What’s happening at Al-Shifa and Rantisi hospitals in Gaza?

Why is fighting taking place in and around hospitals in Gaza?
People stand outside the emergency ward of Al-Shifa Hospital in Gaza City on November 10, 2023, amid the war between Israel and Hamas. (Photo by -/AFP via Getty Images)

On Wednesday morning, IDF troops began fighting Hamas in Gaza City’s Al-Shifa hospital. This comes after U.S. intelligence confirmed long-time Israeli claims that Hamas has a control center in Gaza’s largest hospital, and the terrorist organization has blocked civilians from exiting.

Later on Wednesday, the IDF released evidence of Hamas weapons found inside the hospital:

Medical centers in Gaza have begun shutting down services for several days due to decreasing fuel supplies.

This decrease in power is due to several factors: Hamas siphoning oil from the hospitals, Israel cutting down on the amount of oil it supplies due to this siphoning, and Hamas demanding that Al-Shifa Hospital refuse an oil shipment from Israel.

This shortage has led to patients not receiving necessary treatments and an increase in patient deaths. According to officials at Al-Shifa, 170 people have been buried in a mass grave outside the hospital. Consequently, there is growing pressure on Israel to take action to protect Palestinian citizens.

Israel has called to evacuate patients from Al-Shifa through established evacuation routes created by the IDF on the east side of the hospital, but Hamas has blocked these attempts.

Why is fighting taking place in and around the hospitals, and why have these hospitals become a focal point of the conversation about the war? Here’s everything you need to know.

Does Hamas operate out of hospitals in Gaza?

The U.S. confirmed Monday that Hamas is using Al-Shifa hospital as a command center, siphoning energy from the hospital into Hamas operations and harboring terrorists under the hospital.

During its operation, the IDF said it found “concrete evidence” that the hospital was used by Hamas as a military facility.

Reports from the U.S., EU and Israeli intelligence say that Hamas uses hospitals, schools, mosques and residential buildings as command nodes and to store weapons, rocket launchers, tunnels, and other military infrastructure. 

Human rights organizations and foreign media reports have similarly said the hospital has been used by Hamas, with Amnesty International saying in 2014 that Hamas used the hospital to torture and murder alleged Palestinian collaborators.

IDF Spokesperson Daniel Hagari said recently that the IDF had found additional evidence of Hamas using Rantisi Children’s Hospital and other hospitals as “instruments of war.”

In the basement of the children’s hospital, the IDF found a Hamas command-and-control center, suicide-bomb vests, grenades, AK-47 assault rifles, explosive devices, RPGs, and other weapons, among other evidence.

The IDF additionally found signs that Hamas may have held hostages in the hospital and that Hamas terrorists had gone to the hospital after the October 7 massacre in order to hide.

The IDF has also published footage showing Hamas terrorists firing at Israeli forces from within the al-Quds Hospital in Gaza.

The IDF also claims that Hamas has a tunnel network under Indonesian Hospital and Israeli troops were shot at from Sheikh Hamad Hospital.

UNRWA, the U.N. agency tasked with caring for Palestinian refugees, has also repeatedly found both rockets and tunnels in and under its schools, including in 2022, 2021, 2017, and 2014.

What is happening at Al-Shifa Hospital?

Overnight on Tuesday, the IDF carried out a “precise and targeted” mission at Al-Shifa Hospital, which U.S. and Israeli intelligence experts say is harboring a Hamas command center.

“IDF forces are carrying out a precise and targeted operation against Hamas in a specified area in the Shifa Hospital, based on intelligence information and an operational necessity,” the IDF said.

Eight Israeli officials, speaking anonymously, told The New York Times that Hamas has dug hundreds of feet worth of tunnels and deeper floors, under Al-Shifa hospital, to store weapons and terrorists. 

The officials believe that these tunnels and deeper floors, which have been built up over the past 16 years, can hold several hundred people and include multiple entrances to the medical center from the area around it, according to the Times of Israel.

Additionally, according to Ynet, “there are six hospitals and 25 health facilities” in the northern Gaza Strip [including Al-Shifa]. Israel had called on them to evacuate. Most of them refused.”

The director of the Hamas-controlled health ministry confirmed that the doctors at the hospital refused an IDF evacuation order.

Patients are pictured at Al-Shifa hospital in Gaza City on November 10, 2023, amid the war between Israel and Hamas. (Photo by AFP via Getty Images)

The IDF has established specific evacuation routes from Al-Shifa, Rantisi and Nasser hospitals. The Israelis claim that they spoke to officials at Al-Shifa multiple times about the evacuation plans.

Alongside their statements urging civilians not to evacuate, Hamas also set up roadblocks on evacuation routes in order to block civilians from leaving, according to the IDF. The IDF published footage which they say shows the roadblocks being set up and the traffic caused by them.

Earlier this month, the IDF also stated that Hamas terrorists had fired at IDF soldiers who were attempting to set up a road to allow civilians to evacuate from northern to southern Gaza. 

