Israel's attacks on and around hospitals, and the ensuing fighting, have pushed health care in the Gaza Strip to the brink of total collapse, the United Nations Human Rights Office (OHCHR) says. The attacks and actions aimed at destroying the health system in Gaza are in flagrant disregard of international humanitarian and human rights law, many of which may amount to war crimes or crimes against humanity.
The deliberate directing of attacks against hospitals and places where the sick and wounded are treated, the deliberate directing of attacks against the civilian population as such or against individual civilians not taking direct part in hostilities, including the launching of an indiscriminate attack resulting in the death or injury of civilians, and the deliberate launching of disproportionate attacks, constitute war crimes.
The deliberate destruction of health facilities may constitute a form of collective punishment, which would also qualify as a war crime. Attacks on and around hospitals - if carried out as part of a widespread or systematic attack directed against a civilian population - may also amount to crimes against humanity. They may even be a component of acts or policies that amount to genocide, the worst crime known to humankind.
The 19-page UN report, released on Tuesday, finds, “Israel’s pattern of deadly attacks” on and near hospitals “has led to the destruction of most hospitals in Gaza,” leading to sustained combat in and around many hospitals and “pushing the health care system to the brink of total collapse.”
“The situation has deteriorated to a catastrophic level since October 2023, as this already damaged health system has been targeted, resulting in the killing of hundreds of health and medical professionals,” authors of the report assert.
The report covers the period from October 7, 2023 to June 30, 2024. During this period, the report documents at least 136 attacks on at least 27 hospitals and 12 other medical facilities, resulting in many casualties among doctors, nurses, paramedics, and other civilians, and causing significant damage, "if not complete destruction of civilian infrastructure."
“This report graphically details the destruction of the health care system in Gaza, and the extent of killing of patients, staff, and other civilians in these attacks in blatant disregard for international humanitarian and human rights law,” Volker Türk, UN High Commissioner for Human Rights said in a statement coinciding with the publication of the report.
He said the report raises serious concerns about Israel's compliance with international law. It points out that medical personnel and hospitals are specifically protected under international humanitarian law, “provided they do not commit, or are not used to commit, outside their humanitarian function, acts harmful to the enemy.”
“As if the relentless bombing and the dire humanitarian situation in Gaza were not enough, the one sanctuary where Palestinians should have felt safe in fact became a death trap,” Türk said.
“The protection of hospitals during warfare is paramount and must be respected by all sides, at all times.”
OHCHR reports that attacks on hospitals have occurred in each of the areas where the Israeli military has conducted ground operations, beginning in November 2023 with an attack on the Al-Shifa Medical Complex and other hospitals in Gaza City.
The attacks continue to this day. The report notes that “The appalling destruction wrought by the Israeli military’s attacks on the Kamal Adwan hospital last Friday — leaving the population of North Gaza with almost no access to adequate health care — reflects the pattern of attacks documented in the report.”
In response to the attack on Kamal Adwan Hospital, the UN Office for the Coordination of Humanitarian Affairs (OCHA) on Monday expressed alarm at the ongoing attacks across the Gaza Strip and the airstrike on the hospital, warning that "the very means of people's survival are being dismantled".
OCHA said the Kamal Adwan Hospital in northern Gaza is not functioning, while Al Awda Hospital is partially operational. Despite a limited delivery of UN supplies on Sunday, the Indonesian Hospital also remains non-functional, lacking water, electricity, hygiene supplies and adequate medical staff, with essential equipment destroyed.
According to the World Health Organization (WHO), 15 out of Gaza’s 36 hospitals remain “partially functional,” nine in the south and six in the north.
“The health system is under severe threat,” said Tedros Adhanan Gebgreyesus, WHO Director-General, noting that “hospitals in Gaza have once again become battlegrounds.”
The OHCHR report notes that the increasingly limited health system is preventing many people with traumatic injuries from receiving timely and potentially life-saving treatment. It says that attacks on hospitals in Gaza are also having serious consequences for patients with “initially non-fatal conditions, potentially rendering them fatal.”
“Women, especially pregnant women, are suffering gravely. Many women are giving birth with no or minimal pre- and postnatal care, increasing the risk of preventable maternal and child mortality,” it said.
The report added that people with chronic diseases, such as kidney failure, hypertension, diabetes, and heart disease, also have lost access to their treatment, “placing them at risk of worsening health outcomes and death.”
Authors of the report say, “Intentionally directing attacks against hospitals and places where the sick and wounded are treated, provided they are not military objectives […] and intentionally launching disproportionate attacks, are also war crimes.”
It added that “Under certain circumstances, the deliberate destruction of health care facilities may amount to a form of collective punishment, which would also constitute a war crime.”
Human rights chief Türk is calling for independent, thorough and transparent investigations of all of these incidents, “and full accountability for all violations of international humanitarian and human rights law which have taken place.”
“It must also be a priority for Israel, as the occupying power, to ensure and facilitate access to adequate healthcare for the Palestinian population, and for future recovery and reconstruction efforts to prioritize the restoration of the medical capacity which has been destroyed over the last 14 months of intense conflict.”
In a related development on Thursday, the UN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Tlaleng Mofokeng, and the UN Special Rapporteur on the situation of human rights in the Palestinian territories occupied since 1967, Francesca Albanese, called for an end to blatant disregard of the right to health in Gaza.
