The Targeting of Medical Centers, Ambulance Teams and Civil Defense Teams during the Israeli Offensive “Operation Cast Lead” against the Gaza Strip.
27 December 2008 – 18 January 2009
2.Testimonies
“Some wounded people simply die while waiting for an ambulance,” said Antoine
Grand, head of the ICRC office in Gaza. “This is of course absolutely appalling. The
ambulances must reach the injured as fast as possible.”
1.Statement by the ICRC
“ help them. I was shocked by a powerful explosion hitting the rear of the ambulance. I
fell out of the ambulance with the force of the explosion. After a few moments, I
checked myself and found that I was injured in the head. I got up and went to the rear
of the ambulance to check on my colleagues…..I saw the third injured person who was
being carried to the ambulance by my colleague lying on the ground without his head
or legs.”
When they reached the back door of the ambulance, I went to get out of the car to
Statement by Khaled Abu Se’da, Ambulance Driver at Al Awda Hospital Red Crescent Ambulance Run over by an Israeli Tank as It Parked at the Emergency Center in Tel Al-Hawa
Introduction …………………………………………………………………………………………………………………. 4.Legal Context – Grave Violations of International Humanitarian Law …………………………………. 7
The Targeting of Health Service Organizations and Civil Defense Teams ………………………….. 12.Coordination to Evacuate the Sick and Wounded, and Retrieve the Bodies of Victims ………… 16
The Targeting of Medical and Civil Defense Teams and Premises and the Obstruction of their
Work: A Review of the Main Incidents …………………………………………………………………………..
Annex 1: The names of people working in medical services and civil defense killed in the
Israeli invasion of the Gaza Strip 27 December 2008 – 18 January 2009 ……………………………. 31.Annex 2: List of injured people from the medical and civil defense services during the Israeli
invasion of the Gaza Strip. ……………………………………………………………………………………………. 32
4.Introduction
“ those fighting in Gaza that future abuses too will be ignored.”
Failing to punish soldiers for serious abuses sends a terrible message to Human Rights Watch
2.The continued failure of the international community to hold Israel accountable for grave
breaches of international law and the perpetration of war crimes sends a clear message that
the State of Israel is free to act at will in the occupied Palestinian territory (oPt). The intensity
and brutality of Operation Cast Lead – launched against the Gaza Strip on 27 December 2008
– in which at least 1359 Palestinians were killed, should therefore have come as no surprise.
Following its last major invasion of the Gaza Strip launched in February 2008, in which Israeli forces killed over 100 Palestinians, the international community remained silent. On behalf of the victims of the latest grave violations of international law in the Gaza Strip, which amount to war crimes and crimes against humanity, Al Mezan Center for Human Rights urges the international community to study the findings of this report, and to take immediate and
effective action to bring to justice those responsible for destroying tens of thousands of lives.
The continued failure to act constitutes complicity not only in the most recent attacks, but in all future war crimes that will be perpetrated unless the State of Israel is held to account.
On Saturday 27 December 2008, the Israeli Occupation Forces (IOF) launched a far-reaching
military offensive against the Gaza Strip which was to continue uninterrupted for over three
weeks. Israeli forces unleashed the full might of their military machine against the people of
Gaza with intense air and ground attacks. The Israeli military offensive – unprecedented in
scale and brutality since 1967 – was aimed at massive destruction in the Gaza Strip. Israeli
war planes alone – without accounting for tank, ground troop and warship ammunition –
dropped around a thousand tons of bombs, according to the Israeli television Channel Ten.
This massive use of force overwhelmingly targeted a civilian population; commercial and
industrial premises; civil and governmental institutions; agricultural land; and places of
worship. The offensive left in its wake a humanitarian tragedy in this densely populated
enclave – home to nearly 1.5 million people – of just 350 kilometers of land.
3.The Israeli offensive against the Gaza Strip continued for 23 days until Israel announced a
unilateral ceasefire which commenced at 2am on 18 January 2009. The invading Israeli forces
withdrew three days later. The scale of the destruction wrought in such a short time was
immense; in terms of civilian victims, and the destruction of civilian homes, public premises,
and private commercial and industrial establishments. Information available to Al Mezan initial documentation indicates that at least 1359. Ministry of Health in Gaza, over 5300 people were injured. Data collected by the Palestinian Central Bureau of Statistics indicates that more than 4000 homes were completely destroyed and more than 17,000 partially destroyed. In addition, hundreds of industrial and commercial premises and thousands of dunums of agricultural land were destroyed.
4 people were killed and according to the Palestinian5
3.number of residents in the Strip at the end of 2007 was approximately 1,416,543 million and with an annual growth rate of 3.3% is expected to be 1,463,289 at the end 2008
According to the Palestinian Central Bureau of Statistics ‘Central Census of Population, Housing and Establishments 2007,’ the
4.attacks during Operation Cast Lead ends.
This figure reflects the results of initial documentation. It is expected to rise as the full documentation of the casualties of Israeli
5.Israeli operation codenamed ‘Cast Lead’
Al Mezan is currently preparing a comprehensive survey of human and material loses caused to Gaza’s population during the
5.Israeli actions during its offensive against the Gaza Strip constitute grave and systematic
violations of the rules of international humanitarian law (IHL) and disregard for its obligations towards Palestinian civilians as an occupying power, according to the Fourth Geneva Convention. The application of this Convention to the Gaza Strip, which is part of the occupied Palestinian territories, has been affirmed by an advisory opinion of the International Court of Justice, the conferences of the High Contracting Parties to the Fourth Geneva Convention and periodic United Nations reports related to human rights in the oPt.
6.Israeli military operations conducted during Operation Cast Lead, relied on the use of massive and disproportionate force. Israeli forces failed to distinguish between civilian and non-civilian objects in their attacks. The targeting of civilians and civilian property, and the killing of hundreds inside their houses, was systematic and deliberate, in a clear violation of two basic principles of IHL; particularly the principle of distinction and the principle of proportionality.
The IOF destroyed large parts of Gaza’s infrastructure including: electricity networks, potable
water networks; sewage and sanitation networks; and schools (including those used by
UNWRA as emergency accommodation for IDPs during the offensive). Israeli forces also
targeted UNWRA warehouses located in its Middle East headquarters, media offices and
journalists.
The deliberate targeting of ambulance crews and medical teams is perhaps the most horrifying of these crimes. The IOF deliberately opened fire on these humanitarian workers, obstructed their work, and destroyed their premises and equipment, including ambulances. As a result, 17 emergency workers were killed while on duty, 50 were injured and hundreds of injured peopledied as a result of Israel’s refusal to allow medical personnel access to the wounded. Medical teams were targeted as they were attempting to evacuate the wounded and the sick. In addition, local residents attempting to administer first aid to their injured neighbors were fired at.
The images of Israeli brutality against the people of the Gaza Strip were transported around
the world, leading to widespread popular condemnation, but silence from many states around
the world. Statements by international officials including the High Commissioner for Human
Rights, the UN Special Rapporteur on the Human Rights situation in the oPt, and the General
Secretary of the United Nations have called for investigations into the perpetration of war
crimes, including the deliberate targeting of medical teams and the obstruction of treatment of
the wounded.
Palestinian health institutions were already facing major challenges beyond their capacities
during the Israeli invasion. Al Mezan Center for Human Rights pays tribute to the exceptional
performance and dedication of both governmental and non-governmental medical
organizations. Ambulance and emergency teams, medical teams, civil defense teams, and
hospital emergency departments remained on a state of permanent alert, working around the
clock to deal with the immensity of the humanitarian crisis created by the Israeli military
machine.
In spite of the humanitarian nature of their work and their protected status under IHL – and
especially the Fourth Geneva Convention Relative to the Protection of Civilians in Times of
War and the Additional Protocol to the Fourth Geneva Convention of 1949 and relating to the
Protection of Victims of International Armed Conflict (Protocol I)- humanitarian personnel were
6.Occupied Palestinian Territory:
Duggard, former Special Rapporteur on human rights in the occupied Palestinian territories and his successor Richard Falk, on the website of the Office for the High Commission for Human Rights
See the advisory opinion of the International Court of Justice on the Legality Consequences of the Construction of a Wall in thehttp://www.icj-cij.org/docket/files/131/1671.pdf . See also the reports and statements of John:www.ohchr.org
6. injured and killed in the line of duty. Hospitals, medical centers, ambulances, emergency
teams and civil defense teams were also attacked by Israeli forces.
