Hamas headquarters hidden under Gaza's largest hospital. Credit: IDF.
Hamas headquarters hidden under Gaza's largest hospital. Credit: IDF.
featureIsrael-Palestinian Conflict

10 things to know about Hamas and hospitals

The terror group's use of medical facilities as military sites in contravention of international law has been documented for years.

Hamas has commanded a network of tunnels and terror infrastructure in the Gaza Strip since it took control there in 2007. The Iranian-backed Palestinian terrorist organization uses civilian areas, including hospitals, to store and launch rockets and to spread propaganda. In violation of international law, Hamas also uses hospitals to hide command centers and shield operatives.

Hamas uses hospitals as shields, in violation of the Geneva Conventions.

According to international law, hospitals may not be used for military activity. According to the 1949 Geneva Conventions, “the responsible authorities shall ensure that the said medical establishments and units are, as far as possible, situated in such a manner that attacks against military objectives cannot imperil their safety.” A 1977 additional protocol says that “under no circumstances shall medical units be used in an attempt to shield military objectives from attack.”

Firing rockets from near hospitals is Hamas doctrine.

Storing weapons near civilian sites, including hospitals, is part of Hamas’s doctrine. A NATO report examining Hamas activities between 2008 and 2014 found that they fire “rockets, artillery, and mortars from or in proximity to heavily populated civilian areas, often from or near facilities which should be protected.” Journalists from numerous media outlets, including the Financial Times, have provided eyewitness testimony of rockets launched from near hospitals.

Hamas built a command center underneath Shifa Hospital.

For years, Hamas has been using a bunker underneath Dar Al-Shifa Hospital, the largest hospital in Gaza, as a base for military operations. During the 2009 conflict between Israel and Hamas, Israeli intelligence officials suspected the hospital was being used for cover. According to the Meir Amit Intelligence and Terrorism Information Center, Hamas “closed off some of the departments, stationed armed guards and closely examined everyone in the hospital. … Ismail Haniyeh, head of the de facto Hamas administration, set up his headquarters in the hospital’s burn ward.” Hamas has also insisted on conducting interviews in Shifa’s courtyard, using wounded patients as props for propaganda.

Hamas has hidden under Shifa since 2007.

In 2007, a doctor in Shifa Hospital said, “The medical staff are suffering from fear and terror, particularly of the Hamas fighters, who are in every corner of the hospital.” Former Israeli intelligence chief Avi Dichter said in 2009 that Hamas commanders even at times wear doctor’s robes. The same year, PBS said it “reached a doctor in Gaza who believes Hamas officials are hiding either in the basement or in a separate underground area underneath the hospital.” By 2014, the hospital had become a “de facto” command center for Hamas.

Journalists have documented the use of the hospital by Hamas over the years. One foreign journalist said Hamas’s use of Shifa is an open secret, but reporters in Gaza are refuse to report about it out of fear for their personal safety.

Hamas used hospitals in its 2014 war on Israel.

In 2014, the conflict between Israel and Hamas spotlighted how Hamas made use of hospitals as part of its strategy. “In Hamas’s world, hospitals are command centers, ambulances are transport vehicles and medics are human shields,” the Israel Defense Forces said. This was a flagrant violation of international law.

Hamas used al-Wafa Hospital for military purposes.

Al-Wafa Hospital in the Shajaiyeh neighborhood of Gaza City was turned into a command center, rocket-launching site and observation post, according to the IDF in 2014. “Hamas repeatedly opened fire from hospital windows and [launched] anti-tank missiles from the premises. Hamas deliberately and cynically turned the hospital into a legitimate military target.”

When the IDF carried out a precision airstrike near the hospital, it first called to warn their administrators. Video released during the 2014 conflict showed Hamas launching rockets next to the hospital. The IDF claimed the hospital has been “a hotbed of terrorist activities, with gun and anti-tank missile fire originating from the site.”

Hamas uses hospitals for propaganda.

On Oct. 18, 2023, a rocket fired by Palestinian Islamic Jihad struck a parking lot near Al-Ahli Arab Hospital in Gaza City. Hamas rushed to blame Israel, claiming that more than 500 had been killed. Investigations by Israel, U.S. intelligence and major media concluded that the claims by Hamas were false. Hamas used the incident to blame Israel.

The manipulation behind the al-Ahli Hospital incident is part of the wider media war by Hamas to use civilians in Gaza to score points. This includes inflating death tolls in Gaza and spreading misinformation.

Hamas commits abuses at hospitals.

A 2007 Human Rights Watch report recounted how Hamas executed a rival Fatah member and his two sons at a hospital in Beit Hanun. In 2008, The New York Times reported in gory detail how Hamas murdered six suspected collaborators in a 24-hour span. In 2014, Palestinian reporter Radjaa Abu Dagga said he was taken for questioning by Hamas to Al-Shifa hospital. His passport was taken and he was prohibited from leaving the Gaza Strip.

Hamas interrogates and tortures at hospitals.

Fatah also accused Hamas of using the hospital’s x-ray department as a prison and interrogation room. Amnesty International wrote in 2015 that civilians were “interrogated and tortured or otherwise ill-treated in a disused outpatient’s clinic within the grounds of Gaza City’s main al-Shifa Hospital. At least three people arrested during the conflict accused of ‘collaboration’ died in custody.”

Hamas also uses ambulances for terrorism.

Hamas has also used ambulances during the course of the war as part of its operations. The use of ambulances not only denies civilians who are injured the use of the ambulance but also puts at risk medical workers if terrorists use the ambulance in the course of their activities.

Originally published by the Foundation for Defense of Democracies, a nonpartisan research institute focusing on national security and foreign policy.

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