Days Before Catastrophic Bombing of Gaza Hospital, Israel Had Fired Rocket, Ordered Its Evacuation

The targeting of hospitals is a war crime under the Geneva Conventions.

New Delhi: The al-Ahli Baptist hospital which was bombed on Tuesday night is one of 22 hospitals in northern Gaza which were ordered by the Israeli military to evacuate their patients and staff within 24 hours or be responsible for the consequences.

The Israeli evacuation order was issued late on October 12, and drew swift condemnation from the World Health Organisation and other UN agencies.

“As the United Nation’s agency responsible for public health, the World Health Organization strongly condemns Israel’s repeated orders for the evacuation of 22 hospitals treating more than 2000 inpatients in northern Gaza,” the WHO said in a statement. “The forced evacuation of patients and health workers will further worsen the current humanitarian and public health catastrophe.”

“Forcing more than 2000 patients to relocate to southern Gaza, where health facilities are already running at maximum capacity and unable to absorb a dramatic rise in the number of patients, could be tantamount to a death sentence,” it added.

The WHO statement also noted that hospital compounds in Gaza had emerged as spaces where displaced Gazans had gathered in large numbers on the assumption that hospitals would not be attacked by the Israeli army:

“Additionally, tens of thousands of displaced people in northern Gaza are seeking refuge in open spaces in or around hospitals, treating them as havens from violence as well as to protect the facilities from potential attacks. Their lives, too, are at risk when health facilities are bombed.”

The targeting of hospitals is a war crime under the Geneva Conventions.

On the day the WHO issued this statement, which also called on Israel to rescind its evacuation order, the al-Ahli hospital was hit by Israeli rocket fire, injuring four, according to a statement by the Archbishop of Canterbury, head of the Anglican church:

“Hospitals and patients in Gaza are in grave danger. The seriously ill and injured patients at the Anglican-run Ahli Hospital – and other healthcare facilities in northern Gaza – cannot be safely evacuated. They are running low on medical supplies. They are facing catastrophe.

“The Ahli Hospital was hit by Israeli rocket fire last night, with four staff injured in the blast. Other hospitals have also been hit.

“I appeal for the evacuation order on hospitals in northern Gaza to be reversed – and for health facilities, health workers, patients and civilians to be protected.

“The evil and barbaric terror attacks on Israelis by Hamas were a blasphemous outrage. But the civilians of Gaza are not responsible for the crimes of Hamas.

Please continue to pray for all innocent people, Israeli and Palestinian, who are caught up in the terrible violence in the Holy Land.”

‘War crime is a specific term. The WHO can’t determine that’: WHO representative at presser

Shortly after issuing the statement, the UN health body in a hurriedly convened presser said it was still trying to ascertain the full scale of the loss of human life and other resources in the incident.

Richard Peeperkorn, WHO Representative of the ‘occupied Palestinian territory [this is WHO nomenclature], said he had seen media reports saying the number of dead in the attack could range from 200-800. “I find it difficult to speculate [the number of dead] but it will be verified soon.”

The WHO officials did not say how many patients were undergoing treatment in the hospital at the time of attack but all media reports suggest that all hospitals are overwhelmed in Gaza. The WHO officials did say in the presser that ‘thousands and thousands’ of internally displaced people have taken refuge in the hospitals since they considered it a place that was immune to any military attack. And, al-Alhi hospital was no exception to that.

The international NGO MSF put out a tweet by one of its doctors at the al-Ahli hospital following the bombing:  “We were operating in the hospital, there was a strong explosion, and the ceiling fell on the operating room. This is a massacre,” says Dr Ghassan Abu Sittah, MSF doctor in Gaza.”

Several non-profit organisations working in healthcare have condemned the attack. US-based ‘Physicians for Human Rights’, which is also a recipient of the Nobel Peace Prize, called it the ‘deadliest attack on healthcare across any conflict in the world in recent years’.

“We call for an impartial, independent, international investigation into the Al-Ahli al-Arabi Hospital strike. The perpetrators must be held to account for this serious violation of international law,” it said in a statement

Medicines Sans Frontiers (MSF) said it was horrified by the attack. “We were operating in the hospital, there was a strong explosion, and the ceiling fell on the operating room. This is a massacre,” Dr Ghassan Abu Sittah, an MSF doctor in Gaza, has been quoted in its statement.

“This bloodshed must stop. Enough is enough,” it wrote.