This report documents grave violations that were perpetrated against ambulance and medical
teams by Israeli forces during the military offensive on Gaza and calls on the international
community to take immediate and effective action to bring those responsible for perpetrating
war crimes to justice and to prevent further abuses.7
2.LegalContext–GraveViolationsofInternational
HumanitarianLaw
The West Bank (including East Jerusalem) and the Gaza Strip constitute the occupied
Palestinian territories. According to international law and the Oslo Agreements signed betweenIsrael and the PLO (Palestine Liberation Organization), these lands constitute one political entity. The legal status of the Gaza Strip did not alter subsequent to the implementation of Israel’s unilateral disengagement plan in 2005 which involved the dismantling of Israeli settlements and the withdrawal of Israeli forces from inside the Strip. Not only do the West Bank and the Gaza Strip constitute one geo-political entity, but despite the disengagement plan, Israeli forces retain effective control over the Gaza Strip. They control all crossings to the outside world, the movement of people in and out of the Strip, air and sea space, the civil registry and the nearly all other aspects of life for Palestinians. Further, the United Nations Security Council did not note a change in the legal status of the Gaza Strip following disengagement. Therefore, the ‘law of occupation,’ including the Fourth Geneva Convention 1949 (ratified by Israel) constitutes the legal framework for all Israeli actions inside the GazaStrip and determines the duties of Israel towards Gaza’s civilian population.
The Fourth Geneva Convention of 1949 relative to the Protection of Civilian Persons in Time
of War affords special attention and care to the state of health in an occupied region and with
the situation of the sick and injured in particular. This Convention accords special protection to operations to transport injured and sick civilians. The Convention also attempted to organize medical care services and the work of hospitals as illustrated in the following articles: 15, 16, 17, 18, 19, 20, 21, 38 and 63. The Protocol Additional to the Fourth Geneva Conventions of 12 August 1949 and relating to the Protection of Victims of International Armed Conflicts (Protocol I), 8 June 1977, expands the detail of protection accorded to civilians and determines the situations in which these legal rules apply. These situations include armed conflicts in which peoples are fighting against colonial domination and alien occupation and against racist regimes in the exercise of the right of self determination, as enshrined in the United Nations Charter and the Declaration on Principles of International Law concerning Friendly Relations and Co-operation among States in accordance with the Charter of the United Nations.
7. Article 16 of the Fourth Geneva Convention states: ‘The wounded and sick, as well as the
infirm, and expectant mothers, shall be the object of particular protection and respect. As far
as military considerations allow, each Party to the conflict shall facilitate the steps taken to
search for the killed and wounded…’ Article 17 states that ‘The Parties to the conflict shall
endeavor to conclude local agreements for the removal from besieged or encircled areas, of
wounded, sick, infirm, and aged persons, children and maternity cases, and for the passage of
ministers of all religions, medical personnel and medical equipment on their way to such
areas.’ The Convention emphasizes in the first paragraph of Article 18 that ‘Civilian hospitals
organized to give care to the wounded and sick, the infirm and maternity cases, may in no
circumstances be the object of attack, but shall at all times be respected and protected by the
Parties to the conflict.” Article 19 states “The protection to which civilian hospitals are entitled
shall not cease unless they are used to commit, outside their humanitarian duties, acts harmful
to the enemy. Protection may, however, cease only after due warning has been given, naming,
in all appropriate cases, a reasonable time limit, and after such warning has remained
unheeded. The fact that sick or wounded members of the armed forces are nursed in these
7. Victims of International Armed Conflicts (Protocol I), 8 June 1977.
8. hospitals, or the presence of small arms and ammunition taken from such combatants which have not yet been handed to the proper service, shall not be considered to be acts harmful to the enemy.’ Article 20 of the agreement states that “Persons regularly and solely engaged in the operation and administration of civilian hospitals, including the personnel engaged in the search for, removal and transporting of and caring for wounded and sick civilians, the infirm and maternity cases, shall be respected and protected.’ Article 21 of the Conventions states, “Convoys of vehicles or hospital trains on land or specially provided vessels on sea, conveying wounded and sick civilians, the infirm and maternity cases, shall be respected and protected in the same manner as the hospitals provided for in Article 18, and shall be marked, with the consent of the State, by the display of the distinctive emblem provided for in Article 38 of the Geneva Convention for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field of August 12, 1949.
Article 63 allows national groups such as the Red Crescent to pursue their activities in
accordance with Red Cross principles, the Article states, “Subject to temporary and
exceptional measures imposed for urgent reasons of security by the Occupying Power:
(a) Recognized National Red Cross (Red Crescent, Red Lion and Sun) Societies shall be able
to pursue their activities in accordance with Red Cross principles, as defined by the
International Red Cross Conferences. Other relief societies shall be permitted to continue their
humanitarian activities under similar conditions;
(b) The Occupying Power may not require any changes in the personnel or structure of these
societies, which would prejudice the aforesaid activities.
The same principles shall apply to the activities and personnel of special organizations of a
non-military character, which already exist or which may be established, for the purpose of
ensuring the living conditions of the civilian population by the maintenance of the essential
public utility services, by the distribution of relief and by the organization of rescues.’
8. Protocol I, which is considered a completion to the Geneva Conventions including the Fourth Convention, affirms the protection of individuals from medical and civil defense and allowing the Red Cross and other humanitarian organizations to work. It covers also the role of civilian residents and relief organizations to save the injured and ill, and to protect them. This came in articles 81, 80, 63, 62, 61, 17, 16 and 15 in the Protocol.
Article 15 determines the protection to be accorded to civilian medical and religious personnel
and states:
1. Civilian medical personnel shall be respected and protected.
2. If needed, all available help shall be afforded to civilian medical personnel in an area where
civilian medical services are disrupted by reason of combat activity.
3. The Occupying Power shall afford civilian medical personnel in occupied territories every
assistance to enable them to perform, to the best of their ability, their humanitarian functions.
The Occupying Power may not require that, in the performance of those functions, such
personnel shall give priority to the treatment of any person except on medical grounds. They
shall not be compelled to carry out tasks which are not compatible with their humanitarian
mission.
4. Civilian medical personnel shall have access to any place where their services are
essential, subject to such supervisory and safety measures as the relevant Party to the conflict
may deem necessary.8.
2002.
Encyclopedia of international humanitarian law conventions, issued by the International Committee of the Red Cross in Cairo,9
5. Civilian religious personnel shall be respected and protected. The provisions of the
Conventions and of this Protocol concerning the protection and identification of medical
personnel shall apply equally to such persons.
Article 16 on the general protection of medical duties states:
1. Under no circumstances shall any person be punished for carrying out medical activities
compatible with medical ethics, regardless of the person benefiting therefrom.
2. Persons engaged in medical activities shall not be compelled to perform acts or to carry out
work contrary to the rules of medical ethics or to other medical rules designed for the benefit of the wounded and sick or to the provisions of the Conventions or of this Protocol, or to refrain from performing acts or from carrying out work required by those rules and provisions.
3. No person engaged in medical activities shall be compelled to give to anyone belonging
either to an adverse Party, or to his own Party except as required by the law of the latter Party, any information concerning the wounded and sick who are, or who have been, under his care, if such information would, in his opinion, prove harmful to the patients concerned or to their families. Regulations for the compulsory notification of communicable diseases shall, however, be respected.
Article 17 defines the Role of the civilian population and of aid societies in caring for the
injured and sick. The first article states: ‘The civilian population shall respect the wounded, sick and shipwrecked, even if they belong to the adverse Party, and shall commit no act of violence against them. The civilian population and aid societies, such as national Red Cross (Red Crescent, Red Lion and Sun) Societies, shall be permitted, even on their own initiative, to
collect and care for the wounded, sick and shipwrecked, even in invaded or occupied areas.
No one shall be harmed, prosecuted, convicted or punished for such humanitarian acts.’
In terms of the Civil Defense, a number of articles in the Protocol define the work of the civil
defense and affirm the protection of its individuals and facilitation of their work in areas of
international conflict. Article 61 states:
(a) ”Civil defence” means the performance of some or all of the undermentioned humanitarian
tasks intended to protect the civilian population against the dangers, and to help it to recover
from the immediate effects, of hostilities or disasters and also to provide the conditions
necessary for its survival. These tasks are: (i) Warning; (ii) Evacuation; (iii) Management of
shelters; (iv) Management of blackout measures; (v) Rescue; (vi) Medical services, including
first aid, and religious assistance; (vii) Fire-fighting; (viii) Detection and marking of danger
areas; (ix) Decontamination and similar protective measures; (x) Provision of emergency
accommodation and supplies; (xi) Emergency assistance in the restoration and maintenance
of order in distressed areas; (xii) Emergency repair of indispensable public utilities; (xiii)
Emergency disposal of the dead; (xiv) Assistance in the preservation of objects essential for
survival; (xv) Complementary activities necessary to carry out any of the tasks mentioned
above, including, but not limited to, planning and organization;
(b) ”Civil defence organizations” means those establishments and other units which are
organized or authorized by the competent authorities of a Party to the conflict to perform any
of the tasks mentioned under subparagraph (a), and which are assigned and devoted
exclusively to such tasks;
(c) “Personnel” of civil defence organizations means those persons assigned by a Party to the
conflict exclusively to the performance of the tasks mentioned under sub-paragraph (a),
including personnel assigned by the competent authority of that Party exclusively to the
administration of these organizations;
(d) ” by these organizations for the performance of the tasks mentioned under sub-paragraph (a). Article 62 related to general protection states:
Matériel” of civil defence organizations means equipment, supplies and transports used 10
1. Civilian civil defence organizations and their personnel shall be respected and protected,
subject to the provisions of this Protocol, particularly the provisions of this Section. They shall
be entitled to perform their civil defence tasks except in case of imperative military necessity.
