Al Ahli Baptist Hospital, Gaza City
One year on 

Amos has partnered with the Al Ahli Baptist Hospital for over 30 years. We had just launched Rosie October — or Breast Cancer Awareness Month, when the 7th October Hamas attack occurred. A week later, the hospital’s diagnostic unit was hit by a shell.

Then, on 17th October, Al Ahli was the first hospital in Gaza to be hit by a rocket. At the time, thousands of people were sheltering in the hospital’s courtyard. The hospital was seen as a safe place, an apolitical church-run institution, that was protected under the 4th Geneva Convention. 

The Convention requires that hospitals, clinics, ambulances and their staff must be protected at all times so the wounded and sick can be freely treated. Attacks against medical staff and facilities are violations of international law and can constitute war crimes. The population assumed this core pillar of international humanitarian law would be upheld. 

However, 471 people were killed when the rocket exploded, and thousands were injured; doctors who were present described the most horrific scenes of death and destruction. The next day, the hospital re-opened and resumed treating patients. 

There was an extensive investigation into the source of the rocket fire. Human Rights Watch reported that evidence suggested it was a misfiring rocket from one of the Palestinian groups — while calling for a fuller investigation that has proven impossible.

Then, on 17th October, Al Ahli was the first hospital in Gaza to be hit by a rocket. At the time thousands of people were sheltering in the hospital’s courtyard.

There was an immediate outcry over the attack and a flurry of investigations by the international community on the source of the rocket fire on the hospital. We did not comment on these investigations other than to say that we were far more concerned over the victims of the explosion than the explosion’s source, and that if Israel had not been carrying out such a massive bombardment of Gaza City, this would not have happened.

At the time, we could not voice our deep concern about the consequences of these investigations. The attack was a clear breach of international humanitarian law on a hospital that is supported by leading churches around the world and has received extensive US Aid funding. To clear the Israeli Military of responsibility for this attack would be interpreted as a sign that the international community had little desire to ensure the safeguarding of hospitals, medical facilities and personnel. This has proven to be the case.

A mobile health clinic set up in Rafah run by staff from Al Ahli Hospital
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The destruction of Gaza’s health system

The Guardian reported on the 10th October, 2024 that:
“An inquiry has found that Israel has carried out a concerted policy of destroying Gaza’s healthcare system in the Gaza war; actions amounting to both war crimes and the crime against humanity of extermination, reports Reuters. 

A statement by ex-UN High Commissioner for Human Rights Navi Pillay, which was released ahead of a full report, accused Israel of “relentless and deliberate attacks on medical personnel and facilities” in the war.

“Children in particular have borne the brunt of these attacks, suffering both directly and indirectly from the collapse of the health system,” said Pillay, whose report will be presented to the UN general assembly on 30th October.

Israel says that Gaza’s militants operate from the cover of built-up populated areas, including private homes, schools and hospitals and that it will strike them wherever they emerge while also trying to avoid harming civilians. Hamas denies hiding militants, weapons and command posts among civilians.

A statement by ex-UN High Commissioner for Human Rights Navi Pillay, which was released ahead of a full report, accused Israel of “relentless and deliberate attacks on medical personnel and facilities” in the war. The Guardian

According to Reuters, the UN inquiry’s statement also accused Israeli forces of deliberately killing and torturing medical personnel, targeting medical vehicles and restricting permits for patients to leave the Gaza Strip. As an example, it cited the death of a Palestinian girl, Hind Rajab, in February, along with family members and two medics who came to rescue her from under Israeli fire.

The World Health Organization (WHO) says more than 10,000 patients requiring urgent medical evacuation have been prevented from leaving Gaza since the Rafah border crossing with Egypt was shut in May. The Palestinian Health Ministry says nearly one thousand medics have been killed in Gaza in the past year in what the WHO called “an irreplaceable loss and a massive blow to the health system”.

The statement said the treatment of both Palestinian detainees in Israel and hostages seized by Hamas fighters in the 7th October attack had been investigated and it accused both sides of involvement in torture and sexual violence.

