JERUSALEM – One of the most shocking elements of Israel’s military actions against Hamas in Gaza is the extensive damage inflicted on the region’s healthcare system. Over the last 13 months, Israeli forces have conducted sieges and incursions at no fewer than 10 medical facilities, asserting that their operations are necessary due to allegations of Hamas utilizing these hospitals as operational bases.

An investigation last year examined raids on three hospitals in northern Gaza—al-Awda, Indonesian, and Kamal Adwan—gathering testimonies from over three dozen individuals, including patients, medical personnel, humanitarian workers, and Israeli officials. Despite Israel’s claims, little to no substantial evidence has been provided regarding Hamas activity at these locations. The military’s spokesperson could not comment on specific incidents mentioned in the accounts collected. Recently, all three hospitals have experienced renewed shelling and raids.

According to the World Health Organization, the current state of healthcare in Gaza is dire, with no hospitals remaining fully operational; only 16 out of 39 are functioning at limited capacity, primarily providing basic first aid. Israeli strikes near medical facilities account for the deaths of 765 Palestinians, with an additional 990 sustaining injuries, not counting those patients who have reportedly perished due to a lack of necessary treatment or medical supplies as a result of the sieges, a figure that remains unknown.

Among the findings:

**AL-AWDA HOSPITAL:**
– The Israeli military has never substantiated claims of Hamas presence at al-Awda Hospital. When queried about the intelligence that prompted the siege and assault on the hospital last year, no response was received from military representatives.
– On November 21, as conflict raged nearby, a shell struck the hospital’s operating room, resulting in the deaths of three doctors and a family member of a patient, per reports from Doctors Without Borders.
– Hospital staff have recounted that approaching the facility posed a lethal risk due to sniper activity. Three officials reported that two expectant mothers trying to reach the hospital to give birth were shot on December 12 and subsequently bled out in the street. Medics later recovered their remains.
– Mohammed Salha, the acting director of the hospital, described witnessing the fatal shooting of his cousin and her 6-year-old son while they were en route for treatment. Another patient, Shaza al-Shuraim, recounted the horror of her mother-in-law being struck by gunfire while they made their way to the hospital during her labor, even while signaling their non-combat status with white flags.
– The hospital’s director, Ahmed Muhanna, was taken hostage during a raid, and his current status remains unaccounted for. A prominent doctor, orthopedist Adnan al-Bursh, was also captured and died while in Israeli custody in May.

**INDONESIAN HOSPITAL:**
– Recognized as the most significant hospital north of Gaza City, the Indonesian Hospital faced claims from Israel regarding an underground Hamas command center. The military released unclear satellite images purportedly showing tunnel access and a rocket launch site near the hospital grounds.
– Following the raid, no evidence of any tunnels or underground operations was disclosed by the military, nor did they respond to inquiries about potential tunnel discoveries.
– The military provided footage of two vehicles found on-site, including a truck with military garments and a blood-smeared car belonging to an abducted Israeli, suggesting the vehicle’s use for transporting the injured. Hamas has stated that they have taken wounded hostages to hospitals for care.
– Persisting narratives linking hospitals to Hamas’s tunnel systems have not been substantiated; only one tunnel connected to a hospital has been identified, that being at Shifa Hospital in Gaza City.
– The operations from November to December caused considerable damage, with the top floors charred, walls scarred by shrapnel, and the entrance littered with rubble.
– An attack on the hospital on November 20 reportedly led to 12 fatalities and numerous injuries. Israeli forces claimed a response to “enemy fire” originating from the hospital, yet they denied the use of shells.
– During the sieges, medical staff estimated that around 20% of incoming patients died; at least 60 corpses were found in the courtyard, and minimal supplies forced doctors to conduct numerous amputations on infected limbs.

**KAMAL ADWAN HOSPITAL:**
– Witnesses indicated that while encircled by Israeli troops, at least ten patients died due to deficiencies in water, oxygen, and medication. According to pediatrician Hossam Abu Safiya, who later became the hospital’s director, these situations escalated under siege conditions.
– Accounts described an incident on December 12 where military personnel unleashed police dogs against staff and patients. One eyewitness recounted a graphic moment of a dog biting off a man’s finger. The Israeli military claimed ignorance of the event.
– Reports stated that men and teenage boys faced outdoor interrogations while blindfolded and exposed to harsh conditions. After some individuals were freed, nearby firing from troops left five wounded as they returned to the hospital.
– A bulldozer operated by the military reportedly demolished parts of the hospital’s compound, crushing tents used by displaced individuals. While many had evacuated, Abu Safiya mentioned discovering four individuals crushed in the rubble.
– In response to questions about this, the military spokesperson’s office attributed the removal of bodies to pre-existing conditions and disassociated it from military actions.
– The military continues to claim Hamas used the hospital as a command post, yet lacks substantial evidence, showcasing footage of only a single firearm. They reported the detention of numerous alleged militants, including the hospital director, Dr. Ahmed al-Kahlout. Footage of his interrogation surfaced, in which he purportedly named himself a Hamas operative and described militant activities within the hospital, a claim his colleagues contest as made under duress.