2. The provisions of paragraph 1 shall also apply to civilians who, although not members of
civilian civil defence organizations, respond to an appeal from the competent authorities and
perform civil defence tasks under their control.
3. Buildings and mat‚riel used for civil defence purposes and shelters provided for the civilian
population are covered by Article 52. Objects
used for civil defence purposes may not be destroyed or diverted from their proper use except
by the Party to which they belong.
Article 63 related to Civil defence in occupied territories states:
1. In occupied territories, civilian civil defence organizations shall receive from the authorities
the facilities necessary for the performance of their tasks. In no circumstances shall their
personnel be compelled to perform activities which would interfere with the proper
performance of these tasks. The Occupying Power shall not change the structure or personnel
of such organizations in any way which might jeopardize the efficient performance of their
mission. These organizations shall not be required to give priority to the nationals or interests
of that Power.
2. The Occupying Power shall not compel, coerce or induce civilian civil defense organizations
to perform their tasks in an manner prejudicial to the interests of the civilian population.
3. The Occupying Power may disarm civil defense personnel for reasons of security.
4. The Occupying Power shall neither divert from their proper use nor requisition buildings or
matériel would be harmful to the civilian population.
5. Provided that the general rule in paragraph 4 continues to be observed, the occupying
Power may requisition or divert these resources, subject to the following particular conditions:
(a) That the buildings or mat‚riel are necessary for other needs of the civilian population; and
(b) That the requisition or diversion continues only while such necessity exists.
6. The Occupying Power shall neither divert nor requisition shelters provided for the use of the
civilian population or needed by such population.
Article 81 regulates the activities of the Red Cross and other humanitarian organizations and
states:
1. The Parties to the conflict shall grant to the International Committee of the Red Cross all
facilities within their power so as to enable it to carry out the humanitarian functions assigned
to it by the Conventions and this Protocol in order to ensure protection and assistance to the
victims of conflicts; the International Committee of the Red Cross may also carry out any other
humanitarian activities in favour of these victims, subject to the consent of the Parties to the
conflict concerned.
2. The Parties to the conflict shall grant to their respective Red Cross (Red Crescent, Red Lion
and Sun) organizations the facilities necessary for carrying out their humanitarian activities in favour of the victims of the conflict, in accordance with the provisions of the Conventions and this Protocol and the fundamental principles of the Red Cross as formulated by the International Conferences of the Red Cross.
3. The High Contracting Parties and the Parties to the conflict shall facilitate in every possible
way the assistance which Red Cross (Red Crescent, Red Lion and Sun) organizations and the
League of Red Cross Societies extend to the victims of conflicts in accordance with the
provisions of the Conventions and this Protocol and with the fundamental principles of the Red
Cross as formulated by the International Conferences of the Red Cross.
4. The High Contracting Parties and the Parties to the conflict shall, as far as possible, make
facilities similar to those mentioned in paragraphs 2 and 3 available to the other humanitarian organizations referred to in the Conventions and this Protocol which are duly authorized by the respective Parties to the conflict and which perform their humanitarian activities in accordance with the provisions of the Conventions and this Protocol.
belonging to or used by civil defense organizations if such diversion or requisition 11
The Protocol considered grave violations of the Fourth Geneva Conventions as war crimes in
article 85 (5) which states: “Without prejudice to the application of the Conventions and of this
Protocol, grave breaches of these instruments shall be regarded as war crimes.”
The evidence presented below demonstrates that the Israeli attacks on the Gaza Strip during
the period 27 December – 18 January constitute grave and organized violations of the rule of
IHL in general, and articles related to the work of ambulance teams, medical services, and
The Israeli military offensive against the Gaza Strip – lasting for 23 days – created a
catastrophic humanitarian disaster. It was also a time in which the resilience of the local
population came to the fore. In spite of the death and destruction all around them, the
Palestinians in Gaza struggled to maintain life sustaining services. In the face of grave danger
and continued attacks on civilian infrastructure, Palestinian workers continued to operate
electricity networks, water and sanitation systems and communications systems. Hospitals,
medical services and civil defense teams continued to function and fulfill their humanitarian
duties even under direct fire to which they were not spared despite their status as protected
persons under international humanitarian law. These humanitarian groups were targeted by
the IOF on numerous occasions during the offensive and a number were injured or killed as a
result. In addition, hospitals, clinics, medical equipment and emergency services’ vehicles
were damaged or totally destroyed.
During the air and ground offensive against Gaza, IOF killed 23 emergency workers – medics,
firefighters and sea rescue workers – working in Palestinian medical institutions and the civil
defense, 17 of whom were on duty at the time.
9 Further, 50 emergency workers were injured.
Medical, Emergency and Civil Defense Services in the Gaza Strip
There are five main institutions which provide medical, emergency or civil defense services in
the Gaza Strip:
The Ministry of Health (MoH)
The Palestinian Red Crescent Society (PRCS)
The military medical services
The Civil Defense
All of these services, without exception, came under fire by the Israeli forces during their
offensive against the Gaza Strip. The following section presents human and material losses
inflicted on this sector during the offensive.
Civil Society (non-governmental) medical organizations
3.1. The Palestinian Ministry of Health 10
The Israeli offensive on the Gaza Strip put the Palestinian Ministry of Health to a formidable
test as to the preparedness of its hospitals and medical personnel to deal with the immense
impact of such intense attacks. Not only were medical institutions faced with a scarcity of
equipment and insufficient personnel, but they were directly targeted by Israeli military forces, especially the ministry’s ambulance and emergency teams. and emergency teams were fired upon and shelled on a number of occasions. Three individuals from ambulance and emergency teams were injured whilst on the line of duty and eight ambulances were partly damaged by Israeli forces.
Ministry of Health ambulance 9
Based on Al Mezan field research 10
2009.
Interview with Hani Al Ja’farawi, Director of the Ambulance Department in the Palestinian Ministry of Health in Gaza, 24 January 13
3.2 Civil Defense 11
The Civil Defense is one of the services run by the Palestinian Ministry of Interior. The Civil
Defense responds to fires and undertakes sea rescues and rescues following accidents and
disasters. Israeli forces inflicted severe damage on the Civil Defense which sustained heavy
human and material losses including damage to its vehicles, equipment and premises.
Israeli forces killed 13 people from the civil defense during the offensive, ten of whom
were killed in the line of duty whilst undertaking humanitarian work. The remaining
three were killed off duty by Israeli shelling. Twenty-five individuals were injured, 17
seriously.
Al-Balah district (Az-Zahra Town Center, Deir Al-Balah Center and Al-Bureij Center); one in
Khan Younis district (Abasaan Center) and one in Gaza district (The Sea Rescue Center by
the Fisherman’s port West of Gaza City). Four vehicles were destroyed: two fire engines, a
rescue car and an ambulance. Initial estimated losses of the Civil Defense are USD $2.5
million.
TheIn terms of material losses, five civil defense buildings were damaged: three in Deir
3.3 The Palestinian Red Crescent Society 12
The Palestinian Red Crescent Society provides medical services at all levels. It runs Al- Quds
Hospital, and a number of health centers and ambulance and emergency centers. The PRCS
is officially assigned to provide ambulance services for Palestinian hospitals according to an
agreement between the PRCS and the MoH. The PRCS was heavily targeted by Israeli forces.
During the Israeli offensive, five ambulance and emergency personnel were injured and heavy
material losses were sustained. Israeli forces damaged 14 of its ambulances, including which
were totally destroyed, and two administrative vehicles. Serious damage was inflicted on the
following PRCS premises:
building, comprised of five floors, was bombed and as a result set on fire and burned
entirely. This included administrative offices, a music venue, a theatre, a nursery and a
kindergarten.
The administrative building in Tel Al-Hawa neighborhood, southwest of Gaza City: This
The floor housing the restaurant and breaks room was entirely burned, along with a
part of the medical treatment department, a heritage exhibit, a fitness room, the mental
health office, and the center for PRCS community volunteers.
The cultural building in Tel Al-Hawa: The Israeli forces partly damaged this building.
The warehouse in Tel Al-Hawa: This was totally destroyed.
damage on the ambulance and emergency building in Gaza City in addition to the
ambulance and emergency premises, a carpentry workshop, an aluminum workshop
for the maintenance of facilities and PRCS furniture.
The ambulance and emergency building in Tel Al-Hawa: The IOF inflicted heavy
accommodation section of Al-Quds Hospital in Tel Al-Hawa after leaving it to burn from
shelling. Israeli forces also inflicted partial damage to the hospital pharmacy after
shelling it directly.
Al-Quds Hospital in Tel Al-Hawa: Israeli forces fully destroyed the doctors’
mosque was shelled.
