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Condemning Hamas’ Exploitation of Hospitals and Endangerment of Civilians in the Ongoing Conflict

Updated: Nov 28, 2023

The actions of Hamas in the ongoing conflict reveal a troubling and deliberate departure from international legal norms, specifically in the misuse of hospitals, the reprehensible exploitation of civilians as human shields, the obstruction of civilian evacuation efforts, and the theft and exploitation of civilian resources for its terror activities.

Whereas the objectives of the laws of armed conflict were designed specifically to mitigate the endangerment of civilians, Hamas’ blatant and deliberate abuse of these rules in the face of Israel’s commitment to upholding them has systematically achieved the opposite effect – prolonged conflict in civilian-dense population centers. This blatant manipulation of a law-abiding country by a terror organization exploits the former’s commitment to protecting human life in order to gain an illegal advantage in battle, whilst completely disregarding the outcomes of those actions on civilian lives to the extent of deliberately increasing the death toll of armed conflicts and then cynically decrying the deaths (of civilians the terror group endangered) and claiming victimhood in the hopes of gaining international support and legitimacy.

As the following analysis will demonstrate, the distortion and manipulation outlined herein form the cornerstone of Hamas’ approach to the conflict. We urge the international community to unequivocally condemn this behavior.

Weaponization and Misuse of Hospitals and Deliberate Use of Human Shields

A recent statement by Moussa Abu Marzook, a senior Hamas official and former Deputy Chair of Hamas’ Political Bureau, underscores the calculated nature of their conduct, highlighting the role of the tunnel network in protecting Hamas fighters while shifting responsibility for the safety of Gazan civilians onto the United Nations and Israel. Additionally, Khaled Meshaal, another leader within Hamas and the predecessor of Ismail Haniyeh, openly expressed a willingness to accept mass Palestinian casualties in pursuit of political aims. These explicit admissions by Hamas leaders acknowledging human shields as a key pillar of their terror operations provide undeniable evidence of a calculated strategy that undermines established principles safeguarding the sanctity of medical facilities and protecting civilian lives during armed conflicts.

Specifically, Hamas exploits hospitals and ambulances for military operations, despite the special protection accorded to these assets under customary international law, which also extends to the sick and wounded patients often located in these facilities. Inter alia, these customary rules are reflected in Articles 10, 12(1), and 21 of Protocol I Additional to the Geneva Conventions of 12 August 1949; Articles 8 and 11 of Protocol II Additional to the Geneva Conventions of 12 August 1949; Article 18 of the Convention (IV) relative to the Protection of Civilian Persons in Time of War, Geneva, 12 August 1949; and Article 19 of the Convention (I) for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field, Geneva, 12 August 1949. In addition, under Article 8.2(b)(ix) of the Rome Statue of the International Criminal Court, attacking hospitals (among other types of protected categories) is defined as war crime.

Weaponization of Hospitals: In the ongoing conflict, the use of hospitals as launch sites for attacks on Israel, deliberately placing civilians in harm's way, has been an enduring and troubling practice. This tactic is exemplified by the incident at the Al-Quds hospital in Gaza City, where footage released by the IDF shows terrorists firing rocket propelled grenade launchers at the hospital entrance. During the exchange of fire, civilians were observed leaving the hospital building, only to find themselves unwittingly involved as other terrorists emerged from adjacent buildings, hiding among them and actively participating in the attempted attack. Such actions not only violate the sanctity of medical facilities but also pose a severe threat to the lives of innocent civilians caught in the midst of conflict.

Misuse of Hospitals: In violation of the fundamental principles of the laws of armed conflict, Hamas exploits vital medical facilities, including the Al-Quds, Al-Shifa, Qatari, Indonesian, and Rantisi hospitals, for military purposes. These facilities serve as hiding places for tunnels and command centers, as well as weapon storage for launching attacks on Israel. Additionally, ambulances are repurposed for military activities, and medics are employed as human shields. This egregious misuse places civilians, including patients and medical staff, in immediate danger, transforming medical facilities into de facto military targets.

Recent evidence from the Israeli Defense Forces on November 13 further exposes the extent of this violation. Videos and photographs revealed weapons stored by Hamas in the basement of Rantisi Hospital, a pediatric cancer treatment facility in Gaza. Military spokesperson Rear Admiral Daniel Hagari reported the discovery of a command center with an arsenal, including grenades and suicide vests, confirming the complete militarization of the hospital. The footage showed rudimentary living quarters, a small kitchen, and a tunnel shaft leading to the residence of a senior Hamas naval commander, underscoring the hospital's role as a military base.

This disturbing revelation not only confirms the intentional use of medical facilities for military purposes but also highlights Hamas’ direct endangerment of civilian lives, a blatant violation of international humanitarian law.

For those of us in the international legal community not engaged with practicing war laws, it is crucial to be reminded, that as summarized by Rule 28 set by the International Committee of the Red Cross (as to the protection of Medical Units, a term which also covers hospitals) “Medical units exclusively assigned to medical purposes must be respected and protected in all circumstances. They lose their protection if they are being used, outside their humanitarian function, to commit acts harmful to the enemy.”

Human Shields: The deliberate use of civilians as human shields is evident not only in the actions above but has also been employed across numerous other ‘civilian’ facilities which were found to contain weapons caches. This, of course, also constitutes a direct violation of international law, which expressly prohibits the use of civilians and civilian buildings to shield combatants from attacks. Some recent examples include the fighting from and discovery of weapons caches in a school, and Hamas rocket launchers found beside children’s swimming pools and playgrounds, and tunnel shafts in mosques.

As highlighted in a November 5th editorial from The Washington Post, Hamas "has consciously exposed noncombatants to danger by provoking Israel militarily — all while safeguarding its own leaders and fighters in tunnels." It has also been reported that al-Shifa Hospital in Gaza City, now a major battle site between Israel and Hamas, "has become a de facto headquarters for Hamas leaders, who can be observed in the hallways and offices."

This longstanding Hamas practice is not a recent development, and neither are attempts to divert attention from it with unfounded claims of racism or genocide. The use of human shields not only jeopardizes innocent lives but also reveals a persistent pattern of deliberately placing civilians in harm's way for military advantage.

Obstruction of Evacuation of Civilians from Conflict Zones

Evidence suggests that Hamas actively obstructs the evacuation of civilians from conflict zones, placing Gazans at severe risk and exacerbating the humanitarian crisis. This deliberate obstruction raises serious concerns about Hamas's commitment to the safety of the very population it claims to represent. By contrast, the Israeli Defense Forces have routinely opened evacuation routes and corridors for civilians and defended the evacuees as they navigated to safety.

Theft of Resources from Hospitals

Intercepted communications reveal that Hamas engages in the theft of crucial resources, such as fuel, from hospitals, such as the Indonesian hospital, diverting them to sustain its terror infrastructure. This deplorable act not only jeopardizes the functioning of critical medical facilities but also underscores the organization's blatant disregard for the well-being of the civilian population.

Exploitation of Civilians Construction Materials

A number of reports indicate that Hamas exploits construction materials meant for civilian projects to build underground terror infrastructure, diverting resources away from essential civilian needs.

As representatives of the Israeli legal community, we express unequivocal condemnation for the actions of Hamas. These deliberate and systematic violations of international law endanger the lives of innocent civilians and undermine the very principles established to protect them during armed conflicts. The international community must stand united in condemning these actions and holding those responsible accountable for their egregious disregard for established legal norms.


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