More than 1000 attacks have now been recorded on health workers, patients, hospitals, and other medical infrastructure in the Occupied Palestinian Territories (OPT) since October 7, 2023, more reported attacks on health care than any other conflict over a 10-month period on record, Physicians for Human Rights (PHR) said today. PHR calls for independent investigations and accountability for all alleged instances of targeting or militarization of health care attacks in the OPT.
The World Health Organization (WHO) reports 1500 attacks on health care across all global conflicts since October 7, 2023. More than two-thirds of all global attacks were perpetrated in Gaza and the West Bank (1012 attacks), according to WHO. Independent monitors like Insecurity Insight estimate the toll even higher, with the group reporting 1328 attacks on health care in OPT during the same period.
“More than 1000 attacks on doctors, patients, clinics, and health infrastructure have fueled a public health catastrophe in the OPT. This grim milestone has few if any precedents for the scale and magnitude of attacks on health in the OPT. These are not only attacks on brick-and-mortar buildings, but acts that take away hospital beds, essential medications, surgeries, and life-saving care from women, men, boys, and girls,” said Houssam al-Nahhas, MD, MPH, PHR Middle East & North Africa researcher.
“Protecting health care is not only a moral imperative, but a legal obligation under international law. Health care must never be a target. We call for investigations and accountability for the ongoing attacks against health care facilities in the OPT, including allegations of targeting or militarization of health care,” said Michele Heisler, MD, MPA, PHR medical director.
The ongoing conflict has already resulted in the killing of at least 40,000 people, including 39,400 in Gaza and around 600 in West Bank, and injured more than 91,000 in Gaza and 5,300 in West Bank. 27,300 women and children have been killed in both Gaza and West Bank, in addition to at least 6,100 children injured in Gaza and 660 in West Bank. The death toll may be much higher than reported, according to an analysis published in The Lancet.
Attacks on health care block people from receiving life-saving health care services. The 1012 attacks against health care have limited the availability and accessibility to health services in OPT, with 492 attacks reported in Gaza and 520 in West Bank. Out of 36 health facilities in Gaza functioning prior to October 7, only 16 remain and are only partially functioning; three in the north, seven in Gaza City, three in Deir al-Balah, three in Khan Yunis, and none in the besieged southern city of Rafah, which has been the target of intensive Israeli airstrikes and artillery shelling. In the West Bank, 42 of the 60 hospitals are fully functional while the remaining 18 are partially functional.
As hospitals are damaged or destroyed, the number of available hospital beds has decreased, leading to overcrowded conditions and reduced capacity to handle the influx of patients. In Gaza the number of hospital beds has dramatically decreased from 3,500 before October 7 to just 1,400, with only 800 beds (22%) available in fixed hospitals. The remaining 600 beds are makeshift field hospitals for a population of 2.2 million people, the majority internally displaced peoples (IDPs) who fled northern Gaza to seek refuge in Rafah.
The ongoing violence in Gaza creates and exacerbates health crises. More than 14,000 patients are in urgent need of medical evacuation, with many in need of multiple reconstructive surgeries due to the extensive nature of war-related injuries, according to the WHO. Thousands of people struggling with chronic diseases exacerbated or triggered by the conflict also need medical evacuation. These chronic conditions, such as diabetes, hypertension, and respiratory diseases, often become more difficult to manage during and after a conflict due to disrupted health care services. The lack of clean water, hygiene, and overcrowding add to the suffering with tens of thousands of reported cases of diarrhea, respiratory infections, and hepatitis A. Polio was detected in waste-water samples in Gaza, according to the WHO Director-General.
Women and girls are disproportionately affected by violence against health care. With only one public facility remaining in Gaza that can provide sexual and reproductive health services that meets WHO standards, women are giving birth in unsanitary and overcrowded shelters without adequate medical care, exacerbating the already high maternal and newborn mortality rates in the region. Women in Gaza are now three times more likely to experience a miscarriage and three times more likely to die during childbirth, according to CARE International.
Since the Hamas-led attacks on Israel on October 7 that killed more than 1,200 people, the WHO has reported 68 attacks on health care in Israel. These attacks also warrant investigation and full accountability.
“The extent and scale of attacks on health care by Israeli forces could constitute a violation of the fundamental norm of international humanitarian law protecting health care, as well as a gross violation of the right to health, particularly for communities enduring conflict, besiegement, and ongoing displacement,” said Dr. Heisler. “As the International Court of Justice (ICJ) determined, Israel’s continued occupation of the OPT is unlawful and should be ended as soon as possible. And as an occupying power in Gaza, Israel is legally obligated to uphold the right to health and ensure the unrestricted flow of health care and aid supplies to civilians in Gaza. To protect the health and rights of all affected by the conflict in OPT and Israel, PHR calls on Israel and Hamas to cease all violations of international humanitarian law.”
“Israel must also abide by the International Court of Justice (ICJ) provisional order to prevent genocide and cease its military offensive in the Rafah Governorate. Israel must comply with previous ICJ measures requiring cooperation with UN agencies to ensure unhindered access for the people of Gaza to humanitarian assistance and basic needs. Israel should also facilitate access for any UN-affiliated investigative mechanisms to investigate allegations of genocide, including attacks on health care infrastructure and sexual and reproductive health services,” said Dr. Heisler.
“The international community must also unequivocally condemn and collectively work to stop attacks on civilians, including health care workers and patients, in OPT and in conflicts around the world,” said Dr. Heisler.
Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.