The PRCS Khalil Al-Wazeer Mosque Clinic: This clinic was partly damaged when the 11
27 January 2009.
Source: Dr Mohammed al Ataar, Director of Ambulance and Emergency for the Civil Defense Apparatus in the Gaza Strip 24 – 12
Palestinian Red Crescent Society 25 January 2009.
Interview with Mohammed Abu Mesbeh, Volunteers Director and Coordinator of the Disaster Management Unit in the 14 Initial estimates for material damage inflicted on the Palestinian Red Crescent during the Israeli invasion are around USD $15 million.
Al Quds Hospital Following the Shelling by Tank and White Phosphorus Shells
3.4 Military Medical Services 13
The military medical services are run by the Palestinian Ministry of Interior of the Government in Gaza. Its primary function is to provide health services to the Ministry’s security forces.
Personnel, premises and vehicles of this apparatus were subjected to Israeli attacks during the
military offensive. Nine individuals were killed, and five injured. All of them died on the line of
duty. In addition, four ambulances run by the medical military services were damaged.
3.5 Civil Society (Non-Governmental) Health Organizations
Civil health organizations make a significant contribution to the provision of primary health care in the Gaza Strip. A number of organizations, such as the Union of Health Work Committees, which runs Al-Awda Hospital in the north of the Gaza Strip, also provide secondary health care. This section briefly presents damage sustained by civil organizations working in the field of healthcare, during the Israeli military offensive against the Gaza Strip.
a. Al-Awda Hospital Run by the Union of Health Work Committees
Al-Awda Hospital played a major role in dealing with large numbers of wounded people during the Israeli military offensive. Its ambulances evacuated injured and sick people located in areas which were being invaded and shelled. The hospital and its ambulance teams were fired upon by IOF on numerous occasions during the offensive. Arafah Abdul-Dayim, a 32-year-old medic volunteering at Al Awda Hospital and the PRCS was killed on 4 January 2009 when theambulance he was working in came under direct shelling by Israeli tanks. A further five ambulance drivers and medics from Al Awda Hospital were injured whilst trying to evacuate 13
January 2009.
Meeting with Dr Abd Al Qadir Al Arbeed, Director of Military Medical Services in the Gaza Strip, 25 15 the wounded and retrieve the bodies of victims. Two of the hospital’s ambulances were partly damaged and the car park of the Al Awda Hospital was bombed by IOF targeting a civil police car parked there. The shelling shattered the windows of the hospital, injuring those working there and terrifying the patients. 14
b. The Union of Health Care Committees
Israeli war aircraft directly shelled the Union of Health Care Committees clinic located west of
Gaza City. This clinic was a healthcare center primarily serving the residents of Beach
Refugee Camp. The building also housed administrative offices. Further, the shelling damaged
three mobile clinics (ambulances equipped as field clinics). 15
c. Al-Wafa Hospital for Medical Rehabilitation and Special Injuries
This hospital is the only hospital which provides rehabilitation for complex cases including
severe disabilities which require long-term hospital stays. This hospital, which is located northeast of Gaza City, was directly and deliberately shelled. Despite communications between the International Committee of the Red Cross (ICRC) and the hospital administration in which the ICRC affirmed that the hospital and its buildings would not be fired at by the IOF, the shelling hit overnight rooms directly, from which patients had been evacuated from to another safer location in the hospital a few hours before the shelling. The hospital also sustained serious damanage to its equipment and buildings as a result of later repeated shelling. Injured women brought to Shifa hospital by truck as a result of obstruction of ambulances, many of which were fired at and destroyed during the Israeli offensive. 14
Health Work Committees, 27 January 2009
Meeting with Marwan Abu Naser, Administrative Director of the Al Awda Hospital of the Union of 15
According to field research conducted by Al Mezan 16
4.CoordinationtoEvacuatetheSickandWounded,and
RetrievetheBodiesofVictims
“The shooting went on for around five minutes…So I reversed in the ambulance
and we all withdrew together from the area…. I found out later that the person we
were trying to retrieve was found dead a few days later. Medical teams were not
able to reach him until the Israeli forces had with -drawn….. I heard that the
family of the victim had been ordered to leave the house by the Israeli army and
that the victim had been alive when they left.”
Amer Mohammed Khalil Matar, Ministry of Health ambulance driver
In Article 17, the Fourth Geneva Convention states that, “The Parties to the conflict shall
endeavour to conclude local agreements for the removal from besieged or encircled areas, of
wounded, sick, infirm, and aged persons, children and maternity cases, and for the passage of
ministers of all religions, medical personnel and medical equipment on their way to such
areas.”
These agreements were not respected during the Israeli offensive against the Gaza Strip.
Coordination for the evacuation of the injured and sick was limited to mechanisms utilized
between the Coordination and Liaison Department in the Palestinian Ministry of Health and
Israeli authorities in ordinary times. The ICRC also assisted by coordinating with Israeli
officials in areas of active hostilities.
Coordination mechanisms during the Israeli invasion:
presence of injured or sick people, or the bodies of victims in a particular place.
The Palestinian Department of Coordination and Liaison is informed about the
Israeli authorities to allow relevant medical teams to reach the place of the incident
The Palestinian Department of Coordination and Liaison submits a request to the
was not received for over 24 hours.
The Israeli authorities reject or approve the request. On many occasions the response
about the presence of injured or sick people, or the bodies of casualties in a particular
area and requested that medical teams go to that place.
On some occasions, the Israeli Liaison authorities informed Palestinian counterparts16
Coordination was extremely slow. Often, it took long periods of time of up to one day to secure
coordination, regardless of the urgency of the incident, and the killing and injuring of large
numbers of people on an hourly basis. As a result, many injured and sick people died, or
suffered a serious deterioration in their condition as a result of continuous bleeding. For
example, Israeli delays in coordinating the evacuation of injured members of the Shurab family led to the death of two of them. Three members of this family had been injured after they had been shot at by Israeli forces while on route to their home east of Khan Younis City on 16 January 2009. The father, 64-years-old Mohammed Shurab was with his two sons – 28-yearsold Kasab and 18-year-old Ibrahim. Ibrahim was wounded in the leg and left to bleed from 12.30 in the afternoon of the day he was injured to 10.00 the following morning. Kasab died shortly after being shot in the chest. The Israeli forces refused to coordinate to allow the entry 16
Health, 27 January 2009
Meeting with Rafat Muheisin, Director of Coordination and Liaison in the Palestinian Ministry of 17 of ambulances into the area arguing that the fighting in the area which would expose them to danger. 17
Al Mezan field investigations and the director of Coordination and Liaison at the Palestinian
Ministry of Health confirmed that medical teams were obstructed from their work, and fired at despite having secured coordinated to go to a specific place and evacuate injured or sick
people, or the bodies of victims. Israeli forces justified themselves to the relevant authorities by
arguing that coordination in the field is difficult under conditions of fighting and hostilities. 18
Testimony 1: Ambulance teams with prior coordination
Name: Kayed Abd al Hadi Abd al Qadir abu Owkal
Position: Ambulance driver
I work as an ambulance driver at the Ministry of Health. Since the beginning of the
Israeli military campaign against the Gaza Strip, known as Operation Cast Lead, I was
stationed at Kamal Udwan Hospital located in Beit Lahiya to rescue and evacuate the
people killed and injured. At around 14.30 on the afternoon of Wednesday 7 January
2009, I went in the ambulance by myself to Beit Hanoun (Erez) crossing with prior
coordination. A message reached me from Rafat Muheisin, head of coordination at the
Ministry of Health who received coordination instructions with the necessity of my
attendance in the area of the crossing (Erez) at 15.00 to receive a body from the
Israelis at the crossing itself. I went to the place. But, when I arrived by ambulance at
Al Jamarek area, which is around 1000 meters away from the crossing, I noticed there
was a large bulldozer in the area and that there were high mounds of sandy earth
preventing the ambulance from reaching the crossing. So I called the coordination
official in the Ministry of Health and told him what I had seen. He told me to wait in the
area until he informed me of new instructions. At around 18.00 in the evening of the
same day, the Israeli liaison officer called me and spoke to me in Arabic. He told me
that the ambulance could not reach the crossing and that I had to walk slowly towards
the crossing until I reached it from the northern direction. So I did. I walked until I
arrived at the area of the crossing where the Liaison and Coordination Office for Civil
Affairs is, known as 5/5. The office was empty and I saw the Israeli military vehicles
spreading out east and west from far away. I stopped there. The Israeli officer called
me through the wireless system and said to me: “stay there and don’t move until we
give you the body.” After ten minutes I saw an old man pulling a cart with a body on it
with the help of two Arab porters who work at the crossing. So I said to the officer that
they had arrived. He said to me, “you may take the body.” So I carried the victim’s
body on my shoulders and I began to return towards the ambulance. By chance I saw
some carts for carrying bags by the side of the road. So I put the body of the victim on
it. The porters returned and the old man accompanied me. While walking with the
body towards the ambulance, the old man who was accompanying me told me that
the victim was Ahmed Jaber Abu Huweij, from At-Tuffah area east of Gaza and that
he was a child of 8-years-old, and that the old man accompanying him was his uncle.
