On Oct. 17, 2023, hundreds of people were killed from an explosion at Al Ahli Arab hospital in north Gaza. No one has taken responsibility for the explosion, with Hamas arguing it was an Israeli airstrike and Israel saying it was an errant rocket from another armed group, Palestinian Islamic Jihad (PIJ), which in turn denied the accusation.
Many observers online sought to highlight Israel’s alleged culpability in the destruction of the hospital as claims grew that the Israeli army had ordered an evacuation of that hospital in advance, as well as of the surrounding area. Israel had been ordering evacuations of numerous parts of Gaza, including the northern region that houses around 1 million people, whilst also hammering the territory with airstrikes.
The World Health Organization (WHO) offered some independent evidence that Israel ordered the evacuation of many hospitals and the surrounding region in north Gaza, though there were conflicting accounts on the specificity of the order. As such, we cannot confirm who is responsible for the attack on Oct. 17 until more information comes to light.
The conflict began on Oct. 7, 2023, when the Palestinian militant group Hamas launched a surprise attack on Israel from Gaza, followed by Israel declaring war and attacking and blockading Gaza, actions that resulted in the deaths of thousands of Israelis and Palestinians. Hamas' attacks came after months of surges in violence against Palestinians by the Israeli military.
After the hospital explosion, WHO indicated in a statement that the Al Ahli Arab was one of 20 hospitals that Israel had ordered to evacuate: “The hospital was one of 20 in the north of the Gaza Strip facing evacuation orders from the Israeli military.” We reached out to WHO for more details about the evacuation order and will update this post as more information comes to light.
On Oct. 18, 2023, Palestinian Anglican Archbishop Hosam Naoum, who oversees and runs the hospital, said that the Israeli military had called and texted hospital managers at least three times since Oct. 14, asking its patients and staff to leave the hospital compound, according to The New York Times.
Naoum said the warnings were particular to the hospital, and not part of Israel’s wider push telling civilians to leave northern Gaza for the south. “There were specific warnings to get out of the building,” he said.
Amnon Shefler, an Israeli military spokesman, appeared to refute this according to the Times, saying the calls to the hospital were part of a wider campaign to urge civilians to leave the north ahead of an expected Israeli invasion. Shefler added the hospital was not a target for the military. We have also reached out to the Israeli military to ask for a copy of the evacuation orders.
This was not the first airstrike on the hospital in question. The New York Times confirmed that the same hospital had been hit by rocket fire on Oct. 14, 2023, before the more recent attack, in which four people had been injured. The Anglican Church — which oversees the Ahli hospital — said in a statement the Oct. 14 airstrike was Israel’s responsibility: “The Ahli Hospital was hit by Israeli rocket fire last night, with four staff injured in the blast. Other hospitals have also been hit.”
In the same statement, the Archbishop of Canterbury, head of the church, appealed to Israel to reverse its evacuation order on hospitals in northern Gaza.
An unnamed senior health official in Gaza told Al Jazeera that Israel had fired two artillery shells as a “warning” at Al Ahli Arab Hospital, just days before the explosion. We could not determine if these were part of the Oct. 14, 2023, rocket fire.
Even before the airstrike that killed hundreds of people, the WHO and other human rights organizations were condemning Israel’s evacuation orders, calling them impossible. In an Oct. 14, 2023, statement, they emphasized the impact of such orders on hospitals, one of which was Al Ahli Arab (emphasis, ours):
[The WHO] strongly condemns Israel's repeated orders for the evacuation of 22 hospitals treating more than 2000 inpatients in northern Gaza. The forced evacuation of patients and health workers will further worsen the current humanitarian and public health catastrophe.
The lives of many critically ill and fragile patients hang in the balance. [...] Health facilities in northern Gaza continue to receive an influx of injured patients and are struggling to operate beyond maximum capacity. Some patients are being treated in corridors and outdoors in surrounding streets due to a lack of hospital beds.
Forcing more than 2000 patients to relocate to southern Gaza, where health facilities are already running at maximum capacity and unable to absorb a dramatic rise in the number of patients, could be tantamount to a death sentence.
The WHO also highlighted the impossibility of such evacuation orders in its Oct. 17 statement after the bombing.
In a news conference on Oct. 19, 2023, WHO Executive Director of the Health Emergencies Program Michael Ryan said:
Health is not a target, it can never be a target. It is not an excuse to say it was an accident. The parties to hostilities are not only directed to avoid attacking health services, they are directed to insure that they avoid attacking health services. [...] Damage to healthcare facilities, blasts on healthcare facilities, whether by accident or by intent, are a result of war and are prohibited under international law. Sometimes I hear these arguments around, well, it wasn’t intended, or it's that awful word “collateral damage.” Healthcare workers, healthcare facilities and patients are not collateral damage. They are protected under international law.
While no group has taken responsibility for the Oct. 17 attack, and while parties dispute the specificity of the evacuation orders, WHO has offered evidence indicating Israel issued evacuation orders to hospitals in the area, warning them of strikes. We will update this story if we gather more information.