The evidence is overwhelming and incriminating. Hamas systematically exploited Al-Shifa Hospital and other medical centers in Gaza for command and control centers, terror tunnels, weapons storage, hiding kidnapped hostages, and murdering kidnapped hostages.
The newly released videos are disturbing, but they are not surprising. For nearly fifteen years, Israeli and American officials have publicly acknowledged the existence of Hamas’ headquarters under Al-Shifa Hospital, and the international media has reported on the active presence of Hamas in hospitals, including during rounds of armed conflict.
However, there is one network that has constantly denied Hamas’ exploitation of Al-Shifa and other hospitals in Gaza — the influential community of ostensible human rights NGOs, humanitarian aid organizations, and their UN agency partners. Many of these groups have been actively complicit in covering up the diversion of aid by Hamas. Some of them employ Hamas and other terror operatives. At the same time, these groups have disseminated disinformation regarding Israeli operations and have likely lied to government donors in auditing and oversight processes. As documented below, the NGO strategy of denial and extensive obfuscation has continued and increased during the current Gaza conflict, despite the evidence.
Most troubling, as suggested by the videos of Hamas terrorists openly bringing hostages and captured military vehicles into Al-Shifa’s grounds, it seems likely that NGO officials – particularly those connected to self-declared humanitarian NGOs – had firsthand knowledge of Hamas’ illegal use of Al-Shifa, but remained silent. If this is proven, the NGOs bear responsibility for failing to report on these blatant violations of international law, human rights norms, and medical ethics. Any medical staff involved in covering up these activities could also face civil and criminal liability in both domestic and international courts. Donor governments to these NGOs and UN agencies must launch immediate investigations.
Relevant International Law
Contrary to the claims of many NGOs, hospitals and other medical facilities lose their civilian status if “they are used by a party to the conflict to commit, outside their humanitarian functions, an ‘act harmful to the enemy’.” Examples provided by the International Committee for the Red Cross include “a hospital  used as a base from which to launch an attack; as an observation post to transmit information of military value; as a weapons depot; as a center for liaison with fighting troops; or as a shelter for able-bodied combatants.”
Statements from NGOs
Médecins Sans Frontières (MSF, Doctors Without Borders)
MSF repeatedly denied that Hamas was present in Gaza hospitals, with an official claiming that “we have seen no evidence that the hospital buildings or the compounds are being used by Hamas as a military base.”
Human Rights Watch (HRW)
On November 14, HRW published a statement referring to “Unlawful Israeli Hospital Strikes” and stating that Israel’s claims that “Hamas uses hospitals as terror infrastructures” were “contested.” According to HRW, “Human Rights Watch has not been able to corroborate them, nor seen any information that would justify attacks on Gaza hospitals.” (Notably, the same statement repeated, without any caveat, claims from Palestinians who communicated with HRW “by phone.”)
On November 14, an Amnesty tweet suggested that Israel could not attack Hamas installations even if they were “near hospitals”: “Hospitals and medics must be protected at all times. No one should be conducting hostilities near hospitals or endangering the lives of the sick and wounded, or the doctors and nurses desperately trying to save lives in nightmarish conditions.”
On November 10, Oxfam published a statement, completely ignoring Hamas operations in hospitals and misrepresenting the relevant provisions of international law: “Attacks on hospitals packed with civilians in need of urgent treatment and seeking shelter are abhorrent and can never be justified….Indiscriminately firing on civilians in hospitals is not just a war crime, it’s an assault on humanity” (emphases added).
Norwegian Refugee Council (NRC)
On November 11, NRC published a statement claiming, “We are horrified by reports of relentless attacks on Gaza’s hospitals…. It is an affront to wage war around and on hospitals….The harm to patients besieged in hospitals and the lasting effects of depriving the population of major medical facilities in a time of armed conflict may very well be unlawful. Medical facilities and personnel exclusively engaged in the treatment of the sick and wounded have special protection under international humanitarian law that must be respected in all circumstances. Failure to do so amounts to a grave breach of international humanitarian law.”
Save the Children
On November 10, Save the Children published a statement, “Hospitals and schools cannot be battlegrounds, and children cannot be targets. Yet in Gaza all three are attacked on a daily basis.…The continued, systematic assaults must end. Even during wartime, basic elements of humanity must prevail.”
Al-Haq, Al Mezan, Palestinian Center for Human Rights (PCHR) (Donors include Sweden, Spain, Switzerland, EU, Norway, Netherlands, France, Denmark, UN agencies)
On November 2, 2023, Al-Haq, Al Mezan, and PCHR published a statement, “Gaza Hospitals Are Collapsing and Can Be Targeted Anytime: The International Community Must Intervene and Stop More Israeli Massacres of Palestinian Civilians.” In it, the NGOs alleged that “on 27 October 2023, the spokesperson for the Israeli army incited for the targeting of the Al-Shifa Hospital. The pretext for this claim is the alleged presence of tunnels beneath it, a claim repeatedly made by Israel that has not been substantiated with any reliable evidence. Al Mezan, Al-Haq, and PCHR express concerns that this could be a prelude to justify the potential targeting of the hospital, as seen in previous incidents, potentially leading to thousands of civilian casualties.”
Bisan (Donors include EU, Spain, Belgium, Germany)
On November 16, 2023, Bisan published, “Urgent Appeal to Protect Al-Shifa hospital and All Healthcare Facilities.” According to Bisan’s misstatement of international law, “…In times of war, the targeting or neglect of healthcare facilities not only violates international humanitarian law but also erodes the fundamental principles that form the backbone of our shared humanity…The deliberate targeting of hospitals is a blatant violation of these agreements and represents a reprehensible departure from International law and International humanitarian law.”
Palestinian NGO Network (PNGO) (Donors include EU, Italy, Switzerland)
On November 16, 2023, PNGO alleged that “What happened in Al-Shifaa medical complex goes beyond a flagrant transgression and is an absolute war crime.” According to PNGO, “The violent war against the Palestinian people, and specifically the Gaza Strip is continuing…the barbaric attack on the Al-Shifaa complex in Gaza City…under baseless excuses and pretexts…”
On November 15, in response to a report of IDF finding weapons in Al Shifa hospital, Director of Caabu Chris Doyle tweeted, “Did anyone think there was ever going to a world in which the Israeli army did not say this? It all is possible for sure, Hamas may well have done, but any ‘evidence’ would have to be properly verified. Earlier Israeli efforts were far from conclusive.”