He told me that the child was hit by Israeli shelling in the At-Tuffah area a few days 17
Ibid
18 strongly condemns the abandoning of injured people to suffer alone and unable to reach the hospital and the obstruction of ambulances and health care professionals from reaching them. Some injured people died because ambulances were not giventhe necessary permission to reach them in time. We appeal to all parties in the conflict, and especially Israel, to lift restrictions on medical teams so they can save life. We reaffirms that international humanitarian law applies to all relevant parties and imposes a duty to move the injured, care for them and evacuate them without delay or distinction. See ICRC:
See joint ICRC and Red Crescent Statement on the Crisis in Gaza (13 January 2009). Al Mezan Center for Human Rights http://www.icrc.org/web/ara/siteara0.nsf/htmlall/palestine-news-130109?opendocument18 ago and transferred to ‘Stein’ Hospital in Tel Aviv, and that he died later from his injuries. The uncle was taken with the child to accompany him I pulled the cart strongly to move the victim across the sand and sandy barriers that were left by Israeli military vehicles, and continued walking until I reached the ambulance. There, I told the Israeli liaison office that I had arrived at the ambulance; then I went to Shifa hospital. When I
arrived there I did not find space in the morgue refrigerators as they were full of other
bodies. I found a place with difficulty and put the victim’s body there. Then I went back
to Kamal Udwan hospital.
Testimony 2: Ambulance teams with prior coordination
Name: ‘Amer Mohammed Khalil Matar
Position: Ministry of Health ambulance driver
I work as an ambulance driver at the Palestinian Ministry of Health at Kamal Udwan
Hospital north of Gaza. At around 13.30 in the afternoon of Thursday 8 January 2009,
I went to Izbet Abed Rabbo area located east of Jabalya city in the North Gaza district,
on the basis of instructions from coordination officials in the Ministry of Health saying
that there was permission for us to go there with two UNWRA jeeps to evacuate a
man working for UNWRA, Samir Rasheed Mohammed, that was working in the
maintenance department. We were not sure if the man was alive or dead. We were
told that he had been injured a long time before. One of the two UNWRA jeeps was
leading the procession; it was an armored car carrying foreigners wearing protective
clothing. The second vehicle, in the rear of the procession, was carrying a doctor and
Arab employees working at UNWRA. We reached the Zimmo junction at the entrance
to Izbet Abed Rabbo from Salah Ad-Din street at around 13.40 on Thursday afternoon.
After we entered Izbet Abed Rabbo street by around 50 meters – where an
emergency office of the Red Crescent Society is located south of the street – I heard
the sounds of military vehicles in the area but I did not see them. Then, I heard bullets
hit the car in front, the one that was carrying the foreigners, and I saw smoke and
steam coming out of the front of the car despite the fact it was armored. I got down
behind the wheel in the ambulance and my colleague Mohammed Nasaar got down;
we were scared that we would be shot. The shooting went on for around five minutes.
Then I saw the jeep behind me move forward towards the jeep in front, overtaking me.
Then I saw them pulling back. So I went back in the ambulance and we all withdrew
together from the area and parted at Salah Ad-Din street. Then I went back quickly to
Kamal Udwan hospital. There, we checked on the ambulance and found it intact. I
found out later than the person we were trying to retrieve was found dead a few days
later. Medical teams were not able to reach him until the Israeli forces had withdrawn
from Izbet Abed Rabbo on 18 January 2009. I heard that the family of the victim had
been ordered to leave the house by the Israeli army and that the victim had been alive
when they left. 19
5.TheTargetingofMedicalandCivilDefenseTeamsand
PremisesandtheObstructionoftheirWork:AReviewofthe
MainIncidents
5.1 The Targeting of Ambulances, Ambulance Teams and the Civil Defense
On 27 December 2009, Israeli war aircraft shelled the former Civil Administration premises
north of Gaza, damaging a Red Crescent ambulance in the area at the time. Israeli warplanes
launched at least one missile at an ambulance carrying a three person team at around 1.50
am on Wednesday 31 December 2008. The team members were: Dr Ihab Omar Al-Madhoun,
33-years-old, the director of Az-Zaytoun Clinic in Gaza City; the medic Mohammed Sa’eed
Abu Hasira, 30-years-old; and the ambulance driver, Hishmat Ajour, 30-years-old. The medical team was going to the area of Jabal Al-Rais, located north-east of Gaza City as they had received news of killings and injuries in the area. Upon arrival, and as soon as they got out of the car, they were hit by an Israeli missile which killed the Mohammed, the medic,
immediately. Dr Al-Madhoun died later that same morning from his injuries. The driver was
seriously injured and taken to Kamal Udwan hospital north of the Gaza Strip.
At around 9.40 am on Friday 2 January 2009, Israeli warplanes bombed the house of Nazmi
Mhanna, located north-west of Deir Al-Balah city. When the ambulance – belonging to the
Palestinian Red Crescent – arrived at the place of the bombing, Israeli warplanes bombed the
area a second time, thereby injuring the two medics Mazen Sobhi Abu Mesbeh, 26-years-old,
and Awni Khattab, 40-years-old, and damaging the ambulance.
On the morning of 4 January 2009, Israeli warplanes targeted an ambulance belonging to Al
Awda Hospital run by the Union of Health Work Committees which was on the road leading to
Al Atatara area, west of Beit Lahiya. The bombing killed the volunteer medic, Arafah Abdul-
Dayem, 33-years-old, who died of his injuries at around 2pm in the afternoon of the same day.
The attacks also injured a number of ambulance drivers: Khaled Abu Se’da, 40-years-old, was
lightly injured in the head; and the medic Ala’ Osama Serhan, 22-years-old, was seriously
injured. On Sunday 4 January 2009 at around 16.00 in the afternoon, an Israel plane fired one missile at an ambulance on route to rescue an injured person located east of Az-Zaytoun area. The attack killed three medics: Anas Fadal Na’im, 25-years-old; Rafat Abdul-Aal, 25-years-old; and Yasser Kamal Sa’id, 24-years-old.
On Monday 5 January 2009, at around 17.30, Israeli tanks invading Beit Lahiya fired at two
Red Crescent ambulances causing partial damage. The two ambulances were on their way to
evacuate the injured and retrieve the bodies of people killed in Al-Atatara area after arranging
coordination through the ICRC.
On Monday 5 January, Israeli aircraft bombed a Civil Defense team which was trying to
extinguish a fire which broke out as a result of a missile attack aimed at the Union of Health
Care Committees square located behind Shifa residential tower west of Gaza City. No-one
was injured.
At around 20.30 on Saturday 6 January 2009, two Red Crescent ambulances came under fire.
This incident occurred after the Al-Kurd family’s house in Jabalyia was bombed. The
ambulances went to the area after the first attack to evacuate the injured and retrieve the 20
bodies of the victims, but returning warplanes bombed the house a second time which
damaged the two vehicles and shattered the front and back glass windows.
The Red Crescent Society and the ICRC coordinated for the entry of three Red Crescent
medical teams into Al-Israa area west of Beit Lahiya at around 13.45 on Saturday 10 January
2009. After entering the area, Israeli forces fired at an ambulance which was hit with five
bullets.
On Monday 12 January at around 16.17, a reconnaissance aircraft launched a missile at
Hamouda Tower located in Az-Zarqaa area in Jabalya town. While local residents were
attempting to flee in anticipation of the resumption of bombing, the Israeli military launched
several missiles at the tower which resulted in the killing of Ayat Kamal Al-Bana, 18-years-old,
and the injuring of four other residents including two children. When the ambulance arrived to rescue the injured, which was at around 16.22 in the afternoon, another missile hit the fourth floor of the tower, killing one person – Dr Issa Abd Al-Raheem Saleh, 28-years-old and injuring the ambulance driver, Ahmed Abdul-Bari Abu Foul, 25-years-old – as they were trying to retrieve the body of the person killed in the attacks. The shelling of the tower also killed Feryal Kamal Al-Bana, 23-years-old, and Mustafa Jam’a Al-Basha, 20-years-old, and injured five other people.
