Nearly 230 health workers have been killed in Lebanon since the start of the war in Lebanon, most of them since the Israeli escalation on Sept. 23, the World Health Organization (WHO) reported on Friday.

In total, the U.N. health agency said there had been 187 attacks on healthcare in Lebanon in the more than 13 months of cross-border fire between Israel and Hezbollah over the Gaza war.

Between Oct. 7, 2023 and Nov. 18 this year, "we have 226 deaths and 199 injuries in total," Abdinasir Abubakar, the WHO representative in Lebanon, stated.

He added that "almost 70 percent" of these had occurred since the escalation into all-out war in September.

"This is an extremely worrying pattern," he stressed, "depriving civilians of access to lifesaving care and targeting health providers is a breach of international humanitarian law."

WHO added in a statement that the data came from its system for monitoring attacks on health services worldwide.

In the wake of the Oct. 7 attack on Israel that triggered last year's war in Gaza, and in support of Hamas, Hezbollah opened a front against Israel. On Sept. 23, the Israeli army launched an escalatory bombing campaign across the country, followed by a ground offensive on Sept. 30. 

More ambulances hit in Lebanon

Since the start of the war, 47% of attacks on healthcare in Lebanon have resulted in the death of at least one patient or healthcare worker, according to the WHO, "the highest percentage of any active conflict today."

Abubakar explained that this high percentage of fatalities may be linked to the fact that Israel has targeted "more ambulances" in Lebanon. 

"And whenever the ambulance is targeted, actually, then you will have three, four or five paramedics ... killed."

By comparison, the global average is 13.3%, according to data from the Health Services Attack Surveillance System from 13 countries or territories reporting attacks between Oct. 7, 2023 and Nov. 18, 2024, including Ukraine, Sudan and the Occupied Palestinian Territories.

"Failure to comply with international law must have consequences, and the principles of precaution, distinction and proportionality must always be respected," WHO Regional Director for the Eastern Mediterranean, Dr. Hanan Balkhy, said in the statement.

"Indiscriminate attacks on healthcare are a violation of human rights and international law that cannot become the new norm, not in Gaza, not in Lebanon, not anywhere else," she asserted.

According to the WHO, the Lebanese healthcare system is currently facing "extreme constraints," with 15 out of 153 hospitals having ceased operations or only partially functioning.

"Beyond the loss of life, the death of health workers is a loss of years of investment and a crucial resource to a fragile country going forward," concluded Balkhy.