The independent UN Commission of Inquiry on the occupied Palestinian territory, including East Jerusalem, and Israel, has published its latest report investigating attacks on Gaza’s medical facilities and personnel since 7 October 2023, concluding that Israeli forces have committed war crimes and the crime against humanity of extermination in Gaza.
The report, released on 10 October, details the systematic destruction of Gaza’s healthcare system as well as the mistreatment of healthcare workers, detainees, and patients. The Commission found that Israel has implemented a concerted policy to destroy the health-care system of Gaza, and that its forces have “deliberately killed, wounded, arrested, detained, mistreated and tortured medical personnel and targeted medical vehicles,” constituting the war crimes of willful killing and mistreatment and the crime against humanity of extermination. These acts were carried out in conjunction with Israeli authorities’ collective punishment of Palestinians, through the tightened siege of Gaza which has resulted in shortages of fuel, food, water, medicine and medical supplies at hospitals.
Attacks on healthcare
The Commission investigated attacks on four hospitals in Gaza: Nasser Medical Complex, Al Shifa, Al Awda and the Turkish-Palestinian Friendship Hospital, finding a pattern of attacks that indicated the “existence of operational plans and procedures for deliberately attacking healthcare facilities.” Those attacks included issuing so-called “evacuation orders,” which were not feasible and could not be implemented in a way that guaranteed any safety, as well as direct airstrikes and sniper fire targeting hospitals, which Medical Aid for Palestinians (MAP) has continuously reported over the past year of Israel’s war on Gaza.
The report also finds that detainees, including health workers, are subjected to extreme mistreatment in Israeli detention, including being stripped, transported naked, blindfolded, handcuffed tightly to cause injury, kicked, beaten, sexually assaulted and subjected to death threats. Many detainees are held in arbitrary detention, including health workers, medical staff, patients and human rights defenders, who were arrested during various hospital raids and attacks by the Israeli military.
Impact on women and girls
The “deliberate destruction of sexual and reproductive health-care facilities” found by the Commission has particularly impacted young children, mothers and pregnant women, in violation of women and girls’ reproductive rights and the rights to life, health, human dignity and non-discrimination. The Commission concluded, that “the prolonged physical and mental suffering of injured children and the reproductive harm caused to pregnant, post-partum and lactating women amount to the crime against humanity of other inhumane acts”
Citing the testimony of medical experts, the Commission noted that the destruction of medical infrastructure and targeting of medical personnel, alongside the lack of essential supplies, has compromised children’s access to basic healthcare and treatment. Lack of basic supplies, poor sanitation and attacks on paediatric hospitals has made it difficult for medical teams to treat malnourished children, children with pre-existing conditions, and children who have received direct gunshot wounds, which indicates the “direct targeting of children” by Israeli forces.
The Commission of Inquiry concluded that Israel “has deliberately created conditions of life that have resulted in the destruction of generations of Palestinian children and the Palestinian people as a group.”
The systematic destruction of healthcare is making Gaza uninhabitable
The Commission further found that the systematic destruction of the health-care system of Gaza by the Israeli military has severely undermined the “accessibility, quality and availability of health-care services, drastically increasing mortality and morbidity, in violation of the right to physical and mental health, which is intrinsically linked to the right to life.” Additionally, attacks against health care facilities have “directly resulted in the killing of civilians including children and pregnant women, receiving treatment of seeking shelter and indirectly led to deaths of civilians due to the lack of medical care, supplies and equipment – a direct violation of Palestinians’ right to life.” The Commission concluded that “such acts constitute the crime against humanity of extermination.”
MAP has been sounding the alarm about Israel’s systematic destruction of the healthcare system for over a year, warning that these attacks are making Gaza uninhabitable and constitute an existential threat to the Palestinian people. The Commission’s report recommends that UN member states cease aiding or assisting the commission of violations of international law in Gaza and explore accountability measures for alleged perpetrators, including by cooperating with the International Criminal Court. It further recommends that states comply with their international legal obligation under the Geneva Conventions to ensure respect for international humanitarian law, and additional obligations under the Convention Against Torture and the Genocide Convention.
The Commission’s conclusion that Israeli forces are committing the crime of extermination must be a wake-up call for the international community. MAP therefore urges the UK and other governments to act with due urgency to end any and all complicity in Israel’s war crimes and crimes against humanity, including by:
- Taking meaningful steps to enforce a ceasefire in Gaza, to protect civilians and healthcare;
- Suspending all arms transfers to Israel, to prevent their use in violations of international law including war crimes and crimes against humanity;
- Taking bold and concrete action to ensure Israel complies with the Commission of Inquiry’s recommendations, as well as the ICJ's orders to prevent genocide, and to implement the Court’s Advisory Opinion not to aid or assist Israel’s unlawful occupation of Palestinian territory, and to take measures to ensure its rapid termination; and
- Support international justice mechanisms, including the International Criminal Court, to ensure those responsible for serious violations of international law in the occupied Palestinian territory are held fully accountable