Israeli forces approach key Gaza hospital; what will they do?

FILE PHOTO: Smoke rises as displaced Palestinians take shelter at Al Shifa hospital, amid the ongoing conflict between Hamas and Israel, in Gaza City

By Nidal al-Mughrabi and Emma Farge

GAZA/GENEVA (Reuters) - Israel's military is closing in on central Gaza City and its main Al Shifa Hospital, where Israel claims Hamas fighters have a command centre, raising questions about how Israel will interpret international laws on protection of medical facilities and the thousands of displaced people sheltering there.

Israel has not outlined its possible plans for the hospital but has said its top priority is dismantling Hamas' command infrastructure. Combat engineers are using explosives to destroy tunnels in the Islamist group's vast underground network, Israel says.

Any Israeli attempt to seize Al Shifa, where video Reuters obtained this week showed medics scrambling to treat an influx of injured people, would risk heavy civilian losses and could trigger an international outcry.

Deadly air strikes on refugee camps, a medical convoy and near hospitals have already prompted fierce arguments among some of Israel's key western allies over its military's adherence to international law.

Israel's stated objective is to destroy Hamas, which it says killed 1,400 people and kidnapped 240 others during its Oct. 7 attack on Israeli towns. Health authorities in the Hamas-run Gaza Strip say Israel's bombardment has killed 10,800 Palestinians.

On Thursday residents of Gaza City saw Israeli tanks about 1.2 kilometre (3/4 mile) from Al Shifa Hospital, the biggest medical facility in the Gaza Strip.

Israel's military spokesperson has produced photographs, diagrams and audio recordings he says show Hamas is using Al Shifa to hide command posts and entry points into an extensive tunnel network under Gaza.

"Hamas terrorists operate inside and under Shifa hospital and other hospitals in Gaza," the spokesperson, Rear Admiral Daniel Hagari, said last month.

Iran-backed Hamas, health authorities and Al Shifa directors have denied that the group is concealing military infrastructure in or under the hospital complex and have said they would welcome international inspection of the facility.


Last week Israel targeted an ambulance outside the hospital entrance, saying it was carrying Hamas fighters and adding it would show evidence for that though it has yet to do so. Medics said the ambulance was trying to evacuate injured patients and the blast killed 15 people.

"We know that hospitals are protected buildings under international humanitarian law," said U.N. human rights spokesperson Liz Throssell.

The situation was complicated by allegations that hospitals were also being used for military purposes, she said, something that would also breach international law.

Medical units used for acts harmful to the enemy, and which have ignored a warning to stop doing so, lose their special protection, she said.

However, "regardless of the actions of one side, so for example using hospitals for military purposes, the other side must comply with international humanitarian rules on the conduct of hostilities," she added.

International Criminal Court prosecutor Karim Khan said in an Oct. 30 statement on attacks on protected sites such as hospitals that Israel would "need to demonstrate the proper application of the principles of distinction, precaution and of proportionality".

Although protection under international law could be lost, he said, "the burden of proving that the protective status is lost rests with those who fire the gun, the missile or the rocket in question".

(Reporting by Nidal al-Mughrabi in Gaza, Emma Farge in Geneva and Stephanie Van Den Berg in the Hague; Writing by Angus McDowall; Editing by Cynthia Osterman)