The airstrikes started just before noon. The injured and the dead quickly followed. As the ground in the southern Lebanese town of Marjayoun began to shake from the relentless approach of Israeli bombs, Shoshan Mazraani let her muscle memory take over.
As the emergency room director of its public hospital, she was well versed in the grim logistics of the triage procedures that follow a bombing. Then after five hours of gruelling work, the din of the emergency room was interrupted by a long whistle.
Doctors turned their heads, a reflex after nearly a year of war. Then a blast, the doors of the hospital blown open, the windows shattering and cracks spreading across the hospital walls.
“When I heard the rocket, I thought it was coming to hit us. Then there was a tremendous pressure in the hospital, the doors buckled from it. I really thought the rocket had impacted us,” Mazraani said.
Two airstrikes had landed just metres from the hospital on Monday last week, damaging its interior and forcing medical workers to stop their work until they could figure out if they were under attack.
The airstrikes took Mazraani by surprise. Marjayoun, colloquially referred to as the beginning of the “Christian corridor” by UN peacekeepers in south Lebanon, had remained relatively untouched by fighting. As late as July, residents of the town could be seen going on scenic jogs, UN armoured personnel carriers passing them by and plumes of smoke rising from the hills just a few miles away.
Marjayoun’s hospital, in particular, was thought to be safe. But on 23 September, when Israel began a punishing aerial offensive on Lebanon that has so far killed 700 and wounded more than 2,000, healthcare workers suddenly found themselves at risk.
At least 50 paramedics have been killed by Israeli strikes in Lebanon over the last two weeks, more than doubling the number of healthcare workers killed since the beginning of fighting between Hezbollah and Israel last year.
Of the paramedics killed over the last two weeks, all have belonged to healthcare services affiliated with either Hezbollah or Amal, another Shia political party – affiliations which rights experts say does not affect their protected status under international law.
One after another, Israeli airstrikes last week began to hit near hospitals in Lebanon’s south. On Tuesday one airstrike landed next to Bint Jbeil hospital and another hit the outskirts of Tibnine public hospital as ambulances were approaching it. An empty building next to Ragheb Harb University hospital near Nabatieh was hit on Wednesday and then again on Thursday.
The strikes continued into this week. In the early hours of Thursday, Israel struck a medical centre belonging to the Islamic Health Organisation – a Hezbollah-linked paramedic service – in central Beirut, killing at least nine and wounding 14.
Paramedics say they began to notice a pattern with the strikes: whenever they arrived at a location to start rescue operations, they said Israeli airstrikes would follow. In one case, in the town of Suhmoor in the western Bekaa valley on Monday last week, an ambulance was struck directly after the team left the car. Pictures of the vehicle engulfed in flames circulated in Lebanese media.
Meanwhile, paramedics have begun receiving strange calls with a voice speaking Arabic on the other end, warning them to evacuate their medical centres, said Rabih Issah, a local commissioner of Islamic Kashafat al-Risala medical organisation that serves much of south Lebanon.
Last Wednesday, paramedics in two different villages received calls, forcing the workers to stop their work and evacuate, though the buildings were not bombed. Unlike the wave of Israeli calls that warned 80,000 Lebanese to distance themselves from buildings it alleged contained Hezbollah weapons ahead of Israel’s aerial campaign in south Lebanon the week before, these warnings were directed only at the medical workers.
Human rights experts have said that the targeting of medical workers and false calls for evacuations are forbidden under international law.
“Calls for evacuating areas that are primarily intended to cause panic among residents or compel them to leave these areas for reasons other than their safety are prohibited under customary international humanitarian law,” said Ramzi Kaiss, Lebanon researcher for Human Rights Watch.
He added that healthcare workers and facilities, “regardless of affiliation”, cannot be targeted in attacks unless “they commit or healthcare facilities are being used to commit acts harmful to the enemy”.
The Israeli military told the Guardian in response to claims that it has targeted paramedics and hospitals: “The [Israel Defense Forces] operates in strict accordance with international law [and] takes all feasible precautions in order to mitigate harm to civilians during operational activity.”
Ghassan Abu-Sittah, a plastic surgeon who worked in Gaza over the last year and is now in Beirut, said the treatment of medical workers over the last two weeks in Lebanon’s south was reminiscent of Israeli tactics in Gaza.
“On the 12th of October in Gaza, five days before the attack on al-Ahli hospital, they were phoning hospital directors and blaming him for the deaths of anybody who died when the hospital would be targeted,” Abu-Sittah said. He said he was concerned that damaging the health system in south Lebanon is part of an Israeli strategy to clear areas along the Lebanon-Israel border of its inhabitants.
The phone calls and the bombs that seem to follow them wherever they go have frayed the nerves of medical workers.
“We are scared that we will be bombed,” Mazraani said, adding that she tries to keep the morale of her team high. “We are trying as much as we can to continue, because there are still people here.”
She added, with pride, that no one from her department had left Marjayoun, despite the danger. “Maybe it’s because I haven’t left,” she said. “If I left, morale would fall, and maybe the others would start to leave to.”