“For well over a year into the genocide, Israel’s blatant assault on the right to health in Gaza and the rest of the occupied Palestinian territory is plumbing new depths of impunity,” the experts said.
The independent UN experts called on Israeli authorities, to respect and protect the right to life and the right to health in Gaza and the whole occupied Palestinian Territory, including by ensuring unhindered access to necessary healthcare and urgently restoring the continuity of essential health services in Gaza.
“Under occupation, intentional assaults on healthcare facilities have the potential to expose individuals to cruel, inhuman, and degrading treatment and may constitute a war crime. In Gaza, this is clearly part of a well-established pattern of genocide, for which Israeli leaders will have to be held accountable,” the experts said.
A growing number of independent legal experts and international organizations have concluded that Israel's actions in Gaza against Palestinians as a group amount to genocide.
Genocide is a term used to describe violent crimes committed against a group with the intent to destroy the existence of the group, in whole or in part. According to the Genocide Convention, acts amounting to genocide include deliberately inflicting on a group conditions of life calculated to bring about its physical destruction.
Repeated Israeli military attacks on Palestinian civilians over the past 14 months, the dismantling of the health system and other essential civilian infrastructure, the siege, and the systematic denial of humanitarian aid are destroying the conditions for survival in Gaza. Ongoing indiscriminate attacks by the Israeli Defense Forces (IDF) continue to kill large numbers of civilians, including children.
Israeli security forces have killed more than 45,500 people and wounded more than 108,000 others, most of them civilians, since the start of the war in October 2023. It is estimated that more than 14,500 children are among the dead. More than 10,000 people, including thousands of children, are missing and presumed dead.
One quarter of the injured in Gaza - some 26,000 Palestinians - are estimated to require lifelong specialized rehabilitation and supportive care, including those with severe limb injuries, amputations, spinal cord injuries, traumatic brain injuries, and severe burns.
The fatalities include at least 363 aid workers, 262 UN staff, 1057 health workers and 193 journalists. Since last October, more than 160,000 people, or more than 7 percent of Gaza's population, have been killed, wounded or reported missing in Israel's attacks on Gaza.
An unprecedented humanitarian catastrophe has been unfolding in Gaza for more than fourteen months, with people dying from widespread attacks, starvation, dehydration, hypothermia and disease.
Leading UN officials have called the situation in Gaza "apocalyptic," "hell on earth," a "dystopian nightmare," and "beyond catastrophic. They have said that the humanitarian community is "running out of words to describe what is happening in Gaza."
Gaza is on the brink of famine, with more than 2 million people facing severe food shortages amid high rates of disease, inadequate shelter, and limited access to safe water and sanitation. Some 1.9 million people - 90 percent of Gaza's total population - have been displaced by Israeli military attacks or Israeli evacuation orders, including people who have been forced to flee dozens of times.
On Thursday, OCHA again warned that civilians are not safe anywhere in Gaza. On Wednesday, the Israeli military imposed new evacuation orders on large areas of Gaza. Since then, strikes have been reported in the Al Mawasi area, where people had been ordered to move and take shelter.
The Commissioner-General of the UN Relief and Works Agency (UNRWA), Philippe Lazzarini, said in a statement on social media today that this is yet another reminder that there is no "humanitarian zone", let alone a "safe zone". He warned that every day without a ceasefire brings more tragedy. Over 80 percent of the Gaza Strip is under unrevoked Israeli evacuation orders.
OCHA warns that the ability of humanitarian organizations to assist people in need throughout Gaza continues to diminish. December saw some of the most severe restrictions on humanitarian movement ever recorded.
Impediments included blocking access to border areas to collect supplies and denying attempts to deliver goods and services or assess needs throughout Gaza. Overall, 39 percent of UN attempts to move aid workers anywhere in Gaza were denied by the Israeli authorities, with a further 18 percent disrupted or obstructed on the ground.
Access to besieged areas in North Gaza governorate was denied for 88 consecutive days. Between October 6 and December 30, the United Nations made 164 attempts to reach the besieged areas of northern Gaza, of which 148 were rejected outright by the Israeli authorities and 16 were obstructed.
International humanitarian law requires Israel to ensure that the basic needs of the people of Gaza are met. This includes ensuring that the population of Gaza has access to sufficient water, food, medical supplies and other basic necessities to survive.
However, since Israel imposed a full siege on the Gaza Strip on October 9, 2023, the amount of aid entering the enclave has never been adequate to meet the needs on the ground. For more than a year, Israel has willfully failed to provide or even facilitate the delivery of critical supplies to the 2.1 million people still alive in Gaza.
Some information for this report provided by VOA.
Further information
Full text: Thematic Report - Attacks on hospitals during the escalation of hostilities in Gaza (7 October 2023 - 30 June 2024), UN Office of the High Commissioner for Human Rights, report, released December 31, 2024
https://www.ohchr.org/sites/default/files/documents/countries/opt/20241231-attacks-hospitals-gaza-en.pdf
Full text: UN experts horrified at blatant disregard for health rights in Gaza following deadly raid on Kamal Adwan hospital , UN Office of the High Commissioner for Human Rights, press release, published January 2, 2025
https://www.ohchr.org/en/press-releases/2025/01/un-experts-horrified-blatant-disregard-health-rights-gaza-following-deadly?sub-site=HRC