The UN Human Rights Office says Israeli attacks on and around hospitals have brought Gaza’s healthcare system to “the brink of total collapse” and raised serious concerns about war crimes and crimes against humanity.
A new report describes a pattern in which Israeli forces attacked, besieged and forcibly evacuated hospitals, leaving patients dead or killed.
It acknowledges Israel’s claims that hospitals have been used by Palestinian armed groups, but says the evidence is “vague.”
The Israeli military has not commented. But it has previously said its forces comply with international law and take measures to limit harm to civilians and minimize disruption to medical services.
It comes days after the last functioning hospital in besieged northern Gaza was raided by the Israeli army, which said it was being used as a Hamas command centre.
Israel launched a campaign to destroy Hamas in response to the group’s unprecedented attack on southern Israel on October 7, 2023, which killed around 1,200 people and took 251 others hostage.
More than 45,500 people have been killed and 108,300 injured in Gaza since then, according to the Hamas-run Health Ministry.
“As if the brutal bombings and dire humanitarian situation in Gaza were not enough, the only refuge where Palestinians should have felt safe effectively became a death trap,” UN High Commissioner for Human Rights Volker Türk said on Tuesday.
“The protection of hospitals during warfare is of paramount importance and must be respected by all parties at all times.”
The UN Human Rights Office (OHCHR) said it documented at least 136 attacks on 27 of Gaza’s 38 hospitals and 12 other medical facilities during the period covered by the report, which was between October 2023 and June 2024.
These attacks caused “significant casualties among doctors, nurses, medics and other civilians” and caused “significant damage, if not complete destruction, of civilian infrastructure,” it added.
Medical personnel and hospitals are specifically protected under international humanitarian law, provided that they do not commit or are not accustomed to committing acts harmful to the enemy outside their humanitarian function. Even then, any attack must still comply with the fundamental principles of discrimination, proportionality and precaution in attacks.
The OHCHR said that deliberately targeting hospitals and places where the sick and wounded were being treated, deliberately targeting civilian populations and deliberately launching disproportionate attacks were war crimes.
And under certain circumstances, the intentional destruction of health care facilities could also amount to a form of collective punishment, which would also constitute a war crime.
According to the report, in most cases where Israel has attacked hospitals, it has alleged that the hospitals were being used unlawfully by Palestinian armed groups.
“To date, however, insufficient information has become available to substantiate these allegations, which have remained vague and broad and in some cases appear to be contradicted by publicly available information,” the UN report said.
“If these allegations were verified, it would raise serious concerns that Palestinian armed groups would use the presence of civilians to deliberately protect themselves from attacks, which would amount to a war crime.”
Hamas and medical staff have denied that the hospitals have been used by armed groups.
The report also says that the consequences of Israeli military operations in and around hospitals extend far beyond the physical structures.
“Many women give birth without or with minimal pre- and postnatal care, increasing the risk of preventable maternal and infant mortality,” the report says.
“OHCHR has received reports that a number of newborns have died because their mothers were unable to attend postnatal checkups or reach medical facilities to deliver.”
The report also says that people with trauma injuries were unable to receive timely and potentially life-saving treatment, noting that Gaza’s Ministry of Health had reported an 80% decrease in the number of hospital beds and the deaths of more than 500 medical professionals by the end of June .
“Many injured people reportedly died while waiting for hospital admission or treatment. Even those who managed to receive critical treatment, including surgery, received it without proper beds and facilities, and were often discharged prematurely due to lack of space.”
The OHCHR quotes the Israeli government as saying in response to the report that the Israeli military has taken “extensive measures” to “limit harm to the civilian population and minimize disruption to medical services.”
These include facilitating evacuation routes from hospitals, providing medical equipment, fuel and other assistance to keep hospitals functioning, and setting up field hospitals, the report said.
The Israeli government also alleged that Hamas had chosen to “methodically abuse the protection of medical facilities,” “embed its tunnel system and infrastructure strategically within the buildings of medical facilities, and use them as weapons depots and accessible headquarters for his agents”.
Türk called for an independent investigation into the incidents documented in the report, saying it “must also be a priority for Israel, as an occupying power, to ensure and facilitate access to adequate health care for the Palestinian population.”