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Destroying Gaza’s Health Care System Is a War Crime
The ICC should prosecute Israelis responsible for bombing hospitals, denying access to medicines and vaccines, and causing excessive civilian harm.
On Jan. 26, the International Court of Justice (ICJ) in The Hague issued an initial ruling in South Africa’s lawsuit accusing Israel of genocidal acts in Gaza. The court did not call for an immediate cease-fire, nor did it rule on whether Israel is in fact committing a genocide, but it did instruct Israel to take provisional measures to prevent genocidal acts. In its ruling, the court noted “a large number of deaths and injuries, as well as the massive destruction of homes, the forcible displacement of the vast majority of the population, and extensive damage to civilian infrastructure.”
A less noted pillar of the case against Israel, however, is its systematic assault on Gaza’s medical infrastructure. Since Hamas’s horrific Oct. 7 attack, Israel has repeatedly targeted health care facilities, ambulances, and access roads. It has arrested health care workers, blockaded fuel needed for generators, and withheld critical medical and surgical supplies—all of which are intended to undermine Gaza’s health care system.
There is a particularly cruel circular logic at play here: Israeli forces, as they bomb and besiege Gaza, are creating an urgent need for medical care among civilians while simultaneously denying them access to it. Israeli forces are far from the first to target health care. In Ukraine, where Russian soldiers damaged or destroyed nearly 700 health care facilities in the first 100 days of the full-scale invasion, these attacks drove the mass exodus of 5 million people.
In Syria, attacks on health care were central to the forced dispersion of 14 million people. Government forces killed at least 831 health care workers between 2011 and 2023. Doctors took it upon themselves to build hospitals underground in opposition-held areas in the hope of avoiding deliberate bombardment by the Russian-Syrian military alliance.
Israel’s destruction of Gaza’s health care system is not only an important part of the genocide charges—it is also a blatant war crime that should be prosecuted outright by the International Criminal Court (ICC), which has an active investigation underway of war crimes in Palestine. While the ICJ resolves disputes between states, the ICC adjudicates criminal prosecutions of individuals.
Targeting health care achieves little militarily while amplifying the death toll and suffering caused by indiscriminate bombardment. Such attacks flout the core purpose of international humanitarian law—to relieve civilian suffering—and are thus often an omen of broader atrocities to come.
ISRAELI ATTACKS ON HEALTH CARE started in the immediate aftermath of the Oct. 7 assault. Within the first 36 hours, Israeli forces attacked the Indonesian Hospital in Beit Lahia, Nasser Hospital in Khan Yunis, and Al-Quds Hospital in Gaza City, among several others, killing six health care workers in the process. While offering little proof, Israel routinely blames Hamas for fighting from civilian areas and institutions, yet Israeli forces have regularly deployed methods of warfare that are indiscriminate, impose a disproportionate cost on civilians, or both.
By Nov. 24, 30 of Gaza’s 36 hospitals had been bombed, many repeatedly, even while medical staff, patients, and civilians seeking shelter remained inside. In addition to hospitals, Israeli forces have targeted ambulances, medical aid convoys, and access roads. As of Jan. 30, the World Health Organization (WHO) reported 342 health care-related attacks in Gaza, resulting in hundreds of deaths and injuries. At this point, every hospital in Gaza is either damaged, destroyed, or out of service due to lack of fuel; only 13 hospitals are even partially functioning.
Those hospitals, ambulances, and clinics that have survived bombing have been debilitated by blockades and obstruction of humanitarian convoys, depriving health care providers of not only water, fuel, and electricity but also critical medical supplies, such as oxygen, blood, and anesthesia.
The staggering figure of more than 67,000 people injured in Gaza thus far doesn’t begin to take into account the consequence of the routine medical care that is being denied to the civilian population. From childhood vaccinations to cancer treatment and dialysis, modern medical care has largely come to a standstill for 2.3 million Palestinians in Gaza, whose life expectancy is already 10 years shorter than people living a few miles away in Israel and whose rates of neonatal, infant, and maternal mortality are nearly five times higher.
Gaza’s only hospitals providing treatment for adults and children with cancer, the Turkish-Palestinian Friendship Hospital and Al-Rantisi Specialized Hospital for Children, have been bombed, besieged, and forced to close. Additionally, thousands of patients who previously received specialized treatment in Jerusalem that was unavailable in Gaza—averaging 100 per day—are now unable to access it.
Foreign Policy News, 2024
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