwill gesture by the ruling Hamas party". During the Israeli invasion of the Gaza Strip the main IVF clinic in the Gaza City was hit by a single tank shell, which directly hit the cryogenic storage lab and destroyed over 4000 frozen human embryos, and 1000 aliquots of frozen sperm and eggs, many of which were from couples who are no longer able to produce sperm or eggs.
International law In late October 2023, the Israel Defense Forces (IDF) issued a statement about Hamas activities at al-Shifa Hospital, stating, "The Hamas terrorist organization has continued operating below Gaza's Shifa Hospital, using the thousands of patients, doctors and staff in the building to shield its underground headquarters".
International humanitarian law prohibits the targeting of hospitals unless there is evidence it is used for a military purpose that is "harmful to the enemy", as well as the use of human shields for combatants; both constitute war crimes.
History In 1983, the Israelis built "a secure underground operating room and tunnel network" beneath Building 2 of the hospital. On 20 November 2023, former Israeli Prime Minister Ehud Barak, referring to Israeli built bunkers from decades ago, told CNN "It's already [been] known for many years that they [Hamas] have the bunkers that originally [were] built by Israeli constructors underneath Shifa [which] were used as a command post of Hamas. And, a junction of several tunnels is part of this system." During a renovation in the 1990s a large basement was added, which the IDF later said was appropriated by Hamas and used to store weapons. According to Israeli officials, Hamas subsequently dug out the original basement, later adding new floors and connecting it as a hub within their existing tunnel system.
A France24 investigation in November 2023 concluded that the images and videos of the tunnels published by the IDF were consistent with Hamas built tunnels.
2007 Fatah–Hamas conflict During the Fatah–Hamas conflict in June 2007, Fatah and Hamas clashed at the hospital, killing one member of each organization. Some injured people brought to the hospital were killed by Hamas militants once inside. A doctor in the hospital reported, "The medical staff are suffering from fear and terror, particularly of the Hamas fighters, who are in every corner of the hospital."
2008–2009 war During the 2008–2009 Gaza War, The New York Times reported that "armed Hamas militants in civilian clothes roved the halls" killing alleged collaborators. Several reports by Israeli Shin Bet officials alleged that Hamas used Al-Shifa hospital as a bunker and refuge, knowing it would be spared by air strikes. The Israeli allegations were difficult to confirm because Israel had banned reporters from Gaza at the time. PBS' Wide Angle programme, which interviewed a doctor from Gaza who preferred to remain anonymous, said that he believed that Hamas officials were present under the hospital.
In 2009, the Palestinian Health Ministry, run by the Palestinian Authority in the West Bank, accused Hamas members of taking control of wards in Shifa Hospital.
In the 2014 Gaza War During 2014 Gaza War, the hospital was described by journalists and authors as the de facto headquarters of Hamas. Amnesty International documented how the Hamas forces used the abandoned areas of the hospital to abduct, torture, and kill Palestinians accused of collaborating with Israel.
In the Gaza war During the Gaza war the IDF said that the hospital was being used as a major command and control center for Hamas, and as a consequence it became a major target during the siege of Gaza, culminating in the siege and then occupation of the hospital. This position was disputed by Hamas and hospital administrators, both of whom denied the existence of tunnels beneath the hospital, with the latter requesting that the international community send a delegation to the hospital to verify their claims. US intelligence repeatedly stated that based on their own intelligence they concurred with Israel's assessment and by interrogations with captured Hamas militants, who said there was an extensive underground complex beneath the hospital.
The perception of the media was mixed; while they concluded that a network of tunnels did exist beneath the hospital and that Hamas had used the hospital to store hostages, they also found that Israel's evidence was insufficient to prove that the tunnels were a command and control center or that access points to the network existed within hospital wards. According to Israel, the reason for this was the existence of booby traps that prevented them from fully exploring the unearthed tunnel.
The Atlantic's Mike Powell wrote that it was an "open secret" that Hamas was present at Al-Shifa hospital and that two Médecins Sans Frontières workers had said that there were units of the hospital they could not access which had armed guards.
The IDF released photos showing "Military uniforms, 11 guns, three military vests, one with a Hamas logo, nine grenades, two Qurans, a string of prayer beads, a box of dates". Former US State Department legal advisor Brian Finucane, said "These arms by themselves hardly seem to justify the military fixation on al-Shifa, even setting the law aside".
Following the release of the Israeli photos, Al Jazeera senior political analyst Marwan Bishara was skeptical, since Hamas left the guns and nothing else.
Mouin Rabbani, a Middle East analyst, stated to Al Jazeera, "Israeli forces have invaded Shifa Hospital and been inside it for 12 full hours – having refused any independent party to accompany them – and now we're supposed to believe that there were Hamas militants in there being pursued by the Israeli military but they somehow left their weapons behind?"
Israeli forces continued to search the facility for a second day, unearthing what they described as a tunnel entrance on the perimeter of the hospital complex, although they have not entered due to fear of booby traps. New York Times journalists visited the site and verified that a concrete shaft descending into the earth existed, and that electrical wiring and a ladder was visible, although they were not able to determine how deep the shaft was or where it led. The military said the search would take time.
Jeremy Scahill of The Intercept stated to Al Jazeera that the "Israelis have a multidecade track record of lying, of promoting false information, releasing doctored videos". He claimed regarding the evidence that he had seen more guns in the homes of Americans than in this purported Hamas Pentagon under al-Shifa Hospital. Netanyahu stated in an interview with CBS that the Israeli government had "strong indications" that hostages were in al-Shifa, which was one of the reasons they entered the hospital, adding that "I think the less I say about it, the better." On 16 November, the IDF reported that the body of Yehudit Weiss, a 65-year-old woman who was captured from Be'eri kibbutz, had been located in a structure nearby to the hospital. On 17 November, the IDF had discovered the body of 19-year-old Cpl Noa Marciano in a building next to the hospital.
Jeremy Bowen, BBC News' international editor, noted that there is no independent scrutiny inside the hospital, since journalists are working under the aegis of the Israeli military. He also stated that the evidence that was produced wasn't convincing enough to prove that "this was a nerve centre for the Hamas operation". On 17 November 2023, journalists for The Independent claimed that "Israel has not presented evidence that shows a large-scale headquarters under the hospital". CNN analysis suggested Israel had rearranged the weaponry before allowing press into the hospital.