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Hospitals Are Protected under International Law. But They Cannot Be "Off Limits"
(Newsweek) John Spencer - As a basic principle of the international law of armed conflict - as well as basic humanity - attacks against civilian sites are prohibited, unless those sites are used for military purposes. According to the U.S. Department of Defense law of war manual, if a hospital is used for "interference, direct or indirect, in military operations, such as the use of a hospital as a shelter for able-bodied combatants or fugitives, as an arms or ammunition store, as a military observation post, or as a center for liaison with combat forces," such uses can lead to a hospital losing its protected status. Because of all the special protections surrounding hospitals, they have increasingly been used for military purposes by combatants such as al-Qaeda, Islamic State, and especially Hamas, who do not follow the laws of war and intentionally shield themselves behind protected objects and groups. As a result, the U.S. and many other countries have recently had to conduct operations against enemy forces in hospitals. While the U.S. encountered only sporadic use of hospitals in Afghanistan and Iraq, in Gaza, in almost every hospital the IDF has arrived at, it has uncovered and published military use by Hamas, which purposefully and systematically developed a strategy to use Gaza's hospitals for military purposes. Hamas exploits the laws of war and public sensitivity to both hamper the IDF's actions and invite international condemnation. In Gaza's largest medical complex, the Al-Shifa hospital, the IDF found weapons, ammunition, and equipment in many of the buildings, as well as a large Hamas tunnel with a full command and control architecture utilizing the hospital's power sources that had been constructed purposely under the hospital grounds. Hamas military activity was also documented at Sheikh Hamad hospital, Al-Quds hospital, Indonesian hospital, Al-Rantisi hospital, Kamal Adwan hospital, and Al-Nasser hospital. To date, Israel has followed the rules when interacting with hospitals. It has provided warning before acting, and has gone beyond the requirements of the law. It has facilitated evacuation, provided its own supplies to the hospital, and helped provide alternative medical facilities until the ones being searched can restore full activities. Israel has refrained from attacking hospitals from the air, even where it would be lawful to do so, and has left hospitals as quickly as possible, allowing them to resume full operations. The writer is chair of urban warfare studies at the Modern War Institute at West Point.