Al-Shifa Hospital
Al-Shifa Hospital is the largest medical complex and central hospital in the Gaza Strip, Palestine, located in the neighborhood of northern Rimal in Gaza City.
The hospital was first established by the government of Mandatory Palestine in 1946, and expanded during the Egyptian and later Israeli occupations. During the Gaza war, Israel, supported by the United States, said Hamas was using the hospital as a command center and on 15 November 2023, its forces raided the hospital, where thousands of Palestinians were taking shelter. The Israeli raid was widely criticized and Israel was accused by several news outlets of waging a propaganda war. Medical staff at al-Shifa have accused Israel of directly causing the deaths of civilians being treated at al-Shifa, including prematurely born babies.
Following Israel's release of video evidence of Hamas tunnels under the hospital on 22 November, multiple news agencies concluded that the evidence did not demonstrate the use by Hamas of a command center. Amnesty International said on 23 November 2023 that "Amnesty International has so far not seen any credible evidence to support Israel's claim that al-Shifa is housing a military command centre" and that "the Israeli military has so far failed to provide credible evidence" for the allegation. Izzat al-Risheq, a Hamas official, denied that the group used the hospital as a shield for its underground military structures, saying there was no truth to the claims. A later report in February 2024 by the New York Times, confirmed the earlier reports but also cited classified Israeli intelligence material suggesting that Hamas did use the hospital as cover.
A second Israeli raid on the hospital, during which there were extensive gunfights in and around the hospital complex, ended on 1 April 2024 after two weeks. The hospital was completely destroyed with hundreds of casualties around the hospital. One of its medical units reopened on 1 September 2024.
1948–1967
Dar al-Shifa, which means "house of healing" in Arabic, was originally a British Army barracks, but was transformed into a center to provide treatment for quarantine and febrile diseases by the government of the British Mandate of Palestine in 1946. Prior to the 1948 Arab–Israeli War, al-Shifa was one of two hospitals in Gaza, the other being al-Ahli Arab Hospital. When the Egyptians administered the Gaza Strip after the war, the quarantine and febrile diseases department was relocated to another area in the city, and al-Shifa developed into the central hospital of Gaza. Initially, a department for internal medicine was established, followed by a new wing for surgery, and subsequently new buildings for pediatrics and ophthalmology were added to the hospital.After a brief occupation by Israel during the 1956 Suez Crisis, the returning Egyptian administration, under directives by president Gamal Abdel Nasser, paid more attention to the health and social situation of Gaza, and al-Shifa was expanded to include departments for obstetrics and gynecology. They established a new health administration for the Gaza region, later building several clinics throughout the city that were attended by doctors from the hospital. The largest department in al-Shifa was internal medicine, then pediatrics, surgery, ophthalmology and gynecology.
1967–2005: Israeli occupation until the Gaza disengagement
When Israel occupied Gaza in the 1967 Six-Day War, the entire Egyptian administration and staff in the hospital were taken prisoner. By 1969, the department of internal medicine grew to contain several sub-departments.In December 1987, during the First Intifada, Israeli forces stormed the hospital on multiple occasions. They assaulted patients and staff, arrested people, and destroyed medical equipment. They injured at least 61 people and killed at least four Palestinians, including an 8-year-old child. Additionally, they used the roof of the hospital as an observation point. Palestinian youths threw bottles and stones at the soldiers. A few months later, a delegation of American doctors visited various healthcare sites in Palestine. They said that: "When compared with the lowest level of health services in some of the third world countries, the level of the services in Al-Shifa hospital, for example, was even lower."
Architecture and expansion
The hospital underwent a major Israeli renovation and expansion. The project was designed by Israeli architects Gershon Tzapor and Benjamin Edelson in their Tel Aviv office, both well experienced in the construction of high standard hospitals. The project was done in the 1980s as part of an effort to improve the living conditions of Gaza residents.This project came as part of the Israeli idea of mutual existence between Jews and Arabs. The project intended to house 900 beds in the entire campus, a 50 dunam area. The Israeli additions were considered to be in the same standard as those hospital wings in Israeli hospitals such as Tel HaShomer. The architecture of the hospital came to reflect the modernist and post modernist trends in Israeli architecture. In particular was the similarity of the project to existing Israeli hospitals such as the facades of the Bezalel building in Jerusalem. Similarly to other Israeli projects, the building was built with sharpened diagonal staircases, akin to projects by Israeli architects Dan Eitan, Shlomit Nadler and others at the time.
During a renovation in the 1990s, a large basement was added, which the IDF later said was appropriated by Hamas and used to store weapons. According to Newsweek and the Intercept a bunker beneath building 2 was constructed in 1983 by Israel and "includes a secure underground operating room and tunnel network." According to former Israeli Prime Minister, Ehud Barak in an interview with CNN, the tunnels were built in the 1980s by Israel as part of the hospital's construction. According to Israeli officials, Hamas subsequently dug out the original basement, later adding new floors and connecting it as a hub within their existing tunnel system.
