Fighting has reached the gates of Al Shifa Hospital in Gaza: Israeli ground troops have almost fully encircled the medical buildings which it says sit above Hamas’s underground headquarters in Gaza City. Hamas and hospital staff deny the claims and say Israeli forces have trapped patients and civilians inside in dire conditions.
Al Shifa Hospital has become a focal point of the war in Gaza as a symbol of devastating civilian suffering and conflicting narratives from Israel and Hamas.
At the heart of competing claims about the hospital is Israel’s stance that Al Shifa sits above an extensive tunnel network housing the Islamist militant group’s headquarters in Gaza.
IDF spokesperson Rear Admiral Daniel Hagari said on October 27 that Israel had “concrete evidence” that the hospital was being used to hide Hamas members and provided visuals and intercepted audio that he said was evidence of the organisation's use of Al Shifa as its headquarters.
Hamas has multiple underground complexes under the hospital accessible via several tunnels and an entrance on one of the wards, he said.
Hamas and hospital staff at Al Shifa deny the Israeli allegations and have called for an independent investigation into the claims.
Meanwhile, Israeli troops look to have almost entirely encircled the medical complex, located in Gaza City, where as many as 3,000 patients and staff are sheltering inside without adequate fuel, water or food, the World Health Organization (WHO) and UN agencies said on Monday.
Thousands of people also appear to have fled from Gaza's largest hospital in recent days.
Israel’s military said on Sunday it was providing a safe corridor for people inside the hospital to move south. Al Shifa hospital director, Mohammed Abu Salmiya told FRANCE 24 on Monday that the IDF’s claim was “a lie”.
Read more‘Al Shifa has become a mass grave,’ Gaza hospital director tells FRANCE 24
Palestinian health officials inside the hospital have said the compound is surrounded by constant, heavy gunfire.
‘Alleged evidence’
This is not the first time that Hamas has been linked with Al Shifa. Amnesty International accused the militant group of abductions and the unlawful killings of Palestinians in 2014, some of whom were “interrogated and tortured or otherwise ill-treated in a disused outpatient’s clinic“ within the hospital grounds, its report found.
The militant group has also confirmed that it operates an extensive tunnel network in Gaza. “I am telling you that the tunnels we have in the Gaza Strip exceed 500 kilometres [310 miles],” Yahya Sinwar, Hamas’ political leader, claimed in 2021.
Yocheved Lifshitz, an 85-year-old woman taken hostage by Hamas on October 7, told journalists after her release that, while captured, she had walked for kilometres through tunnels in Gaza that were like “a spider’s web”.
“It is very plausible to believe that Hamas might have a weapons cache and they might have tunnel access underneath [Al Shifa],” said Dr Marina Miron, researcher in the War Studies Department at King’s College London.
“However, to demonstrate that will be very difficult.”
The “alleged evidence” that Israel has provided so far is simply not enough, Miron added. “We have seen in the past that such evidence can be doctored.”
Even so, Israel doubled down in its claims in a New York Times article published Monday, in which eight Israeli defence and intelligence officials described further details of a subterranean hub underneath the hospital that can hold at least several hundred people.
The complex relies in part on electricity diverted from Al Shifa Hospital, they said in a statement.
American officials who wished to remain anonymous told the New York Times they were “confident” Hamas was using a tunnel network under Al Shifa as an operations headquarters and for weapons storage.
Independent verification
Yet The New York Times concluded that photos it had been shown as evidence of entrances to the tunnels near Al Shifa Hospital could not be authenticated.
“It is very, very hard to verify much of the narrative that the Israelis want to present when they don't allow independent journalists into Gaza to actually give first-hand witness accounts about what is actually happening on the ground,” said Clive Jones, Professor of Regional Security Durham University.
“Unless both sides are prepared to let independent observers to go in and verify the claims of each other then all we have is narratives and counter-narratives,” he added.
An explosion at Al Ahli Hospital in Gaza in October, which Israel and Hamas blamed on each other, illustrated the difficulty of establishing facts when ground access is restricted.
So far only Hamas has said it would welcome such an investigation, which would require ensuring safe access for a team of independent experts along with lengthy analysis of multiple data sources such as footage, maps and satellite imagery.
In the current circumstances, such an investigation is highly unlikely. This plays to Hamas’ advantage, according to Miron. “For them, depicting [the narrative] as Israeli atrocities targeting the hospital is beneficial.”
Emphasising the humanitarian crisis within hospitals has strengthened international calls for a ceasefire which, for Hamas, would likely mean an opportunity to “regroup, recover and strike again”, Miron said.
‘Human shields’
Under international law hospitals are entitled to protection during conflicts but can become legitimate targets under certain conditions, such as if they are being used for military purposes.
It is on these grounds that Israeli troops have hit targets near and possibly inside Gaza hospitals and entered medical buildings, sparking international concern.
The UN’s permanent observer for Palestine said on November 10 that hospitals in the enclave had become Israel’s “primary target” for attack.
But establishing exactly how closely Israel is targeting hospitals is also difficult.
“Israel is arguing that they actually haven't hit the hospitals per se and are not actually firing on the hospitals themselves,” said Jones. “Unless we actually can get independent verification, we don't know how true those claims are.”
Israel meanwhile says that Hamas is using workers and patients inside Al Shifa as “human shields” to protect its operations hub – claims which are supported by the US.
“Hamas is operating in a way that is outside the bounds of any civilized concept of how you would think about using a hospital,” US National Security Adviser Jake Sullivan said on Sunday.
“Without getting into intelligence information, we can just look at the open-source reporting that Hamas is using hospitals… for command-and-control, for weapons storage, to house its fighters, and this is a violation of the laws of war.”
The European Union on Monday gave more tacit endorsement, echoing Israel’s language as its top diplomat Josep Borrell condemned “the use of hospitals and civilians as human shields by Hamas”.
Hamas said Borrell’s comments were “outrageous and inhuman” and served as a “cover-up” for Israel “to commit more crimes against children and defenceless civilians”.
Amid the near impossibility of getting humanitarian supplies into the enclave, Doctors Without Borders (Médecins sans Frontières or MSF) warned of an additional “danger” to Gaza’s hospitals and civilians created by endorsements of Israel’s rhetoric.
“This is not a hospital, we are told, when a hospital is threatened with bombing,” said Claire Magone, MSF general director, at a press conference in Paris on November 7. “Those were not civilians we hear as well, after strikes on displaced people.”
Casting doubt over the legitimacy of Gaza’s hospitals – even as they continue to treat patients and house civilians – contributes to a climate of acceptance that attacks on medical facilities will happen, which is now the risk at Al Shifa.
The next step for Israeli forces, currently on the ground outside the medical compound, will be an attempt to enter the hospital and the tunnel network underneath, Miron expects, even though doing so comes with its own risks for Israel.
Unlike Hamas, which does not claim to abide by international conventions, “Israel has a burden of proof to demonstrate that they are not in violation of international humanitarian law”, she said.
"One wrong move or one video from Hamas showing Israeli soldiers shooting inside the hospital would be very damaging.”
