By Lila Li
On December 31, 2024, the U.N. Human Rights Office (OHCHR) released its fourth thematic report, titled “Attacks on Hospitals During the Escalation of Hostilities in Gaza.” The 23-page document challenges prevailing Israeli narratives used to justify Israeli military operations against Gazan hospitals. Through detailed legal analysis and independently verified evidence, the report offers a rigorous counterpoint to misinformation and propaganda while urging accountability and an international response. In particular, the report highlights that blindly accepting narratives from either side risks perpetuating misinformation and betraying the principles of justice and accountability. As citizens, it is our responsibility to question claims, seek out verified evidence, and remain vigilant against attempts to manipulate public opinion.
Overview of Findings
The UN report begins by acknowledging that, since the escalation of hostilities in October 2023, OHCHR has documented repeated attacks on hospitals and operations conducted within and around them. This has led to the destruction of the majority of hospitals in Gaza, pushing the healthcare system to a near-complete collapse. OHCHR’s analysis underscores that these actions are not isolated incidents, but part of a broader pattern that demands scrutiny. Its methodology centered on intensive monitoring and verification of violations, employing expertise from independent experts.
The OHCHR report emerges in a landscape of reporting fraught with selective media narratives and framing bias. Much of the coverage of the war in Gaza has either minimized or omitted critical details about the humanitarian impact of Israeli military actions, or justified their occurrence. In particular, some media outlets have emphasized unverified Israeli claims of militant activity within hospitals, echoing narratives that obscure the gravity of Israel’s international humanitarian law (IHL) violations.
Case Study of Al Shifa Medical Complex
The report highlights these omissions and presents independently verified evidence that refutes many of these claims. It specifically analyzes the case of Al Shifa Medical Complex, for which the Israeli military reportedly gave the “most information on their grounds for attack.” The Israeli military made numerous claims of Hamas military presence and/or control of the hospital, demonstrated through familiar allegations that “‘Hamas’ was using people inside the hospital as human shields,” that “‘Hamas’ was holding hostages in the hospital,” and that there were “extensive… tunnels and infrastructure under and in the hospital.” OHCHR directly challenges these distortions, positing that the IDF has not released sufficient evidence to enable independent verification of these claims.
The report analyzes different examples of information released by the IDF as justification for the Al Shifa operation. It found that, in some cases, said information fails to support the IDF’s statements. For example, the IDF published animations and infographics claiming to depict extensive tunnels under Al Shifa hospital as justification for its November operation, but later released videos instead showing much more limited tunnels. Likewise, the report deems images that the IDF published of “a small number of small weapons” reportedly found at the medical complex “not necessarily of a nature to conclude” that hostilities had been directed from the hospital. As such, the report reveals that the conclusions reached by the IDF as justification for its attacks were often either baseless or an overreach in judgment.
Violations of International Humanitarian Law
In its analysis of Israel’s attacks on Gaza’s hospitals, the OHCHR identified various violations of IHL protections. Under the Geneva Conventions and International Committee of the Red Cross rules, hospitals, medical personnel, and patients are entitled to special protections. Articles 18-20 of the Geneva Conventions specify that these protections are only forfeited if such units are used for acts harmful to the enemy. Even then, stringent criteria must be satisfied before they can be considered lawful military objectives, including the provision of fair warnings and adherence to the principles of proportionality, distinction, and precaution, and attacks must be limited to the part of the facility specifically deemed a military objective. The OHCHR report alleges that Israel repeatedly failed to meet these conditions before and after its attacks.
Across the 136 documented strikes on medical facilities across the reporting period, OHCHR identified various violations including but not limited to the provision of insufficient evidence for military justification, in which verifiable evidence was not provided or IDF statements were contradicted or inadequately substantiated; indiscriminate and disproportionate attacks, in which strikes failed to distinguish between civilian infrastructure and alleged military targets; and failure to adhere to precautionary measures, which violated obligations to minimize harm to and ensure the safety of civilians.
Under OHCHR’s legal analysis, Israel was consequently unjustified in conducting its strikes upon Gaza’s hospitals firstly for its insufficient evidence of Palestinian militant presence; for conducting its strikes upon Gaza’s hospitals without sufficient evidence that the hospitals met the criteria to be deemed a military objective, even if militant presence was confirmed; and in the indiscriminate nature of its attacks even assuming the hospitals could be deemed military objectives.
Further Responsibilities of the Occupying Power
As the occupying power, Israel also holds additional responsibilities, which it has failed to fulfill or outwardly violated. Under Articles 55 and 59 of the Geneva Conventions, Israel is obligated to ensure and maintain medical services in Gaza and facilitate relief efforts. Israel’s destruction of hospitals, medical transport, and personnel, as well as its blockade on medical supplies and necessities, directly undermines local authorities’ ability to provide healthcare. Further, its evacuations of civilians without providing alternative medical care or ensuring access to life-sustaining resources fall under the category of forced displacement, which is prohibited under the Geneva Conventions and customary IHL.
Broader Implications
The cumulative effect of this destruction of Gaza’s healthcare system and its consequences on Gaza’s civilian population represents not simply individual violations but a systematic undermining of the foundational principles of IHL. The report raises concerns that these actions, if proven to be part of a deliberate policy, could constitute war crimes under Article 8 of the Rome Statute and potentially crimes against humanity if linked to widespread and systematic attacks on civilians. Further, by failing to substantiate its justifications for its attacks, provide safe alternatives for medical care, or mitigate harm, the Israeli military’s operations appear to contravene the IHL principles of distinction, proportionality, and precaution in attack.
Call to Action
It is imperative that we implement independent investigations and accountability mechanisms to address these violations and uphold the protections guaranteed under IHL, and that we continue to challenge propaganda and misleading narratives intended to minimize or justify the suffering of Palestinians. Through taking the time to acknowledge both parties’ persisting responsibilities under IHL, we can work to dispel the destructive narrative of Israeli impunity, and restore humanity to our perspective of the Palestinian experience.
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Lila Li is an intern at Massachusetts Peace Action passionate about international human rights law