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‘Hospitals may in no circumstances be the object of attack’

Part 13 of a series recounting the findings of South African jurist Richard Goldstone’s UN Fact Finding Mission on the Gaza Conflict.

Bethlehem – Ma’an – On 8 January 2009, one year ago today, Israeli artillery shells struck the seventh-floor apartment of Dr Jaber Abu An-Naja, the former PLO ambassador to Senegal and a well-known Fatah politician.

The doctor’s wife and son-in-law were killed immediately as they sat on the balcony eating pastries. His wife was cut in half by the explosion and his son-in-law was thrown from the balcony on to the street below.

His daughter, Ihsan, was seriously injured and taken for treatment to Al-Quds Hospital, a medical center located near Abu An-Naja’s and a number of other civilian apartment buildings on Al-Abraj Street in Gaza’s Tal El Hawa district, which had come under attack for four days.

According to three senior doctors at the hospital and two residents from Al-Abraj Street, at some point between 3 and 6 January several tanks were stationed several hundred meters east of Al-Quds, visible from the hospital’s ambulance depot. Throughout the days of 5-8 January, there was significant artillery fire on apartment buildings nearby to where Abu An-Naja’s relatives were killed.

The shelling on 8 January was just one incident of dozens in and around the area that damaged portions of the hospital and destroyed other buildings in their entirety during Israel’s three-week assault on the Gaza Strip, which ended in late January 2009.

Continuous damage to medical buildings

When the air offensive began on 27 December, for instance, a government building opposite the hospital’s administrative building on Al-Abraj Street was almost totally destroyed. The building had previously served as a criminal detention center and is still referred to locally by that designation although it had recently been used for other purposes, including customs administration. The same building was reportedly struck on a number of other occasions after 27 December, after which the site was completely demolished.

Kitty-corner to the hospital, on Jami’at Ad-Duwal Al-Arabiya Street, was another building rented to the de facto government and used primarily as a public registry office. At the time of writing, only the ground floor of the building remained. Witnesses, speaking to the Goldstone commission, indicated that the upper floors had been destroyed, probably by artillery fire, on 6 and 7 January.

By 15 January, the area immediately to the south of Al-Quds Hospital (the customs building and the registry building) had been totally or very substantially destroyed. The area to the east on Al-Abraj Street had been significantly attacked by artillery fire.

By this time, several hundred civilians had also gathered in the hospital buildings seeking safety.

The Al-Quds Hospital belongs to the Palestinian Red Crescent Society (PRCS). It consists of three buildings facing west toward the sea on the corner of Jami’at Ad-Duwal Al-Arabiya Street and Al-Abraj Street in the area of Tel Al-Hawa.

The building nearest the corner was seven stories high. Its principal purposes were administrative and cultural rather than medical. It stored a huge quantity of PRCS archives. The middle building contained the accident and emergency treatment areas as well as other offices of medical and administrative staff. The building furthest from the corner was the main medical building with operating theaters in the basement. About 200 meters east on Al-Abraj Street was the PRCS ambulance depot.

The buildings all suffered significant damage in the course of an Israeli bombardment on 15 January 2009, which included the use of white phosphorous, endangering the lives of staff and more than 50 patients. There was no warning given for any of the attacks.

Direct Attack on the Hospital

During the night of 14 January, Israeli forces began an extended barrage of artillery fire over the area. It continued into the morning of 15 January. Between 8 and 9am doctors in the main building were in the principal meeting room when shells landed on either side of the building. They saw white phosphorous wedges burning near a container of diesel and efforts were successfully made to move those away.

The initial explosions blew out the office windows. The administrative building on the corner was also hit. Because the hospital building was largely constructed out of timber (rare in Gaza), staff were worried that the fire would spread. A witness described how hospital staff, including senior doctors, all sought to break, by hand, the wooden bridge linking the administrative building to the hospital building, in an attempt to prevent the fire from spreading.

