Healthcare in the north of Gaza has virtually collapsed: even the last hospital is no longer functioning

Due to persistent Israeli shelling and raids and a severe lack of medical supplies, health care in the north of the Gaza Strip has virtually collapsed. “There is no longer a health system in the north of Gaza,” says Léo Cans, Palestine coordinator for Doctors Without Borders, on the phone. “Israel has systematically targeted and deliberately destroyed healthcare in northern Gaza. I have never seen it on this scale in any other war.”

On Monday evening, Israel also invaded the last partially operational hospital in the north, Al-Ahli Hospital in Gaza City. The facade of the building was destroyed and most of the staff arrested. Two doctors and four nurses are still caring for a hundred seriously injured patients, without running water or electricity.

Like Al-Ahli – which was the scene of a controversial explosion in the hospital parking lot on October 17, possibly killing hundreds – there are three other hospitals in northern Gaza that are still functioning minimally. The rest of the institutions had been closed for some time.

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Israel called on the people of northern Gaza at the beginning of last month to move to the south of the strip. Many responded, but according to estimates there are still at least tens of thousands of people living in the north. Anyone who is injured or becomes ill in the north of Gaza has little place to go.

If you manage to reach one of the minimally functioning hospitals, says Léo Cans of Doctors Without Borders, the question is whether you will survive, because of the presence of Israeli soldiers. “People have been shot while on their way to a hospital, or while they had already entered the building.”

Hospitals are also facing serious shortages of food and safe water for staff, patients and displaced people. The World Health Organization (WHO) is “gravely and increasingly” concerned about persistent hunger in the Gaza Strip and the impact of malnutrition on people’s health and susceptibility to infectious diseases.

The ongoing shortage of childhood vaccinations in the Gaza Strip is worsening the health status of newborn children, especially in shelters. And the United Nations Population Fund reports that some 45,000 pregnant and 68,000 breastfeeding women in Gaza are at risk of death due to “a severe shortage of food.” A significant proportion of them will experience bleeding or anemia in any case.

According to figures from the Gaza Ministry of Health, 310 health workers have been killed to date. Nearly a hundred hospital employees have been arrested by Israel, including the directors of several hospitals.

Habituation

While the explosion in the parking lot of Al-Ahli in October kept people busy for weeks, the shelling and forced evacuation of hospitals in Gaza now seems to be getting used. “We are surprised by the silence in the world when we see the massacres carried out by the Israeli occupation forces in northern Gaza after the liquidation of the health care system in front of the eyes and ears of the world,” the Gaza Ministry of Health said on Tuesday afternoon at a press conference.

Israel claims that it is raiding the hospitals because Hamas militants are said to be hiding there. The Shin Bet security service has released a video of an interview with the director of the Kamal Adwan hospital in Jabalia, arrested by Israel. Against the backdrop of an Israeli flag, this Ahmed Kahlot says that Hamas used his hospital as a military facility.

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Sixteen hospital employees, including doctors and nurses, are said to be members of the Al-Qassam brigades, the military branch of Hamas, according to the director. “They hide in hospitals because they believe hospitals are a safe place,” Kahlot said in the Shin Bet video. Hamas is also said to drive around with its own ambulances, which, however, never transport the sick.

It cannot be determined whether Kahlot gave his testimony under duress or not; the Gaza Ministry of Health on Wednesday denounced the “oppression, torture and intimidation” under which the video was made. According to the same ministry, publishing the video with a captured enemy is a war crime. The department does not dispute that there were soldiers present in the hospital: they are said to form a regular part of the Palestinian military-medical infrastructure.

Experts point out that Israel could also have other motives for attacking hospitals. For example, according to Amnesty International, attacking hospitals is a well-known war strategy to clear areas. And analyst Omar Rahman of the Qatari research institution Middle East Council on Global Affairs calls it a form of “psychological warfare”.

International humanitarian law

According to international humanitarian law, hospitals may not be attacked. This protection extends to the injured and sick, but also to medical personnel and means of transport.

Hospitals can lose this protection if they are used as a base from which an attack can be launched; as an observation post to transmit information of military value; as a weapons depot; as a center for connection with combat troops; or as a shelter for unwounded combatants. If hospital director Kahlot told the truth, Kamal Adwan would have lost his protection under international humanitarian law.

According to a report from Reuters news agency Israeli soldiers left a trail of rubble on the grounds of the Kamal Adwan and outside the shattered entrance last week. The hospital has been “effectively destroyed,” according to the WHO.

At least eight patients at Kamal Adwan have died. WHO Director-General Tedros Adhanom Ghebreyesus wrote on X that many patients had to evacuate themselves because ambulances could not reach the institution. “Of the deceased patients, several died due to lack of adequate health care, including a nine-year-old child.”

With the cooperation of Roland van Erven and Liza van Lonkhuyzen