Testimony 1: Israeli Forces Fire at Ambulance Teams
Testimony from: Khaled Abu Se’da
Position: Ambulance Driver at Al Awda Hospital
At around 22.20 on Sunday 4 January 2009, in response to a telephone call to
evacuate the wounded from an area located near Adawar Al-Gharbi in Beit Lahiya, I
went in an ambulance belonging to Al-Awda Hospital, accompanied by two volunteer
medics – Ala’ Osama Serhan and Arafah Hani Abdul-Ddayim. We were all wearing
ambulance uniforms bearing the distinguishing insignia. As soon as we reached
Addawar Al-Gharbi located east of Al-Atatara area, by the area of Al-Qura Al-Khamisa
which the Israeli occupation forces had invaded, we headed south on Beit Lahiya
West Street. When we arrived at the place, we saw a number of injured people in one
of the streets on the road to the west; the street which leads to Abu Ubaida Ibin Al-
Jarah Secondary School for Boys. Ala’ and Arafah, the medics, got down to move the
wounded people into the ambulance, as there were three injured people in the area,
and I remained behind the wheel of the vehicle, ready to drive to the hospital. The
medics moved the first two injured people into the ambulance, and then they both
went to get the third injured person, as there was no other ambulance in the area to
take him. When they reached the back door of the ambulance, I went to get out of the
car to help them. I was shocked by a powerful explosion hitting the rear of the
ambulance. I fell out of the ambulance with the force of the explosion. After a few
moments, I checked myself and found that I was injured in the head. I got up and went
to the rear of the ambulance to check on my colleagues. I saw my colleague Arafah
kneeling and saying the carried to the ambulance by my colleagues lying on the ground without his head or legs. I did not find my colleague Ala behind the ambulance, and then I heard his voice calling for help. I followed the voice and found him lying in front of the ambulance. I called Al-Awda Hospital and the Red Crescent on my mobile phone requesting help, and during this time my colleague Arafah was bleeding from the chest, hand and right
leg. Ala was bleeding from different parts of his body and complaining about his legs.
Two military medical services ambulances arrived and I began to help the medic carry
shehada19 and I saw the third injured person who was being 19
A religious saying 21 my colleague Arafah to the car. I returned towards the ambulance that I was working in and I found that the injured person in the side seat had been cut into pieces. The injured person who was on the stretcher was alive, and I found that the back door of
the ambulance had been directly hit and it had a hole in it of around 50 cm. I was
taken with Arafah in a medical services ambulance to Al-Awda hospital. He was taken
to the operations room immediately on arrival. At around 13.45, he was pronounced
dead. It found I had been injured lightly, so I went back to work three days later. After
the Israeli forces withdrew from the area, I returned to the place of the incident. I
noticed that the location in which the ambulance had been fired at was visible from the
site where Israeli tanks had been stationed. Because of this, I think that shell that hit
us was the shell of a tank that was watching us; and I think that their crew could see
the ambulance, and the insignia on it and on our clothes, and that they had time and
capability to see the ambulance team attempting to move the injured.
Testimony 2: Israeli Forces Fire at Ambulance Teams
Name: Ahmed Abdul-Bari Al-Abed Abu Foul
Position: Ambulance Driver in Civil Defense and the Red Crescent
My name is Ahmed Abdul-Bari Al-Abed Abu Foul. I am 25-years-old. I work as an
ambulance driver in the Civil Defense and at the Palestinian Red Crescent Society.
During the Israeli war on the Gaza Strip on Monday 12 January 2009, at around
22.30, I received a telephone call from the Palestinian Red Crescent Ambulance and
Emergency Center telling me that I had to go by ambulance to Hamouda Tower
located in Az-Zarqaa area in Jabalya town north of Gaza. It was mentioned that there
were killed and injured civilians inside the tower. I went immediately by a Civil Defense
ambulance that was driven by my colleague Khaled Ayoub. There were a number of
Palestinian Red Crescent Society and military medical services ambulances behind
us. There had been continuous and intense aerial and ground bombardment by
aircraft and invading Israeli tanks since the beginning of the military ground operation.
My colleague reached the tower around ten minutes after we received the information.
As soon as I arrived, I saw a number of civilian cars evacuating the injured from the
tower. Then I went down with my colleague from the ambulances and went into the
tower. I began to check the apartments on each floor to search for injured people until
I reached the fourth floor of the tower where I saw a young man from Al-Basha family
lying on the ground with his body torn to pieces. I picked up the victim and placed him
with difficulty on the stretcher I had brought with me. At that moment, my colleague Dr
Issa Saleh arrived. I asked him to carry the victim with me and take him out of the area
quickly afraid of further bombing from Israeli planes and tanks that were randomly
bombing the area. I lifted from the front and Dr Issa lifted from the back, then we
walked for a little when a civilian arrived to help us. Then, another missile hit the fourth
floor where we were. I heard a powerful explosion; shrapnel scattered and I saw
smoke and dust everywhere. Then I saw Dr Issa lying on ground with his head cut off
and his body torn into pieces. I was injured by shrapnel in my head and feet and I fell
on the ground. I did not lose consciousness. After a short while, a man called
Mahmoud Mohra came and carried me to the ambulance parked by the door of the
tower which took me to the Al-Awda Hospital in Tel Az-Zaatar and I received the
necessary treatment.
Testimony 3: Israeli Forces Fire at Ambulance Teams
Name: Hazim Yehia Badawi Al-Barawi
Position: Ambulance Driver in the Ministry of Interior Medical Services 22
I have worked as an ambulance driver in the Ministry of Interior medical services for
about a year. At around 15.15 on Sunday 4 January 2009, a telephone call was
received from an unknown person saying that there were injured people on Street 10 in
Tel Al-Hawa, west of Gaza City on the stretch of Al-Sina’a Street on the land of the Al-
Dahdouh family. On receipt of the information, two ambulances went towards the place.
My colleague Yahia Hussein, the ambulance driver, was leading the procession, along
with my colleague Anas Fadel Na’im, a medic. I was driving the other car accompanied
by my colleagues Yasser Shbeer and Rafat Abdul-Aal. It took us around ten minutes to
get to the place. It was relatively quiet in the area. Israeli warplanes were in the area of
the city. There were also Israeli tanks in the area of the former settlement ‘Nizarim’
heading west in the direction of the sea. We arrived at the place and went with the two
ambulances into a side street, south of Ahmed Yaseen junction into land owned by the
Quz’aat family. We went west towards the house of the Al-Buradi family at the end of
the street, where we saw a child of around 12-years-old. I later found out that his name
is Omar Al-Burdani. He was standing in the Shammalakh family land and he was
calling in a loud voice to the ambulance team, then he pointed to the location of the
injured people in the Shammalakh land in the south. So, I went with the ambulance I
was driving and the second ambulance was following behind me. Went I got there I
backed up the car to bring its rear towards the injured people to make the task of my
colleagues easier and to make it faster to get to the hospital. My colleagues, Yasser
Shabir and Rafat Abdul-Aal got down, and then my colleague Anas Na’im got down
from the second car. They were carrying stretchers and wearing medical teams;
uniforms (florescent orange) with a medical insignia on the front and back and
phosphorus belt that lights up in the night. Then, my colleague Yahia Hassan, the driver
in the second ambulance, called to tell me that the ambulance he was driving was stuck
in the ground and the wheels were turning in their place. I opened the door of my
ambulance and went to get out, and then I heard the sound of an extremely powerful
explosion behind the ambulance I was driving; I was thrown out of the ambulance
involuntarily. I looked behind it and I saw black smoke and dust rising from the place of
the explosion; I wasn’t able to see for a few moments. I was in a state of panic and
began to call “ away, I saw my medic colleagues who were torn into pieces. I looked at the second ambulance and saw it withdrawing away towards the east, so I called my colleague
Yahia who was driving it. I caught it up after around 40 meters, and another explosion
went off in the place that I had been standing the first time. I got in the ambulance and
while I and my colleague Yahia were leaving the area, I heard the sound of a number of
explosions in the same place. The car that I had got down from was still running with
the emergency lights on, and my colleague and I went back to the ambulance center at
Al Wi’am hospital in Tel Al-Hawa. I told the unit manager, Jamal Abu Silmiya, what had
happened to us, so he immediately called the ICRC and told them what happened. The
ICRC promised to try to retrieve the two bodies of my colleagues. After around an hour,
there was coordination for the Red Crescent ambulances, and so the Red Crescent
ambulances went to get the bodies of my colleagues. I went with some of my
colleagues to wait for them in Shifa Hospital. Around an hour after they left, the Red
Crescent ambulances arrived carrying the body of my colleague Yasser Shbeer, 23-
years-old. My colleague Anas Na’im, 20-years-old was very seriously injured; his chest
was torn apart by shrapnel of the shell launched at us. He died around half an hour
after his arrival at Shifa hospital. The Red Crescent medics were unable to bring the
body of my third colleague, Rafat Abdul-Aal, 20-years-old, because his body was not in
the place. The next day, during the hours of the ‘lull’ at around 14.00 a Red Crescent
ambulance went to bring his body, and the body of the child Omar Al-Burdani, who had
been calling the medical teams to rescue the wounded when we first arrived at the
place. They brought Rafat’s body without a head. The next day some people brought
his head and I learned from them that his head had been around 100 meters away from
his body. shabab, shabab (guys, guys), where are you,” and then about ten meters 23
Testimony 4: Israeli Forces Fire at Ambulance Teams
Name: Hasan Fawzi Sa’id Al Atal
Position: Ambulance Driver at the Red Crescent
I have worked as an ambulance driver at the Palestinian Red Crescent, at the Jabalya
ambulance center for ten years. On Wednesday 7 January 2009, at around 13.00, I
received a telephone call from one of the employees at the Red Crescent ambulance
center saying that someone had been killed in the Zimmo junction area east of Jabalya,
next to the Red Crescent on Izbet Abed Rabbo street. Israeli forces were invading Izbet
Abed Rabbo. I went in the ambulance with my colleague, Fayiz Al-Ajrami. We arrived at
the place around five minutes after being informed. As soon as we arrived, I found the
body of the victim lying on the ground. He was a civilian of around 35-years-old. I don’t
know his name. I knew that Israeli forces were on top of people’s houses and on the
roofs of high buildings in Izbet Abed Rabbo. I and my colleague Fayiz got out of the
ambulance. We picked up the stretcher and went towards the body of the victim who
was lying on the ground towards the east. We picked up the body and put him on the
stretcher; then we walked for around three meters towards the ambulance in a western
direction. Then, the Israeli soldiers began to fire intensely in the direction of me and my
colleague from the roofs of the houses on Izbet Abed Rabbo street as we were carrying
the body and walking towards the ambulance. My colleague and I were wearing
insignia specific to medics (the color orange with the Red Crescent sign on it). Due to
the intensity of the fire, we had to leave the body and run towards the ambulance for
protection. During that time, I felt a severe pain in my left leg. When I checked my leg I
saw blood pouring out of an entry and exit bullet wound. My colleague, Fayiz, took me
to Al-Awda Hospital in Tel Az-Zaatar. 24
5.2. The targeting of hospitals, medical centers and civil defense premises
On 27 December 2009, when Israeli war aircraft bombed the former Preventative Security
premises in Tel Al-Hawa area, the Gaza Ambulance Center nearby was damaged, and three
ambulances parked opposite the premises were destroyed.