2005–present: Palestinian control
In 2005, Israel withdrew from Gaza and handed over control to the Palestinian Authority.2007 Fatah–Hamas conflict
During the Fatah–Hamas conflict in June 2007, Fatah and Hamas clashed at the hospital, killing one member of each organization. Some injured people brought to the hospital were killed by Hamas militants once inside. A doctor in the hospital reported, "The medical staff are suffering from fear and terror, particularly of the Hamas fighters, who are in every corner of the hospital." Hamas fired about 600 doctors affiliated with Fatah, threatening to shoot them if they returned to the hospital. Two Norwegian medical doctors, Erik Fosse and Mads Gilbert, have done humanitarian work at the hospital.2008–2009 war
During the Gaza war, Al-Shifa hospital overflowed with Palestinians injured by Israeli airstrikes. Already before the war, the blockade of Gaza had caused a shortage of ventilation systems, patient-handling systems such as operating tables, beds, trolleys, and various types of medical equipment. These shortages affected clinical work.In the first 13 days of the war, about 360 surgical operations were performed. Among the people brought to the hospital, about 340 were pronounced dead on arrival. The number of injuries treated during this period was 1039, but this is regarded as an underestimate, since it doesn't include many patients with minor injuries.
Much of the media coverage of the 2008–2009 Israel–Gaza conflict was broadcast or written by correspondents reporting from the hospital.
During the 2008–2009 Gaza war, The New York Times reported that "armed Hamas militants in civilian clothes roved the halls" killing alleged collaborators. Several reports by Israeli Shin Bet officials alleged that Hamas used Al-Shifa hospital as a bunker and refuge, knowing it would be spared by air strikes. The Israeli allegations were difficult to confirm because Israel had banned reporters from Gaza at the time. PBS' Wide Angle programme, which interviewed a doctor from Gaza who preferred to remain anonymous, said that he believed that Hamas officials were present under the hospital.
In 2009, the Palestinian Health Ministry, run by the Palestinian Authority in the West Bank, accused Hamas members of taking control of wards in Shifa Hospital.
In 2013, a special surgical building was opened.
2014 war
During the 2014 Gaza war, Israeli operations, initiated following Hamas kidnappings and attacks on Israeli civilians centers, killed more than 2,100 Palestinians and injured over 11,000. During the war, a total of 8,592 patients visited Al-Shifa hospital, mostly civilians. Of these, 490 were dead on arrival. After a detailed triage, 1808 patients were admitted, of whom 78 died in the hospital. 842 major life-saving surgeries were performed, including 90 laparotomies, 146 orthopaedic fixations, 106 craniotomies, 69 thoracotomies/airway interventions, 38 vascular procedures, 49 amputations, 68 debridements, and 176 other procedures.Compared to the 2012 war, Intensive care unit admission rates doubled and ICU mortality rates tripled. The authors speculate that might be due to the "extreme character" of the attacks in 2014.
Amnesty International stated that Hamas forces used the abandoned areas of the hospital to kill, detain, interrogate, torture and otherwise mistreat Palestinians accused of collaborating with Israel, in an operation that Hamas operatives called "Operation Strangling Necks". According to Amnesty, they did this while the hospital continued to function, and used the functioning hospital morgue to support the operation by dropping off bodies for families to collect. One member of Fatah described suffering two hours of torture at the hospitals outpatient clinic, during which he was beaten with a hammer.
During the war, Hamas officials would conduct hourly interviews with media from the hospital, condemning "Israeli aggression". Norman Finkelstein said the evidence for the accusation was weak, and if this happened it would have been noticed by the 13,000 people who were present at the hospital during the war.
Former Israeli Navy commander Eli Marom said Hamas leaders were hiding in basement of Al-Shifa hospital. Finkelstein writes that the official Israeli report of the war did not accuse Hamas of doing anything at the hospital more serious than "security service interrogations". Washington Post London bureau chief William Booth wrote for The Washington Post that the hospital had become a "de facto headquarters for Hamas leaders, who can be seen in the hallways and offices." Orde Kittrie described Shifa hospital as Hamas' headquarters. Hamas officials were also described as disguising themselves in medical attire within the hospital.
Dr. Erik Fosse, who worked at the hospital at the time, found no evidence that it was a Hamas base. Norwegian doctor Mads Gilbert, who also worked at the hospital during the war, rejected that the hospital was used a base by Hamas officials or militants. Professor Sara Roy concluded that "it was highly improbable that Hamas made military use of the hospital building".
Wall Street Journal correspondent Nick Casey tweeted a photo of Hamas MP and media spokesperson Mushir Al Masri conducting media interviews right outside of the Shifa hospital, but later deleted it. The Guardian journalists saw Hamas officials at the hospital. Reporting from the Gaza hospital to the Finnish newspaper Helsingin Sanomat, Aishi Zidan reported that a rocket was fired from the area of the hospital. This was seized upon by the Israeli press, prompting the journalist to take to Facebook to note that her words had been taken out of context and used as propaganda, and that the rocket had actually been fired from "somewhere behind the hospital".