Attack on a hospital in the Gaza Strip: a descriptive study

Abstract

BackgroundArticle 8(2) of the Rome Statute describes “war crimes” as grave breaches of the Geneva Conventions. Article 18 of the Fourth Geneva Convention provides protection for civilian hospitals and staff. On July 21–22, 2014, Al Aqsa hospital, a 190-bed government hospital in the Gaza Strip, was hit by several Israeli military strikes while fully operational, with hundreds of refuge-seeking civilians in its buildings and grounds. The attacks killed three people, injured 70 people (including 11 medical staff), and destroyed or damaged buildings, equipment, and ambulances. The aim of this study was to investigate the response to the attack in persons who were at or near the hospital during the attacks . MethodsFor this descriptive survey, we used convenience sampling of persons at or near the hospital during the attacks. 26 of the 29 people who were approached on Sept 1–2, 2014, consented to interview. 13 participants were hospital staff, two were patients, three were relatives of patients, five were refuge-seekers, one was a relative of a refuge-seeker, and two were hospital neighbours. Written consent was obtained from all participants, and reasons for refusal were recorded. FindingsAll refusals cited fear of Israeli reprisals. All participants reported no resistance presence or activity in or near the hospital before or during the attacks. Ten (38%) participants were injured, including seven staff members, two relatives visiting patients, and one patient. 21 (81%) participants believed the attacks were deliberately directed at the hospital. 12 (92%) of the 13 staff members reported high levels of concern about the future safety of hospital staff. 20 (77%) participants reported no longer feeling safe anywhere. Eight (31%) participants commented that the attacks showed that neither the international community nor international humanitarian law protect Palestinian hospitals and medical workers. InterpretationThe absence of resistance activity indicates that the attacks on Al Aqsa hospital were not justified by military necessity and were thus in breach of the Geneva Conventions, constituting war crimes. Residual fear and loss of faith in international instruments can only be addressed by holding Israel accountable. This will have important implications for both the credibility of international law and the safety of civilians, medical staff, and facilities in future conflicts, everywhere. FundingNone.