Intended for healthcare professionals


Israeli forces attack medical facilities in Gaza and destroy brand new hospital

BMJ 2014; 349 doi: (Published 28 July 2014) Cite this as: BMJ 2014;349:g4865

The Israeli army’s attacks on civilians lives and civilian infrastructure in the Gaza Strip, including health facilities, should be named correctly.

Owen Dyer reports in the British Medical Journal ( BMJ) on the Israeli attacks on medical facilities in the Gaza Strip during the ongoing excessive military offensive ironically named ‘Operation Protective Edge’ (OPE) [1], and attempts to cover his story from the sides of both the victims and the aggressor. In the context of the neglect of health journals in giving sufficient attention to the humanitarian and health crisis in the Gaza Strip, which have been ongoing since the 8th of July 2014 , we appreciate any kind of coverage from medical and health journals, especially from the BMJ. However, we, as Palestinian doctors working in the Gaza Strip, found that relying on details provided by the public relation officers of the Israeli army gives the aggressor, and the occupying power in the Gaza Strip, an appreciable advantage.

Our experience and documented evidence show that the Israeli Army deliberately and systematically targets civilians and the foundations of civilian lives, including health facilities, in its onslaught on the Gaza Strip. According to the United Nation’s Office of Coordination of Humanitarian Affairs (OCHA), the majority of Palestinians killed by the Israeli army during the last onslaught were civilians[ 2]. The Israeli army targeted health facilities, including Alaqsa hospital, as confirmed by the World Health Organization[3], and Al-shifa [3]- the largest hospital in the Gaza Strip was not spared Israeli attacks. As we write our response, the Israeli army is attacking Al-Najjar hospital in Rafah[3]. In addition to targeting civilians and health facilities, the Israeli Army shelled Gaza’s only power plant resulting in its shut down, making the daily electrical supply to the various locales in the strip range from zero to three hours. The absence of electricity in the most of the Gaza Strip localities has led to the inability to pump water to those localities, which could pave the way for increasing the burden of communicable diseases in the overcrowded Strip.

More than 450,000 ( 25%) of the 1.8 million Palestinians who live in Gaza Strip have been forcibly displaced, including 280,000 who are sheltered in the schools of the United Nations ( UN) and other formal shelters [2]. Even those who sought shelter in UN schools were not spared from Israeli attacks with UN schools targets at least three times.

Making false excuses to justify targeting the civilians lives and infrastructures which support life and health, and negatively affecting the determinants of health is absolutely unacceptable, and serves only as a failed plea to defend Israel’s disproportionate attacks on the civilians lives and to blame the victims for their own sufferings.

Our experience as health professionals in the Gaza Strip indicates that Israeli attacks on health facilities, including hospitals, are neither incidental nor accidental; instead, Israel has a long history of targeting civilians and civilian infrastructure, including hospitals, making these attacks part of the Israeli military doctrine. The collective memory of Palestinians in the Gaza Strip and elsewhere will keep the atrocities and mass killing of civilians by the Israeli army alive for years to come.

One of several example of mass killing of civilians includes an incident when dozens of people in Khan Younis were machine-gunned by the Israeli army against a wall and others were shot with pistols in 1956 [4,5 ]. More recently, Operation Cast Lead, conducted by the Israeli army in the Gaza Strip from the 27th of December 2008 to the 17th of January 2009, hospitals, including Al-Quds and Al-Wafa, were not spared from the Israeli military activities and destruction. According to the UN Fact Finding Mission , on the 15th of January 2009, the Israeli army attacked directly and intentionally Al-Quds hospital in Gaza City and the adjacent ambulance depot with white phosphorous shells; and the mission rejected the Israeli allegations that fire was directed at the Israeli army from the hospital [6].

Targeting the lives of civilians and civilian infrastructure intentionally and repeatedly constitutes an integral part of the Israeli military doctrine. Therefore, it is the right time now, more than ever, to name these actions correctly: War Crimes.

[1] BMJ 2014;349:g4865
[2] Office of Coordination of Humanitarian Affairs in the Occupied Palestinian Territory- Occupied Palestinian Territory:
Gaza Emergency Situation Report (as of 1 august 2014, 1500 hrs): (last retrieved on the 3rd of August 2014)

[3] WHO Regional Office for the Eastern Mediterranean. Situation report 6. The 1st of August 2014. ( Last retrieved on the 3rd of August 2014)
[4] Jean-Pierre Filiu, Histoire de Gaza (The History of Gaza), Fayard, Paris, 2012.
[5] Joe Sacco, Footnotes in Gaza, Metropolitan Books, New York, 2009.
[6] Human Rights in Palestine and other occupied Arab territories- Report of the United Nations Fact-Finding Mission on the Gaza Conflict: (last retrieved on the 2nd of August 2014 )

Competing interests: Both authors of this response letter are Palestinian physicians who practice medicine in the Gaza Strip; both of them oppose the occupation of their Palestinian territory, including the Gaza Strip, and the repeated Israeli onslaughts on the Palestinian people, especially in the Gaza Strip. Khamis El-essi was the ex-director of Al-Wafa hospital till 2010 when he launched the Evidence Based Medicine Unit at Faculty of Medicine, Islamic University, Gaza City, occupied Palestinian territory.

03 August 2014
Majdi Ashour
Physician and Public Health Practitioner
Khamis El-essi
Apartment 2, Building 17, El-Zahra Microcity, Gaza, Gaza Strip, occupied Palestinian territory.