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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 civilian sites are used for military purposes. Hospitals have a special level of protection under international law, given that they are places of sanctuary. That is also why international law specifically requires that hospitals not be used to shield military objectives from attack. The U.S. Department of Defense law of war manual states that 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 in Iraq, Islamic State, and Hamas, who historically 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. In almost every hospital the IDF has arrived at in Gaza, it has uncovered (and published) military use by Hamas. The terrorist group purposefully and systematically developed a strategy to use Gaza's hospitals for military purposes. It exploits the laws of war and public sensitivity to hamper the IDF's actions and invite international condemnation. Israel has documented Hamas use of Al-Shifa Hospital, Sheikh Hamad Hospital, Al-Quds Hospital, the Indonesian Hospital, Al-Rantisi Hospital, Kamal Adwan Hospital and Al-Nasser Hospital. When interacting with hospitals, the IDF has provided warning before acting, facilitated evacuation of patients and hospital staff, provided its own supplies to the hospital, and helped provide alternative medical facilities. It has sent doctors, Arabic speakers, and other specially trained staff to assist hospital staff and patients. Most importantly, Israel has refrained from attacking hospitals from the air, even where it would be lawful to do so. It is telling that the International Committee of the Red Cross, World Health Organization, and UN have made public statements condemning Israel for searching hospitals and never condemn Hamas for using the hospitals in the first place. This sends a message to all terrorists that the use of hospitals is an effective, albeit illegal, military strategy. The writer is chair of urban warfare studies at the Modern War Institute at West Point.