“There’s no reason why we just can’t take the patients out of there, instead of letting Hamas use it as a command center for terrorism, for the rockets that they fire against Israel, for the terror tunnels that they use to kill Israeli civilians,” Israeli Prime Minister Benjamin Netanyahu said on CNN’s “State of the Union” Monday. 

Is Israel providing humanitarian aid to the hospitals?

On Sunday, the IDF supplied 300 liters of fuel for urgent medical needs to Al-Shifa, but video shows that Hamas blocked the hospital from accepting it. According to Israeli sources, the fuel would have been more than enough to get generators working in the neonatal unit. 

The BBC reported that over the past 48 hours, neither people nor aid have been allowed in or out of the hospital. Prime Minister Netanyahu attributes this to Hamas blocking the exits.

Israel delivered incubators for newborns, baby food and medical supplies to Al-Shifa Hospital since those at the hospital no longer work, according to the IDF.

WHO Director-General, Tedros Adhanom Ghebreyesus, said on X that “constant gunfire and bombings in the area” had “exacerbated the already critical circumstances” at Al-Shifa.

IDF Spokesman Rear Adm. Daniel Hagari said that the IDF is evacuating patients from Rantisi to safer hospitals “because our war is against Hamas, not against the people in Gaza. Especially not the sick, the women, or the children.”

As of Saturday, it is believed that all patients and civilians have been evacuated from Rantisi. The IDF said that they refrained from firing at any individuals, including Hamas members, leaving on foot with civilians to prevent harm to noncombatants.

What happened at Rantisi Children’s Hospital?

The IDF Navy’s elite Shayetet 13 commando unit and the 401st Armored Brigade entered Rantisi Children’s Hospital in Gaza Saturday, which was being used to store weapons and hide terrorists.

IDF Spokesman Hagari released video and photo evidence that Rantisi’s basement was used to hold hostages captured on October 7. 

“Underneath the hospital, in the basement, we found a Hamas command and control center, suicide-bomb vests, grenades, AK-47 assault rifles, explosive devices, RPGs, and other weapons, computers, money, etc,” Hagari said. 

“Additionally, we found evidence that Hamas terrorists came back from the massacre [in southern Israel] on October 7 to this hospital, among others, after butchering Israelis in their homes,” he added. “Hamas hides in hospitals. Today, we will expose this to the world.” 

Photos from the IDF operation at Rantisi exposed Hamas bombs, grenades and RPGs “proving that Hamas systematically runs its terror machine under hospitals in Gaza,” Hagari said.

International law gives hospitals special protections during wars, but hospitals can lose these protections if they are storing weapons or fighters. 

“In recent weeks we have stressed, again and again, that because of Hamas’s use of hospitals for military purposes, [the hospitals] will lose [their] special protection in the international court,” Hagari said at a press conference.

How has the international community responded?

On Sunday, U.S. National Security Advisor Jake Sullivan said that the White House is concerned about potential civilian casualties in the IDF operation at Al-Shifa. 

He said that the U.S. is working with Israel to maintain the safety of patients in the hospital “while they also try to figure out a way to try to deal with the fact that Hamas is…using human shields.”

U.S. National Security Advisor Jake Sullivan answers questions during the daily briefing at the White House on November 13, 2023 in Washington, DC. Sullivan answered a range of questions during the briefing focusing primarily on Israel and U.S. President Joe Biden’s upcoming meeting with Chinese President Xi Jinping. (Photo by Win McNamee/Getty Images)

“The United States does not want to see firefights in hospitals where innocent people, patients receiving medical care, are caught in the crossfire. And we’ve had active consultations with the Israel Defense Forces on this,” Sullivan told CBS News.

On Tuesday, Canadian Prime Minister Justin Trudeau called on Israel to “exercise maximum restraint” in Gaza and around the hospital and also demanded that Hamas stop using human shields and release all hostages.

Netanyahu fired back at Trudeau on X, writing, “While Israel is doing everything to keep civilians out of harm’s way, Hamas is doing everything to keep them in harm’s way.” 

“Israel provides civilians in Gaza humanitarian corridors and safe zones, Hamas prevents them from leaving at gunpoint. It is Hamas, not Israel, that should be held accountable for committing a double war crime — targeting civilians while hiding behind civilians,” Netanyahu added.

U.K. Defense Minister Grant Shapps also condemned Hamas’ continued use of Al-Shifa, adding that civilian deaths are the unfortunate reality when human shields are used. 

“When you have an organization like Hamas hiding and shielding themselves with and under the civilian population, it’s a sad fact that some people will lose their lives,” Shapps said.

“I think Israel is obviously in a difficult place because when they go after the terrorists, some civilians are getting caught up. No one wants to see civilian life, whether it’s an Israeli, or somebody from Gaza, taken,” he said. 

“However, if Britain had been subject to an attack of terrorists coming in and murdering people, cutting off heads, and we knew where those terrorists had gone, no one would be saying to Britain, ‘just stop going after them.’”

Meanwhile, the European Union signed a joint statement Monday condemning Hamas for using civilians in hospitals as human shields and urged Israel to try to protect civilians when striking on Hamas.

All 27 members of the bloc wrote in their statement that “the EU condemns the use of hospitals and civilians as human shields by Hamas.”

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