Doctors Without Borders (Médecins Sans Frontières, MSF) announced this weekend that it has suspended all non‑critical activities at Gaza’s Nasser Hospital, citing repeated observations of armed individuals moving weapons and interrogating patients inside the facility. The decision, made in January 2024, marks the first time a major international humanitarian organization has publicly confirmed the presence of combatants operating within a Gaza hospital since the conflict erupted on 7 October 2023.
The MSF statement echoes long‑standing claims by the Israeli Defence Forces (IDF) that Hamas has systematically embedded itself in civilian infrastructure, turning hospitals into command centres, weapons depots and “human shields.” By acknowledging these allegations, MSF’s report could shift the already heated debate over the legality and morality of military actions near medical facilities.
What MSF reported
In a press release dated 11 January 2024, MSF said its medical teams at Nasser Hospital had witnessed “suspected movement of weapons” and “incidents of intimidation and arbitrary arrests of patients by armed terrorists.” The organization stopped all non‑essential services, including elective surgeries and routine outpatient care, although continuing emergency treatment for life‑threatening conditions. MSF deliberately avoided naming any group, but added a call for “all armed groups, as well as Israeli forces, to respect medical facilities.” The full statement can be read on the MSF website here.
IDF’s long‑standing position
Since the war began, the IDF has repeatedly warned that Hamas militants use Gaza’s health‑care network to hide weapons, store ammunition and launch attacks. In a January 2024 briefing, the IDF described Nasser Hospital as “a hub for command and control activities, linked to an extensive tunnel network built at great cost by Hamas” source. The Israeli military argues that this militarisation forces it to consider the hospitals themselves as legitimate targets when they are used for hostile acts.
One of the most contentious incidents involved an Israeli strike on Nasser Hospital in August 2023 that killed several journalists. Israel’s foreign ministry expressed “deep regrets,” while the IDF admitted that the strike was “approved” because a Hamas target was believed to be present, though it also said the operation was under investigation source.
Broader humanitarian context
International organisations, including the World Health Organization, have repeatedly called for the protection of health facilities under international humanitarian law. WHO’s 2023 statement stressed that “attacks on health‑care facilities are prohibited” and urged all parties to “ensure the safety of patients, staff and supplies” source. However, many NGOs and UN agencies have previously described Israel’s accusations of hospital militarisation as “exaggerated” or “unverified,” fueling a polarised narrative.
MSF’s recent acknowledgment could prompt other NGOs to reassess their public positions. The organisation’s staff have also faced mounting pressure from Israeli authorities, which demanded a list of MSF’s Palestinian and international employees as a condition for resuming full operations in Gaza and the West Bank. After a brief agreement and subsequent back‑track, Israel announced it might terminate MSF’s operating licence in the territory source.
Implications for the war and civilian protection
Recognising the presence of armed groups inside hospitals does not constitute an endorsement of any particular military campaign. Rather, it highlights the tragic reality that the use of civilian sites for combat endangers everyone inside – patients, health‑care workers, aid staff and soldiers alike. The principle that “the protection of health facilities must be upheld” remains central to international humanitarian law, but its application becomes increasingly complex when those facilities are deliberately militarised.
For humanitarian actors, the key takeaway is the renewed need for transparent reporting, and verification. Accurate documentation of violations can support accountability mechanisms, while also informing the public debate and helping to prevent further civilian casualties.
What to watch next
As the conflict continues, the following developments will be closely monitored:
- Whether MSF or other NGOs will expand their public statements on hospital militarisation.
- Any new investigations by international bodies into alleged misuse of health facilities.
- Potential changes in Israeli operational guidelines concerning strikes near or within hospitals.
- The humanitarian response to the suspension of services at Nasser Hospital and its impact on Gaza’s civilian health‑care capacity.
Continued vigilance and independent verification are essential to safeguard the principle that medical facilities remain zones of safety, even amid the fog of war.
Disclaimer: This article is for informational purposes only and does not constitute legal, medical, or professional advice. Readers seeking assistance related to health or safety concerns should consult qualified professionals or appropriate authorities.
If you or someone you know is affected by the conflict and needs support, resources are available through the UN Office for the Coordination of Humanitarian Affairs (OCHA) at www.unocha.org and mental‑health hotlines listed on the WHO website.
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