Hospitals and Medical Facilities: Special Protection under International Humanitarian Law

Under Article 18 of the Fourth Geneva Convention and customary international humanitarian law, civilian hospitals are “protected at all times” and must not be attacked. The Office of the United Nations High Commissioner for Human Rights (OHCHR) documented 136 strikes on 27 hospitals and 12 clinics in Gaza from October 7, 2023, to June 30, 2024—hospital attacks which amounted to war crimes. Israeli forces repeatedly bombarded facilities like Al‑Shifa, Nasr, Awdah, Turkish, and European Gaza Hospitals—despite these being civilian sanctuaries and often busy with displaced families and medical staff.

Failure to Distinguish & Use of Heavy Weapons

The OHCHR found that Israel violated the principles of distinction, proportionality, and precautions, which require separating civilian and military targets and minimising civilian harm. One egregious case involved the European Hospital in Khan Yunis, struck on May 13, 2025, with bunker-buster bombs—no evacuation warnings were issued and WHO personnel present had been assured of safety. Attacks on ambulances outside Al‑Shifa and other hospitals similarly were found “apparently unlawful” by Human Rights Watch.

Seizing and Sieging Medical Structures

Reporters confirmed Israeli troops entered and occupied hospital grounds—sometimes seizing facilities without evident military necessity. In December 2023 and March 2024, Shifa and Nasr hospitals were stormed; shelling occurred near maternity wards and ICUs, with no verified military usage present. These actions violate International Humanitarian Law protections and, as the UN Commission observed, may constitute war crimes of wilful killing and attacks on protected objects.

Devastating Impact on Civilian Health

Destruction of hospitals has left Gaza’s health system on the brink of collapse. By mid‑2024, nearly 22 of the 38 hospitals in Gaza were non-functional, with over 500 medical staff killed and mass graves discovered at Al‑Shifa, some shockingly with bodies still hooked to medical equipment. OHCHR confirmed that these actions resulted in wilful killing, destruction of protected objects, and collective punishment—all in breach of Articles 18–19 of Geneva Convention (GC) IV and Additional Protocol I.

Legal Violations: Core Pillars of International Humanitarian Law

• Article 18 (GC IV): Prohibits attacks on civilian hospitals.

• Article 19 (GC IV) & AP I: Protect medical personnel, ambulances, and relief objects.

• Additional Protocol I Articles 48, 51, 57: Reinforce distinction, proportionality, and precautions.

Israel’s bombardment of hospitals with no credible evidence of military use, insufficient warning, and high civilian toll constitutes war crimes or even crimes against humanity, per UN and Human Rights Watch conclusions.

The infant intensive care unit of Kamal Adwan Hospital following an Israeli air strike (December 2023)

Image credit: The Boston Review