On Wednesday 31 December 2008, at around 21.50, Israeli aircraft bombed a charitable clinic
in Qezan An-Najar area, south of Khan Younis city, completely destroying it.
On Monday 5 January 2009, Israeli war aircraft bombed the Union of Health Care Committees located west of Shifa residential tower which is west of Gaza City, damaging the premises and destroying three of its ambulances.
On 6 January 2009 in the early morning, Israeli aircraft bombed the house of Manar Al-Kurdi located in ‘Block 2’ in Jabalya refuge camp. When the ambulance went to the scene, an Israeli warplane fired a second missile at the same house. This caused debris from the house to fly towards the ambulances in the area. One was an Al Awda Hospital ambulance, three were
Red Crescent ambulances, one was a Medical Services ambulance and one was a Civil
Defense ambulance. These vehicles were damaged and the following medics injured: Majdi
Shehada, (48 years), Ibrahim Al-Ajrami, (25 years), Mu’ayid Abu Dgheem, (26 years), Nidal
Ismail Gheith (33 years), Hassan Fawzi Al Attal, (34 years old), Ramadan Mahmoud Husou,
(28 years), Jamal Ibrahim As-Sayid (21 years) and Fawzi Abdul-Sattar Al-Kurdi, (18 years).
At around 19.00 on Wednesday 14 January 2009, Israeli warplanes bombed the Civil Defense
premises in An-Nasser area near Al-Maqqousi towers, north-west of Gaza City. This attack
injured six people.
At around 14.00 on Thursday 15 January 2009, invading Israeli tanks in Tel Al-Hawa area
south of Gaza City fired heavy artillery fire towards Al-Quds hospital run by the Palestinian
Red Crescent Society. This set the hospital pharmacy on fire and burned large parts of the
social center run by the hospital. The hospital administration had to evacuate employees,
patients and injured people and send them to other hospitals. Israeli tanks also shelled the
storage facilities at the ambulance station of the Red Crescent oppose Tel Al-Hawa towers,
this set the warehouse on fire, burning all of its contents.
On 3 January 2009, at around 15.00, Israeli tanks shelled Jabalya ambulance center run by
the Red Crescent society setting it on fire. 25
PRCS Al-Quds Hospital following the shelling by white phosphorus Statements by International Committee of the Red Cross 20
“The only people that can legitimately be attacked are those who participate directly in
the hostilities. Everyone else must be spared. Likewise, essential civilian infrastructure
such as hospitals, the water supply and sewage networks must not be directly attacked.
Respect for the rules of IHL – respect of civilians, distinction between civilians and
combatants, measures of precaution – are of the utmost importance, all the more so
when one considers that Gaza is one of the world’s most densely populated areas. As
the conflict intensifies, it is becoming ever more dangerous for civilians. They must be
spared. Their security is of paramount importance.”
“Many people in Gaza don’t get the emergency medical care they need. Some are even
dying because ambulances can’t reach them in time, which is frankly appalling.”
“It is unacceptable that wounded people receiving treatment in hospitals are put at risk,”
said Jakob Kellenberger, the president of the International Committee of the Red Cross
(ICRC), who just completed a three-day visit to the area that included a stop at Shifa
Hospital in Gaza.
Statement by the Irish Red Cross 21 Condemning the fact that Red Crescent hospitals and warehouses in Gaza have been so severely damaged and its paramedics and other staff prevented from carrying out their life-saving work, Noel Wardick, Head of the International Dept of the Irish Red Cross said: “the situation is completely and utterly unacceptable based on every known standard of international humanitarian law and universal humanitarian principles and values.”
5.3. Israeli Forces Obstruct Civil Defense and Ambulance Teams 20
At around 11.45 on Wednesday 7 January 2009, Israeli forces in Izbet Abed Rabbo opened
fire at a Red Crescent ambulance while it was attempting to evacuate Sameer Rasheed
Mohammed, a 42-years-old UNRWA employee, from inside his house in Izbet Abed Rabbo. At
around 13.30 on Thursday 8 January, a procession including two UNWRA armored vehicles
and a Ministry of Health ambulance went to the area after receiving prior coordination with the Israeli forces. When they reached the area, the procession was heavily fired upon by Israeli forces, which damaged one of the UNWRA vehicles, and the procession left the area without accomplishing its task.
At around 19.40 on Wednesday 7 January 2009, Israeli forces in Izbet Abed Rabbo seized an
ambulance belonging to Al-Falah Association while its driver, Sameeh Atwa Rasheed Ash-
Sheikh, was attempting to rescue a number of injured people from the area. They then
destroyed the ambulance.
On Friday 9 January 2009 in the evening, Israeli artillery shelling in the Al-Mahkama Street
area east of Jabalya set four houses on fire and injured ten of its residents, most of whom
were women and children. When the civil defense and ambulance teams went to the scene,
Israeli forces opened fire at them forcing them to retreat.
Testimony 1: The Obstruction of Medical Teams
Name: Sameeh Atwa Rasheed Ash-Sheikh
Position: Ministry of Health Ambulance Driver
I work as an ambulance driver in the Ministry of Health at Kamal Udwan hospital and I
also work as a driver for ambulances run by Al Falah Charitable Association. I live east
of Izbet Abed Rabbo. I remained on duty during the Israeli operation against the Gaza
Strip, ‘Cast Lead’. Since the start of the Israeli ground operations, I was in my house
and was not able to leave it. I had an Al-Falah Charitable Association ambulance with
me. From the morning of Wednesday 7 January, the area where I live was shelled
dozens of times, and there was continuous shooting. I heard cries for help from some
of my injured neighbors, so I decided to try to reach them with my ambulance and help
them. I went out to get my ambulance which was parked outside the house. I saw
Israeli tanks parked on the main street around 20 meters from my house, opposite the
house from where the cries for help were coming from, where Khaled Abed Rabbo lives
with his extended family. When the soldiers saw me, one of them signaled to me to go
towards them. I was wearing an ambulance uniform and I walked towards him. He told
me to evacuate the residents of my house and to go to tell the neighbors to evacuate. I,
and my family of nine, including my wife and three children, walked towards the Israeli
military vehicles parked north of my house on the main street, Izbet Abed Rabbo (Al-
Quds) street. The time was around 15.00 in the afternoon of the same day
(Wednesday). One of the soldiers signaled to us to go west on the main street, so we
did. When we reached Salah Ad-Din Street located on the main street I saw a tank
parked in front of it. The soldiers stopped me. They ordered me and my male children
to lift up our clothes to the chest area, take off are trousers and stay in our underwear.
Then, one of the soldiers told us to wait on the street opposite to the tank. After around
30 minutes, the soldier allowed us to put our clothes on. There were eight members of
the Badwan and Ayyoub families sitting with us. They told me that members of their
families had been killed and left in their houses. After that, the Israeli officer told us to
go west outside of Izbet Abed Rabbo, so me, my family and our neighbours walked.
While walking I saw three bodies surrounded by tanks, some of whose bodies were
more than half covered in sand. We all walked until we reached Salah Ad-Din main
street by Zimmo junction. This area was safer. After that, my family and I went to the
house of relatives in Jabalya town. After that, I found out that the Israeli forces had
made all of Izbet Abed Rabbo’s residents leave their houses. I didn’t find out what had 27
happened to the ambulance that I had been driving, owned by Al Falah Charitable
Association. On the same day, I learned that the family of my neighbor Khaled Abed
Rabbo had been shot by Israeli soldiers from the tank crew stationed in front of their
house, and that they were requesting help because Khaled’s three girls, and his mother
had been shot, that two of the girls shot had died. Later, Khaled told me that his third
daughter was in Belgium for treatment, and that she was paralysed. Khaled also told
me that the soldiers had ordered his family to leave Izbet Abed Rabbo on foot, and that
he and his relatives had had to carry his injured children and his mother for around two
kilometers, and that when the driver of a horse and cart called Adham had tried to help
them, the Israeli soldiers had shot and killed him and his horse.