Shortly after the initial explosions and fire were observed, a tank shell directly penetrated the rear of the middle hospital building. That part of the building was made of corrugated iron. The shell made a clearly defined home in the hospital wall, and the impact crater continues through the cement wall into the hospital’s pharmacy.The pharmacy was completely destroyed as a result.

An eyewitness said that through the resulting hole, he observed a tank on a road between two buildings about 400 meters east of the building. Although he could not say whether it was this tank that had struck the hospital directly, it was in a direct line in relation to the entry point of the shell.

No civil defense forces were available to fight the fire at the hospital, so medical staff worked on their own to save the building and ensure the safety of the patients.

It was not until 4pm that the International Committee of the Red Cross (ICRC) was able to respond and help evacuate patients. Officials at the ICRC made it clear upon arrival that it would be able to carry out this procedure only once. Those not evacuated at 4pm were relocated to the operating theaters of the damaged hospital.

At 8pm, another fire broke out in the hospital. As a result, a total evacuation of remaining patients and those who had sought refuge at the hospital was carried out. It was at this stage that one of the senior doctors took an eight-year-old girl who had been struck by a bullet in the jaw and was critically ill to Ash-Shifa Hospital, where she later died. One of the medical staff at the hospital told the Goldstone commission that there was very heavy fire in the area, and he felt sure there were direct hits by Israeli forces on the ambulance depot.

As the hospital was evacuated, the depot, 200 meters to the east in Al-Abraj Street, sustained damage, and one of its principal buildings was entirely destroyed. Remnants of three PRCS ambulances that had been parked at the entrance to the depot were seen were still visible by summer. Two had been crushed by tanks but not burned out. The other ambulance showed signs of having been struck directly in the front below the windscreen by a missile of some description and having been burned out.

The devastation caused to both the hospital buildings, including the loss of all archives in the administrative building, and the ambulance depot was immense, as was the risk to the safety of the patients.

The Israeli position

In the conclusions of their investigations on 22 April 2009, Israeli authorities did not specifically mention the incident at Al-Quds Hospital, although a portion of it addresses some allegations regarding the use of ambulances. In another report, released in July 2009, the Israeli government quotes part of an article from Newsweek magazine:

One of the most notorious incidents during the war was the Jan. 15 shelling of the Palestinian Red Crescent Society buildings in the downtown Tal-al Hawa part of Gaza City, followed by a shell hitting their Al Quds Hospital next door; the subsequent fire forced all 500 patients to be evacuated. Asked if there were any militants firing from the hospital or the Red Crescent buildings, hospital director general Dr. Khalid Judah chose his words carefully. “I am not able to say if anyone was using the PRCS buildings [the two Palestine Red Crescent Society buildings adjacent to the hospital], but I know for a fact that no one was using the hospital.”

In the Tal-al Hawa neighborhood nearby, however, Talal Safadi, an official in the leftist Palestinian People’s Party, said that resistance fighters were firing from positions all around the hospital. He shrugged that off, having a bigger beef with Hamas. “They failed to win the battle.” Or as his fellow PPP official, Walid al Awad, put it: “It was a mistake to give Israel the excuse to come in.” [para. 173].

While the Israeli government does not comment further on the specific attack, it would appear to invoke these comments to justify the strikes on the hospital and surrounding area.

The final report of Richard Goldstone’s UN inquiry understood that the Israeli government “may consider relying on journalists’ reporting as likely to be treated as more impartial than reliance on its own intelligence information,” but said its investigators were “nonetheless struck by the lack of any suggestion in Israel’s report of July 2009 that there were members of armed groups present in the hospital at the time.”

The report also said it addressed questions to Israel’s government regarding the use of white phosphorous munitions against the hospital and the direct military advantage pursued by their use under the circumstances, but received no reply.

Factual findings

The Goldstone report finds that on the morning of 15 January the hospital building and the administrative building were struck by a number of shells containing white phosphorous and by at least one high explosive shell. “The fires these caused led to panic and chaos among the sick and wounded, necessitated two evacuations in extremely perilous conditions, caused huge financial losses as a result of the damage and put the lives of several hundred civilians including medical staff at very great risk.”