Calling the attack ‘totally unacceptable’, Volker Türk, UN High Commissioner for Human Rights, said, once again, the most vulnerable section of people were targeted. He demanded the guilty must be held accountable and gave a call to ‘all States with influence’ to do ‘everything in their power to bring an end to this horrendous situation’.

Hours after the bombing, doctors from the al-Ahli hospital held a press conference amidst the bodies of some of the hundreds of victims of Israel’s bombing on October 17.

Ever since the current conflict started, 3,000 people had been killed in Palestine, according to the WHO.

The WHO officials said before the attack on al-Ahli hospital, there had been 115 attacks on ‘health’ in Palestine with 51 of them in Gaza and the rest in the West Bank. As many as 15 healthcare workers had been killed on the line of duty while 27 others were injured. As many as 24 health facilities were affected and damaged in Gaza, they said.

The WHO officials refused to say if they had any information whether the attack was carried out by the Israeli military or it was a case of Palestinian Islamic Jihad, on the basis of information that they could have gathered from their team on the grounds.

“That’s for criminal investigation to find out,” said Mike Ryan, executive director of WHO’s Health Emergencies Programme. “The WHO can’t determine the origin or the trajectory of the weapon. We are here to condemn the attack of this ferocity.. of this scale of violence,” he added.

The UN agency experts also did not say whether they would like to classify the attack as a ‘war crime’, while replying to a journalist’s query, even though they condemned it very strongly.

“War crime is a specific term. The WHO can’t determine that…the causation or attribution is a vast call for the WHO,” Ryan said, while adding that international humanitarian law calls for protection of healthcare and healthcare workers. And, any such attack was a violation of international humanitarian laws, he said.

The WHO officials expressed ‘frustration’ with the fact that truckloads of essential supplies, including medicine, equipment, food and other such materials were lying idle at Egypt’s border while the people in Gaza are suffering badly due to scarcity of these items.

Asked to clarify if the problem was from Israeli side or Egyptian, Richard Brennan, Regional Emergency Director of WHO’s Eastern Mediterranean Regional Office, said, “The Rafah crossing remains closed at this stage and there’s a lot of aid that has built up on the Egyptian side…We’re ready to go as soon as there is an opening.”

Ryan added it was not just about the Rafah crossing. “It’s what happens on the far side of that crossing. Because delivering aid to the other side of the crossing is not good enough,” he said.

“The people are scattered all over Gaza. The hospitals are scattered all over Gaza. There needs to be safe access to those facilities,” Ryan explained.

As for why the supplies couldn’t be transported further from the Egyptian side into Gaza, Brennan replied, “There are a lot of different dynamics going on. We understand that. We know there’s a lot of diplomacy here.”

He added that senior UN officials were arriving at Egypt’s capital Cario that night and the next day he hoped they would be able to negotiate with all the relevant parties to get the opening going as soon as possible.

State of healthcare centres

As for the state of affairs of healthcare centres, Peeperkorn said more than 60% of primary health centres were not functioning in Palestine. As far as hospitals are concerned, 30 out of 34 were functioning but with fast-dwindling supplies.

He said medicines required not just for surgeries and trauma were nearly exhausted but even basic things such as cleaning materials for hospital wards. Therefore, hospitals are now reporting cases of infections arising out of unhygienic conditions in the wards.

He also said patients who suffer from diseases such as cardiovascular, oncology and other such ailments are not able to find medicines anymore. It had become difficult for hospitals even to cater to pregnant women. The blood banks are also on the verge of being dried up, he added.

Worse, the hospitals may run out of fuel in a day or so, Peepkorn added.

Since hundreds of thousands of people have been displaced, the WHO officials also feared outbreak of communicable diseases. Lack of drinking water and sanitation services would only exacerbate the health issues of the people living in Gaza, Peepkorn said.

All officials reversal of evacuation order given by Israel. Even in most advanced countries, evacuation of patients admitted with serious injuries was impossible, Ryan said, adding, it was impossible to imagine doing it in a conflict-ridden situation in which incessant attacks and bombings were taking place.

Earlier, the WHO had called Israel’s evacuation order a death sentence for patients undergoing treatment in the hospitals.

Ryan also said the WHO was in touch with Israel and had offered medical assistance. But since Israel’s medical system was highly advanced, the country did not feel the need to take any help.

Note: This article, first published at 5.38 am on October 18, 2023, was updated and republished at 8 am on the same day with details on the WHO presser.