Testimony 2: Obstructing medical and coercing medical personnel to provide
information
Name: Marwan Mohammed Abu Reeda, 39-years-old
While I was at work at the ambulance station at Khan Younis hospital, I received
information about an injured woman in Khoza’a town, located east of Khan Younis city,
near to the eastern borders of the Gaza Strip. This was at around 8.15 on the morning
of 13 January 2009. I went to rescue the injured person in my Ministry of Health
ambulance. When I arrived at Khoza’a town east of Khan Younis, I began to hear
shooting and intermittent explosions and I learned from the residents that the area was
under Israeli incursion. I went to the address of the injured person in An-Najar area on
Ezata street; this is the street that crosses with An-Najar street. In the middle of the
road I was shocked by direct fire at my ambulance from one of the houses, which made
me enter a nearby side street which has no exit. I parked the car; the shooting was
continuous. I saw the bullets hit the wall of a house no more than about two meters
away. I stayed on the street and I tried to call the ICRC so they could coordinate to get
me out of the place but to no avail. After around an hour, the shooting in the street
intensified and one of the residents opened his door and called me to go and shelter at
his. So I went quickly to that house and as soon as I got in, the house was intensely
fired at which caused one of the gas pipes in the house to blow up (in the stairwell). I
sheltered with the inhabitants of the house in one of the rooms and I learned from them
that Israeli Special Forces were in a number of the houses in the area. I called the Red
Cross again, more than one time, and they told me they were trying to get coordination
for me. I received a call from someone claiming that he was from Btselem Human
Rights Association. He spoke to me in Arabic and said he wanted to check on my wellbeing,
then he began to ask about the place where I was and details about the house
that I was detained inside of, and I began to explain the area. Then he asked me
whether I was in a building of three floors or the building next to it. I felt that the
questions were strange and thought that he was from the intelligence. Then he said to
me that the Israeli army would blow up the ambulance; then he said that if I told him
about the location of one of the people in the area (the person giving the testimony did
not provide this persons’ name), the army would let me leave the area. I then closed
the phone. After that, I received a number of calls from Israeli cell phones from the
‘orange’ or ‘cellcom’ networks. This is made clear because of the first three numbers of
the number of the caller. Then, a person who claimed to be called ‘Abu Karam’ called
me and spoke to me in the same way and asked me for information. Then I received a
call from a woman claiming to be from an organization whose name I can’t remember
and she spoke to me in the same way. Then I closed the phone and stopped answering
calls from numbers I didn’t know. I remained detained in the house until 20.00 in the
evening when we felt that the Israeli forces had withdrawn from the area, and we
confirmed that from calling one of the neighbors. When I went out of the house to
rescue the injured woman that I had come to this area because of in the first place, I
got into the ambulance and went to hers quickly. When I arrived, the woman was no 28
longer alive. She had died after being short in the head, and her body had begun to
swell. I picked her up and took her to the ambulance and from there we went to Nasser
Hospital in Khan Younis where they confirmed her death.
As well as targeting ambulance and civil defense teams and obstructing their work, the Israeli
forces tried to crush the spirit of community solidarity. On more than one occasion, they
deliberately targeted civilians who were trying to help their injured neighbours and family
members. Even though international humanitarian law states clearly in Article 17 of the
Protocol I that, “The civilian population shall respect the wounded, sick and shipwrecked, even if they belong to the adverse Party, and shall commit no act of violence against them. The
civilian population and aid societies, such as national Red Cross (Red Crescent, Red Lion and
Sun) Societies, shall be permitted, even on their own initiative, to collect and care for the
wounded, sick and shipwrecked, even in invaded or occupied areas. No one shall be harmed,
prosecuted, convicted or punished for such humanitarian acts.”
The following incident illustrates the extent to which IHL was disregarded by the Israeli forces.
They deliberately killed a man and his son who were trying to save an injured person and then
returned and killed the man’s wife and another woman trying to save the man and son.
Killing civilians attempting to rescue the wounded.
At around 2.00 in the morning of Sunday 11 January 2009, an Israeli reconnaissance
aircraft launched a missile at a group of civilians that were next to a residential
building in the Al-Karama towers area, killing one young man, Ibrahim ‘Ayish
Sulaiman, 25-years-old. When the residents of the building tried to help the injured
person, the aircraft fired another missile in their direction which killed Ala’ Fat’hi
Basheer, 40-years-old and his son, Suheib 18-years-old. In a second attempt to
rescue the wounded and killed, the aircraft launched a third missile killing Lamia’
Hassan Basheer, 40-years-old – the wife of Ala Basheer and the mother of Suhaib
Basheer. In addition, Jamila Hassan Ziyada, an elderly woman of 75-years-old was
killed with her, and four others were injured in the attacks. 29
Conclusions
The evidence presented in this report demonstrates clearly that Israeli forces systematically
and deliberately targeted medical teams, ambulances, the civil defense and medical centers
during its offensive, ‘Operation Cast Lead’ against the Gaza Strip which took place 27
December 2008 – 18 January 2009. The evidence presented is based on comprehensive field
investigations, witness testimonies and statements from local and international officials.
That Israeli forces opened fire on ambulances and ambulance crews that were attempting to
evacuate the wounded from areas under fire is indisputable. This resulted in the killing of 17
and injuring of 50 emergency personnel on the line of duty. Large numbers of the sick and
injured died as a result of the obstruction by Israeli forces of evacuation operations, with many of the injured left alone to bleed to death.
Israeli forces also opened fire on members of the civil defense as they were attempting to
extinguish the fires ignited by Israeli bombing and shelling, and in particular the widespread
use of the highly flammable white phosphorous shells.
These violations constitute deliberate and systematic violations of the rules of international
humanitarian law applicable during times of armed conflict. In particular, Israeli actions
constitute grave breaches of the Fourth Geneva Convention Relative to the Protection of
Civilians in Time of War, as well as the First Additional Protocol to the Fourth Geneva
Convention signed 12 August 1949 Relative to the Protection of Victims of International Armed
Conflicts which is considered a completion of the four Geneva Conventions, including the
Fourth Geneva Convention.
In articles 15, 16, 17, 18, 19, 20, 21, 38 and 63, the Fourth Geneva Convention accords
special protection to the organization of health care services and the work of hospitals, and of
the necessity to respect and protect those searching for civilians, injured, sick people,
maternity cases and the elderly. Protocol I affirms the protection of individuals working in the
medical services, the civil defense, and the enabling of the International Committee of the Red
Cross and other humanitarian organizations to undertake their work, and the role of civilians
and humanitarian organizations to save the injured and sick, and protect them. This comes in
articles 15, 16, 17, 61, 62, 63, 80 and 81 of the Protocol.
While preventing relief teams from reaching the sick and injured, Israeli forces also failed to
undertake their duty to provide medical care and relief to them. Thus, in the full knowledge of
the Israeli forces, sick and injured civilians were left without care for long periods of time.
In a context of continued international silence on these crimes, Al Mezan Center for Human
Rights calls for immediate and effective action from the international community:
To the High Contracting Parties to the Fourth Geneva Convention:
Gaza Strip and ensure the State of Israel respects its obligations under the Fourth
Geneva Convention Relative to the Protection of Civilians in Time of War
Take immediate and effective action to halt Israeli war crimes against civilians in the
party disregards its obligations under the Fourth Geneva Convention
Al Mezan Center for Human Rights emphasizes that the High Contracting Parties must take
effective and immediate action to halt, prevent, and punish Israeli war crimes, and protect
civilians.
Convene an urgent conference to examine measures that must be taken when a state 30
To the International Committee of the Red Cross
related to the targeting of medical teams and ambulances, and the obstruction of such
teams from their humanitarian work according to the Fourth Geneva Convention and
agreements signed between the ICRC and Israel
Take action to follow up on crimes perpetrated by Israeli forces and especially those
during the Israeli invasion
Issue a report on the targeting of medical teams and the obstruction of their work
To the United Nations, including the General Assembly, the Human Rights Council and
the Committees of the Human Rights Treaties
all necessary measures to hold to account those who: conducted deliberate attacks on
medical teams; ordered attacks on medical teams; prevented medical teams from
reaching the injured or sick, resulting in their deaths
Al Mezan Center for Human Rights also emphasizes that ambulance, emergency and civil
defense teams must be provided with higher levels of protective equipment whilst on the line
of duty in dangerous areas, such as flak jackets and protective helmets, as well as armored
ambulances for highly dangerous areas.
In addition, destroyed premises, equipment and emergency vehicles destroyed by the Israeli
forces must be urgency replaced.
Undertake serious efforts to investigate Israeli violations of international law, and take 31
