Hundreds of patients, including dozens of babies, remain trapped inside Gaza’s largest hospital as Israeli troops and Hamas militants take part in heavy fighting outside it. What is happening there and why?
Where is al-Shifa hospital and how important is it to healthcare in Gaza?
The Dar al-Shifa (House of Healing) hospital is a sprawling complex of medical facilities in Gaza City, in the north of Gaza. Located about 500 metres from the coast and a major north-south road, it comprises a group of six-storey buildings that dominate the skyline. With between 600 and 900 beds and thousands of staff, it was the mainstay of healthcare provision locally, with a range of services that few of the other hospitals in Gaza could offer. Since the beginning of the war in Gaza, it has become a shelter for those displaced by the fighting and continuing Israeli bombardment.
What are the competing claims about Hamas operations there?
Israel claims that Hamas has built its headquarters in bunkers and tunnels under the hospital, effectively using the building, patients and staff as a human shield. Security officials have also said that, after the surprise attacks into Israel by Hamas which killed 1,200 Israelis, mainly civilians in their homes or at a dance party, the senior Hamas leaders have been based in a “command complex” under the hospital.
Is there evidence for the Israeli claims?
At a recent press conference an IDF spokesperson displayed a satellite photograph of the hospital site with military “command” elements marked on it, which it described as an illustration based on “the true material that we have in our hands”. In footage said to be from an interrogation, a Hamas militant captured last month described how Hamas had “hidden in the hospitals”. Israel has also released other evidence apparently showing tunnels close to or in other medical facilities in Gaza.
How do Hamas and others answer the claims?
Hamas and officials of the Hamas-run health authorities in Gaza have denied the claims, saying they are propaganda used to justify attacks on health facilities. Dr Ghassan Abu-Sittah, a British doctor working at al-Shifa described the Israeli claim as an “outlandish excuse”. Human Rights Watch, the US campaign group, said it could not corroborate the Israeli allegation.
What are conditions like in the hospital?
Thousands of people have fled al-Shifa but health officials say remaining patients were dying due to energy shortages amid intense fighting between Israeli troops and Hamas militants. Life-saving equipment such as incubators cannot run without fuel to run generators. At least 32 patients, including three premature babies, had died over the past three days, Gaza’s Hamas-run health ministry said.
There are between 600 and 650 inpatients at al-Shifa, as well as 200 to 500 health workers, and about 1,500 displaced people seeking shelter there, according to information shared with the World Health Organization, which was posted on Sunday on X.
The Israeli military said it was providing safe corridors for people to escape intense fighting in the north and move south, but Palestinian officials inside al-Shifa said the compound was surrounded by constant heavy gunfire and that Israeli snipers are all around.
How might this end?
There are various scenarios. Israeli forces might try to fight their way into the hospital, though this has huge political and diplomatic risks. Hamas might decide to withdraw from Gaza City, possibly via tunnels, to the south of Gaza, though this is unlikely. A ceasefire – possibly after the conclusion of a deal for the partial release of the more than 240 hostages that Hamas seized last month – would allow humanitarian organisations, the IDF or other actors to organise a full evacuation or get vital supplies to the hospital.
Is the hospital’s significance just medical?
Not any longer. Al-Shifa has become a strategic objective for Israel, which sees the hospital as the nerve centre of Hamas’ administrative and military capabilities. For Hamas and its supporters, it has become a symbol of the organisation’s ability to fight against a militarily more powerful foe. For millions across the world, it has come to epitomise the suffering of innocent civilians. More than 11,000 people, about 40% of them children, have been killed, according to Palestinian authorities, and more than half of the population of Gaza have been made homeless.