The Commission of Inquiry (CoI) has a broad mandate to collect evidence and identify suspected perpetrators of international crimes committed in Israel and the Occupied Palestinian territories. It bases its findings on a range of sources, including interviews with victims and witnesses, submissions and satellite imagery.

The World Health Organization (WHO) says more than 10,000 patients requiring urgent medical evacuation have been prevented from leaving Gaza since the Rafah border crossing with Egypt was shut in May. The Guardian

The CoI has previously alleged that both Israel and Hamas committed war crimes in the early stages of the Gaza war and that Israel’s actions also constituted crimes against humanity because of the immense civilian losses. The term is reserved for the most severe international crimes knowingly committed as part of a widespread or systematic attack against civilians.

Israel has not cooperated with the inquiry, which it says has an anti-Israel bias. The CoI has accused Israel of obstructing its work and preventing investigators from accessing both Israel and the Palestinian territories, reports Reuters. In the past, evidence gathered by such UN-mandated bodies has formed the basis for war crimes prosecutions and could be drawn on by the international criminal court.”

One year on

Amid all this, the Al Ahli Hospital has continued to operate despite facing many acute challenges. For a period leading up to November’s ceasefire, it was the only operating hospital in Gaza, despite only having 80 beds. It had over 400 inpatients — and converted the chapel, library and reception areas into temporary wards.

It has continued to run well beyond its capacity and has faced continuing shortages, whether in medical personnel, medicines, dressings and other basic medical supplies, anaesthetics and antibiotics, food for patients and staff or power. Before Christmas, the hospital was having to carry out major surgeries without anaesthetics or antibiotics — these included amputations and caesareans.

For a period leading up to November’s ceasefire, [Al Ahli] was the only operating hospital in Gaza, despite only having 80 beds. It had over 400 inpatients — and converted the chapel, library and reception areas into temporary wards.

On 19th December, we heard that the hospital had been attacked again; this time, the entranceway and walls were destroyed and some medical staff were detained by the Israeli Military. These staff were gradually released in the south of Gaza, with the final person released in early February, who reported systematic mistreatment.

January/February

Patients and staff survived on one meal of rice a day in January and February, and in February, the hospital ran out of fuel. This meant they depended on the hospital’s damaged solar panels for electricity. They charged mobile phones during the daytime and had to use their phone torches for medical procedures after dark. The solar panels were further damaged when one US aid drop landed on them. 

With the destruction by the Israel forces in March, and the closure of Al Shifa Hospital — Gaza’s largest, Al Ahli was once again one of a handful of hospitals running in the north of Gaza and were inundated with patients — receiving over 200 injured patients each day and the operating theatre working non-stop and approximately 150 inpatients.

Al Ahli Hospital in happier times
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The situation had settled down slightly since March but they were still facing massive shortages. In September, their 60-bed hospital still had 80-100 inpatients and 22,000 registered outpatients and they were carrying out between 20-30 outpatient surgeries each day for those injured in the conflict.

Resumed offensive

However, with the resumed offensive against Gaza City, specifically in Beit Lahiya, Beit Hanoun and Jabaliya camps, the attempts to force the evacuation of the 400,000 people sheltering there and the Israeli order that three of the last remaining hospitals in the north of Gaza have to close, the situation is desperate.

As the letter last week from 15 NGOs working in Palestine stated, “Families in the north are trapped, unable to leave their homes to find food or water, subjecting them to starvation, and aid workers and trucks providing life-saving resources are prevented from doing so. The two main roads south, including Salah ad-Din have been destroyed and are reportedly impassable. Ambulances can no longer transport the wounded and critically ill from Kamal Adwan Hospital in Beit Lahia to Al Ahli Hospital for necessary surgeries, as tanks have cut off North Gaza from Gaza City.”

We do not know what the next steps for Al Ahli will be. However, we do know that they will continue offering hope and healing for as long as possible.