The Devastating Toll on Health Care in the Israel-Hamas Conflict

A closer look at the impact of violence on health care workers and facilities in Gaza
In the midst of the fifth major conflict between Hamas and Israel in the past 15 years, the toll on health care workers and facilities has been catastrophic. As Hamas continues its attacks, the murder of over 1,200 Israelis represents the largest instance of violence against Jews since the Holocaust. Israel, in response, has launched massive airstrikes that have resulted in the deaths of over 1,900 Palestinians, including more than 450 children. The escalating violence has not only claimed lives but has also left thousands wounded and displaced, with the health care system in Gaza on the brink of collapse.
Violence against Health Care Workers and Facilities
The violence against health care workers and facilities in conflicts is not unique to the Israel-Hamas conflict. In Ukraine, Russia has targeted health facilities, ambulances, and health workers over 1,000 times in just 18 months of war. Similarly, in Myanmar, nearly 800 health workers have been arrested since the 2021 coup. These incidents highlight the alarming trend of violence connected to health care in conflicts across 32 countries in 2022.
Previous Attacks on Health Care in Gaza
The violence against health care workers and facilities in Gaza is not new. In previous conflicts, Israeli missiles, airstrikes, and tank assaults damaged or destroyed over 200 health facilities and more than 150 ambulances. More than 30 health workers were killed, and over 175 were injured. The health system in Gaza has never fully recovered from these attacks.
Factors Contributing to the Toll on Health Care
Airstrikes and ground fighting in densely populated urban areas inevitably result in civilian casualties and damage to infrastructure. While Israel has alleged that Hamas uses hospitals for military purposes, it still has a legal obligation to minimize harm to civilians. However, the sheer number of attacks on ambulances and paramedics cannot be solely attributed to urban combat.
Delayed Approvals and Erosion of Political Commitment
Research on previous conflicts in Gaza reveals that Israeli soldiers often shot at ambulances, even when the process for medical evacuation had been established. In some cases, approval for ambulance entry took so long that paramedics proceeded without permission, while in others, ambulances were fired upon even after approval was granted. The erosion of political commitment and leadership on safe evacuation has contributed to these attacks.
Declining Commitment to International Law
Visceral outrage at Hamas’ atrocities has led to a declining commitment by Israel to conduct combat operations in accordance with international law. Israel’s denial of essential resources, such as water, food, and fuel, into Gaza is a de facto repudiation of its duty to facilitate humanitarian relief. This shift in approach raises concerns about the deprivation, suffering, and death that Palestinians may experience if Israeli tactics and obligations continue to be disregarded.
The ongoing conflict between Hamas and Israel has taken a devastating toll on health care workers and facilities in Gaza. The repeated attacks on ambulances and health facilities, coupled with the denial of essential resources, have pushed Gaza’s health care system to the brink of collapse. The erosion of political commitment and declining adherence to international law further exacerbate the situation. As the conflict persists, it is crucial to recognize the importance of protecting health care and upholding humanitarian principles to prevent further suffering and loss of life.