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Palestinians transport the injured to the Indonesian Hospital in Jabalia, north of the Gaza Strip on Oct. 9, 2023 (Wafa Agency via Wikimedia Commons)

What’s Behind Israel’s Attacks on Hospitals in Gaza?

A look at a decades-long strategy to destroy morale in the Gaza Strip.

Words: Wa’el Alzayat, Osama Hamed

More than eight months into Israel’s war on the Gaza Strip, Palestinians in the besieged enclave are staring down a catastrophic health crisis. Hospitals are decimated. Innocent people facing bombs and starvation can’t get anywhere close to the care they need to treat gruesome war-caused injuries and health conditions. And that’s to say nothing of the care needed to handle other regular medical needs, like cancer treatment, delivering babies, and surgeries. 

Since Oct. 7, the war has killed more than 37,000 Palestinians, displaced some 80% of Gaza’s population, and destroyed schools, residential buildings, houses of worship, and medical facilities up and down the Strip. With the bombs still falling, the need for safe healthcare is more pressing than ever

Yet, doctors and other providers are losing morale. They want to help, but many are leaving the government health system to go to nonprofits, which can provide higher pay and greater safety from Israel’s indiscriminate attacks. 

Israel claims that its assault on hospitals is necessary because Hamas has been using these facilities to conduct operations. That’s a farce. Israel has been chipping away at Gaza’s healthcare system for decades. And there’s very little evidence — if any at all — that Hamas is using Gaza’s hospital system with the intensity that Israel claims. Even if that was the case, Israel has taken no real steps to prevent civilians from becoming victims due to its military  operations. 

For us — a doctor who has performed emergency surgeries in Gaza and a former Middle East policy expert for the US State Department — the reasoning is clear: Israel’s assault on healthcare is part of a calculated, inhumane, decades-long strategy to wipe out any remnants of Gaza

Destroying Morale

History shows that attacking a healthcare system is one of the most potent strategies an aggressor can use to destroy a region’s morale and its ability to recover in the long run. Civilians can’t get access to care to maintain their basic physical health. They also experience the deep psychological damage of living in a warzone in constant fear for their lives and livelihood. They quickly learn: no one is safe, anywhere

Once the conflict ends, it will be enormously difficult to rebuild infrastructure, acquire necessary supplies, and recruit providers. 

That’s what makes healthcare attacks so tempting for aggressors. And they’ve been on the rise for the past decade. In 2022, there were nearly 2,000 incidents of violence against or obstruction of healthcare, a 45% increase from the previous year, according to a report from the Safeguarding Health in Conflict Coalition. 

Israel is a master of this strategy. During the 2008-2009 war on Gaza, for example, Israel launched an assault that damaged or destroyed 58 hospitals and clinics, according to an analysis in the Journal of Palestine Studies. In a 2014 offensive, Israeli forces damaged or destroyed 73 hospitals and clinics and 45 ambulances. And in May 2021, Israel fired airstrikes that damaged 33 health centers.

Israel has barely received a slap on the wrist for any of its assaults — even though attacking hospitals is a violation of international law. Israeli leaders know that they can get away with their assault as long as they keep claiming their target is Hamas. 

Complete Destruction of Gaza

So now Israel is charging full steam ahead with its ultimate vision: The complete destruction of Gaza. 

They’re making it impossible for Gazan civilians to emerge from the wreckage and rebuild their society free from foreign control. Instead, they’ll have to depend on foreign sources for aid — especially as Gaza’s doctors flock to NGOs. There’s no question: Left unchanged, Israeli actions will ensure that the Gaza of the future is permanently dependent on international aid. 

And all the while, the United States is funneling money to Israel to allow this complete destruction to come to fruition. President Biden recently approved $26 billion for Israel. By comparison, the bill provides just $1 billion in humanitarian aid for Gaza.

We have to do better. First, by doing everything in our power to secure an immediate, permanent ceasefire. That’s the only way to protect the remnants of Gaza’s healthcare system and allow them to rebuild. Additionally, the United States needs to put a clear condition on funding: If Israel continues to target medical facilities, they lose their aid. 

The clock is running out for Gaza’s healthcare system. We need a change — immediately.

Wa’el Alzayat, Osama Hamed

Wa’el Alzayat is CEO of Emgage Action, which supports and advocates for just policies that strengthen America's pluralistic democracy and protect human rights. Alzayat previously served as a Middle East policy expert for the US Department of State for 10 years. Dr. Osama Hamed is director of Specialized GI, Liver, Pancreas and Bariatric Surgery Center (SGBC) in Jordan.

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