A man stands next to a damaged ambulance and a car at the site of an overnight Israeli airstrike in Hebbarieh near the Israeli border on March 27, 2024. (Credit: Rabih Daher/AFP)
BEIRUT — Repeated attacks on paramedics, hospitals and medical centers in Lebanon are "apparent war crimes," says Human Rights Watch (HRW), as it warned on Wednesday that the attacks on health workers have growing parallels to Gaza.
A new report published by the international rights group found three cases in which it was able to determine that Israeli forces had "unlawfully struck medical personnel, transports, and facilities, including paramedics" in Lebanon.
Medical personnel and health facilities are protected under International Humanitarian Law and can only be considered a military target if used to commit 'acts harmful to the enemy.'
"In none of the cases we investigated did we find that to be the case," Lebanon researcher for Human Rights Watch Ramzi Kaiss told L'Orient Today.
Israeli strikes killed at least 163 health and rescue workers across Lebanon over the past year, with 158 ambulances and 55 hospitals damaged, according to the latest figures published by Lebanon’s Health Ministry on Oct. 25. In Gaza, over 500 healthcare workers have been killed by Israeli bombardments, since Oct. 7, 2024, according to the United Nations.
The majority of health workers killed in Lebanon died in the last month and a half, following Israel's drastic escalation of the war. "This is extremely concerning," Kaiss said. "We spoke to a member of the Islamic Health Committee who told us that since since October 2023, they have lost 70 paramedics, but 60 of those were killed in the weeks of mid-September to October."
The building damaged by an Israeli airstrike in the Bachoura neighborhood of Beirut on October 3, 2024. (Credit: Ibrahim AMRO / AFP)
Bashoura: Strike on health center
The first of three cases that the HRW investigated was an overnight Israeli strike that hit a Civil Defense center belonging to the Hezbollah-affiliated Islamic Health Committee on Oct. 3 in the Bashoura neighborhood, two kilometers away from Downtown Beirut. The center, located on the third floor of a residential building, was providing rescue and first aid services to residents in Beirut as well as displaced people.
HRW says the damage indicated that at least two munitions had detonated in the committee's offices.
Seven of the nine people killed were part of the Islamic Health Committee, who had reportedly been resting in the center after a day of rescue work in Beirut’s southern suburbs.
"Medical workers, regardless of their affiliation, are specially protected under international humanitarian law and they cannot be targeted unless they are are being used to commit 'acts harmful to the enemy,'" Ramzi told L'Orient Today. HRW's report also casts doubt on suggestions circulating on social media that two of those dead were members of Hezbollah, saying it could not find sufficient evidence to confirm this.
Marjayoun: Strike on paramedics
Just 24 hours later, on Oct. 4, seven Islamic Health Committee paramedics were killed “in a direct attack on the ambulance crew" at the Marjayoun government hospital in southern Lebanon, according to the organization.
Though the Lebanese Civil Defense is present, the Islamic Health Committee and the Amal Movement's al-Rissala Scouts serve as the primary emergency services in the South.
The emergency room's head nurse, Shoshan Hassan Mazraani, told HRW that the strike was “directly on the ambulances" as they were approaching the hospital.
HRW cross-analyzed a photo taken on Oct. 4 showing a burned ambulance with satellite imagery from Oct. 11 of the area around Marjayoun Hospital showing the burned vehicle.
"The Israeli military did not publicly provide any evidence that Marjayoun hospital or the ambulances targeted near the entrance were being used to carry out hostile acts" such as using ambulances to transport weapons and fighters, the report states.
Since these strikes, the hospital has been closed. Prime Minister Najib Mikati condemned the strike, which he said "violates international law and established humanitarian norms."
Bint Jbeil: Strike on Salah Ghandour Hospital
On the same day of Oct. 4, nine hospital workers were injured, including doctors and medical workers, when a Israeli strike hit Salah Ghandour Hospital in Bint Jbeil, southern Lebanon. One shell struck the on-call room, the other two pounded the paramedics' waiting room, HRW found.
Salah Ghandour Hospital, Bint Jbeil (Credit: Facebook / Salah Ghandour Hospital)
"We found that an evacuation warning was given to the hospital through local officials," Kaiss explains. "People told us that Israeli officials said they had four hours to evacuate paramedics, but the hospital was subsequently attacked 2.5 hours later, injuring hospital workers and causing significant damage ... which resulted in the hospital shutting down."
The next day, the Israeli military issued a statement that its Air Force aircraft had attacked “Hezbollah terrorists who were operating within a command center that was located inside a mosque adjacent to the Salah Ghandour Hospital.” HRW says the Israeli military did not provide public evidence that either the hospital or the mosque were being used to commit hostile acts.
International law
Under International Humanitarian Law (IHL), medical personnel carrying out medical duties "must be respected and protected in all circumstances."
Additionally, under the Statute of the International Criminal Court, “intentionally directing attacks" against medical personnel constitutes a "war crime" in international armed conflicts.
Israel did not respond to HRW's request for comment. However, in a previous comment to The Guardian, it claimed that its forces operate "in strict accordance with international law [and] take all feasible precautions in order to mitigate harm to civilians during operational activity.”
Wider impact of strikes on Lebanon's healthcare system
Another major concern stated in HRW's report is the wider impact Israeli strikes are having on Lebanon's healthcare system.
A recent World Health Organization report found that 100 out of 207 primary health care centers and dispensaries in conflict-affected areas in Lebanon are now closed, either due to evacuations, structural damage or their proximity to bombardments.
"One director of a hospital in the South told us they were forced to shut down the operations of the hospital because they were receiving evacuation warnings; but also because they had been unable to get medical supplies — fuel and water — to the hospital," Kaiss said.
"The impact is not just on health workers and medical facilities, but also on the rest of the civilian population and their ability to access needed medical care. And this is why these strikes and the targeting of medical workers, hospitals and medical transports are very dangerous because they also impact the larger civilian population."
Calls for accountability
HRW has called for the Israeli military to "immediately halt unlawful attacks on medical workers and healthcare facilities". It is also calling for Israel’s allies to suspend the transfer of arms to Israel.
'What we have seen over the last year is documentation of IHL violations and war crimes but not enough action taken by states who have influence on Israel to get it to change its behaviors and respect the laws of war," Kaiss said.
HRW has urged the U.N and member countries to "establish an international investigation into the recent hostilities in Lebanon and northern Israel."
Alongside the loss of medical workers, the last year has been the deadliest period for journalists in more than 30 years, CPJ has said, with at least 126 reporters and media workers among the nearly 45,000 people killed in Gaza, the Israeli-occupied West Bank and Lebanon, according to Reuters. In Lebanon, 1.4 million people have been displaced since the end of September.