Once considered untouchable, Al Shifa hospital's 'immunity' no longer applicable under international law

IDF's incursion into Gaza's Al Shifa hospital, thought to house Hamas HQ, was initiated following extensive legal groundwork in Israel, not merely to align with international law's stipulations, but also to safeguard political legitimacy; WHO chief: 'Hospitals are not battlegrounds'

The IDF's sudden incursion into Al Shifa hospital in Gaza, which took place under the cloak of night between Tuesday and Wednesday, marked the culmination of several weeks of meticulous legal groundwork. This operation has drawn significant attention, and some reproach, given the unique protections that hospitals enjoy under war conventions.
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However, in the case of Al Shifa, along with other Gaza Strip hospitals, they have been exploited by Hamas for their nefarious activities. In contrast to past Gaza operations where similar suspicions arose, this time, Israel stands resolute in its mission to eradicate terrorists, even if they take refuge in medical facilities, using patients as their human shields.
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בית חולים שיפא עזה כוחות צה"ל סיוע הומניטרי
בית חולים שיפא עזה כוחות צה"ל סיוע הומניטרי
IDF with humanitarian aid for Al Shifa Hospital
(Photo: IDF Spokesperson's Unit)
The topic of IDF operations within Gaza's hospitals, especially Al Shifa – where it's believed the Hamas headquarters operates and hostages might even be detained – emerged early in the war during legal conversations. Underpinning these debates is not just the delicate matter of engaging in combat within hospitals, which are, as noted, safeguarded by international law. Equally significant is the apprehension that such actions could tarnish the legitimacy of Israel's activities on the global political stage.
While it's true that hospitals receive distinct protection, it is imperative to acknowledge it's not an inviolable shield. International law specifies that if these facilities are exploited for military purposes, their immunity is forfeited. As per these legal guidelines, the attacking party – in this instance, the IDF – must issue a prior warning before launching an attack.
In fact, the IDF spokesperson had alerted Hamas since the onset of the war that Israel was aware of the activities occurring within Al Shifa, an assertion further substantiated by various media outlets. The IDF spokesperson's public revelations, which included proof of the existence of Hamas' headquarters beneath the hospital shared two weeks ago, met the warning requirement under international law.
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תיעוד מאיתור אמצעי לחימה ואמצעים טכנולוגיים על ידי כוחות אוגדה 36 ויחידת שלדג במרחב בית החולים שיפאא'
תיעוד מאיתור אמצעי לחימה ואמצעים טכנולוגיים על ידי כוחות אוגדה 36 ויחידת שלדג במרחב בית החולים שיפאא'
Shaldag unit and 36th Division forces uncover weapons in Al Shifa Hospital complex
(Photo: IDF Spokesman's Unit)
Hamas received numerous warnings that persistent military activities within the hospital would make it a viable target, provided the principle of proportionality was adhered to. This principle is a cornerstone of war laws, mandating the attacking force to assess whether the anticipated civilian casualties would be disproportionately high compared to the military advantage gained from striking the target.
Hence, prior to the Al Shifa incursion, the IDF endeavored to minimize civilian risk. From the operation's initiation, it advised Gaza's inhabitants to relocate to safer zones in the southern Gaza Strip. Additionally, hospital administrators were presented with options to transfer patients to alternative medical facilities, as part of the preparations for entering Al Shifa.
An X post from the IDF's official account read: "The IDF is conducting a ground operation in Gaza to defeat Hamas and rescue our hostages. Israel is at war with Hamas, not with the civilians in Gaza."
The IDF forces include medical teams and Arabic speakers, who have undergone specified training to prepare for this complex and sensitive environment, with the intent that no harm is caused to the civilians being used by Hamas as human shields.
In recent weeks, the IDF has publicly warned time and again that Hamas' continued military use of Al Shifa hospital jeopardizes its protected status under international law, and enabled ample time to stop this unlawful abuse of the hospital. Yesterday, the IDF conveyed to the relevant authorities in Gaza once again that all military activities within the hospital must cease within 12 hours. They did not.
Eylon Levy, the government spokesperson for foreign media, broached this sensitive subject even prior to the start of the raid. He took to the X network, posting an image of Article 13 from the Geneva Convention. This article asserts that a hospital's protected status can be revoked if it's being used for "actions harmful to the enemy," provided that these activities persist after sufficient warning has been given.
"We didn’t write the rules," his X post said. "If you think a terror headquarters should receive blanket immunity because it was built under a hospital, write a new Additional Protocol to the Geneva Conventions. For now, we’ll go by customary law as reflected in this one."
Israel's strict adherence to international law notwithstanding, swift criticism of the IDF's conduct followed. Speaking at a press briefing in Geneva, the director-general of the World Health Organization, Tedros Adhanom Ghebreyesus, emphasized that the safety of patients and health care staff must be upheld, even in instances where hospitals are exploited for military objectives.
"Hospitals are not battlegrounds," he said. "Israel's military incursion into Al Shifa Hospital in Gaza City is totally unacceptable."
Last night, IDF Spokesperson announced the IDF showed a bag with Hamas munitions inside, hidden behind an MRI machine, and noted that troops are still active inside Al Shifa Hospital, occasionally interrogating medical personnel to uncover more hidden Hamas gear and the location of other Hamas terrorists, with many of them embedded within the General Gazan population.
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