In its conclusions, the mission also notes that as a result of the conditions the attack created, the hospital was unable to provide the necessary care for an eight-year-old girl. “Despite heroic attempts to save her, she died later in another hospital. The girl had been shot by an Israeli sniper. The Mission finds the Israeli armed forces responsible for her death.”

On the issue of armed groups being present in the hospital buildings, the team does not agree that anything in the extract cited from Newsweek magazine justifies the conclusion that the hospital premises were being used by armed groups.

The fact that Dr Judah spoke with certainty about matters within his knowledge “cannot be presumed to mean that he believed other parts of the hospital premises were being used by armed groups,” the Goldstone report notes, speculating that it could have been “journalistic gloss and is tantamount to putting words in the mouth of Dr. Judah.” The comments attributed to Safadi that “resistance fighters were firing from positions all around the hospital” can mean either that people were inside the hospital firing or were in positions outside but near to the hospital, Goldstone adds, “The journalist did not clarify precisely what was meant.”

The mission carried out over eight hours of interviews with senior and junior staff at the hospital, and having sought to verify the matter with others, including journalists who were in the area at that time, concluded that it was unlikely there was any armed presence in any of the hospital buildings at the time of the attack. It also notes that no warning was given at any point of an imminent strike and at no time has the Israeli government suggested such a warning was given, compared to other instances in which they insist they did.

Goldstone’s report states that in reviewing the scene at the time of the strikes, “it is important to bear in mind that a great deal of destruction had already occurred and that buildings with an apparent connection to the local government had been attacked and largely destroyed. As such, Israeli tanks had a relatively clear view of the area immediately to the south of the hospital.

“The Mission also notes that as a result of the attacks on al-Abraj Street by tanks for several days, the scope for resistance, if any, from that particular quarter had been significantly reduced.

The mission concedes that it was aware of reports that there was significant resistance from Palestinian groups in the area on the night of 14 January, in which Israeli troops entered buildings along the street and allegedly used human shields to check if there was any presence of enemy combatants of explosive devices and found none.

Legal findings

Article 18 of the Fourth Geneva Convention provides that civilian hospitals may in no circumstances be the object of attack but shall at all times be respected and protected by the parties to the conflict. Civilian hospitals’ protection shall cease “only after due warning has been given, naming, in all appropriate cases, a reasonable time limit and after such warning has remained unheeded,” article 19 states.

“Even in the unlikely event that there was any armed group present on hospital premises, there is no suggestion even by the Israeli authorities that a warning was given to the hospital of an intention to strike it,” the Goldstone report states. “As such the Mission finds on the information before it that Israeli armed forces violated articles 18 and 19 of the Fourth Geneva Convention.

“On considering the information before it, the Mission takes the view that there was intent to strike the hospital, as evidenced in particular by the high explosive artillery shell that penetrated the rear of the hospital and destroyed the pharmacy.

“Even if it is suggested that there was no intent to directly strike the hospital but that Palestinian armed groups had taken up positions near al-Quds hospital, the Israeli armed forces would still have been bound to ensure that risk of death, injury or damage to the people in the hospital or the hospital itself would not be excessive in relation to the military advantage anticipated in attacking the hospital.

“Taking into account the weapons used, and in particular the use of white phosphorous in and around a hospital that the Israeli armed forces knew was not only dealing with scores of injured and wounded but also giving shelter to several hundred civilians, the Mission finds, based on all the information available to it, that in directly striking the hospital and the ambulance depot the Israeli armed forces in these circumstances violated article 18 of the Fourth Geneva Convention and violated customary international law in relation to proportionality.”

January 8, 2010 Posted by aletho | Illegal Occupation, Subjugation - Torture, War Crimes | Comments Off on ‘Hospitals may in no circumstances be the object of attack’