Why Israeli forces are raiding Gaza’s Al-Shifa hospital – again

(CNN) — Israeli forces last week launched another military operation on Gaza’s largest hospital, Al-Shifa, bringing the sprawling medical facility north of the enclave back into the spotlight.

Now in its 11th day, the operation is the second of its kind at the hospital, which sits in the western part of northern Gaza City. The Israel Defense Forces (IDF) first raided Al-Shifa in November, an operation in which the facility’s main building was heavily damaged and effectively ceased to function.

The raid also comes despite the IDF in January claiming it had completed dismantling Hamas’ command structure in northern Gaza.

While the IDF said civilians, patients, and medical teams were evacuated during the operation, Palestinians inside Al-Shifa and around it have reported civilian casualties and arrests, as well as large-scale destruction at the complex.

Heavy fighting around the hospital has also been reported by Israel, Hamas and civilians, with United Nations officials saying hospitals must not be battlegrounds.

Here’s what we know:

Why are the Israeli forces raiding Al-Shifa again?

Israeli forces began their most recent operation there on March 18, saying they are conducting “precise operational activities against terrorists” located at Al-Shifa – a statement also echoed in November’s raid.

The IDF had returned in force to Al-Shifa despite Israeli Defense Minister Yoav Gallant in January announcing that the most intensive phase of operations in northern Gaza was complete.

Speaking to his troops in a video shared by the Defense Ministry, Gallant on March 26 hailed the operation, saying the hospital was reached “in a flash” and that Hamas operatives still holed up at the hospital “are considering their future: surrender or death.”

Throughout its 11-day operation, the Israeli military this month said it had detained hundreds of Hamas and Islamic Jihad militants in and around the hospital, killing dozens of others.

Around Al-Shifa, the IDF said in an update Wednesday, “approximately 200 terrorists have been eliminated in the area of the hospital since the beginning of the activity.” The IDF also claimed that “terrorists fired at IDF troops from within and outside of the ER (emergency room) building at the Shifa Hospital.”

CNN is unable to verify these numbers.

Israel has for years claimed that Hamas fighters are sheltering in mosques, hospitals and other civilian places to avoid Israeli attacks. Hamas has repeatedly denied the claims.

Israeli officials have echoed the accusations since October 7, and following their first raid in November escorted CNN into Gaza to see a newly exposed tunnel shaft discovered at the compound of Al-Shifa Hospital.

The evidence did not establish without a doubt that there was a Hamas command center underneath the hospital as Israel had claimed.

What are Palestinians saying?

Some 3,000 people were sheltering in Al-Shifa at the time of the recent raid, the ministry of health in Gaza said, adding that those attempting to leave were being targeted by snipers and fire from helicopters.

Hamas accused Israel of striking targets “without regard” to the patients or medical staff inside – a claim echoed by people at the complex.

Hundreds of those sheltering remained stranded inside the hospital for days — with little food or water — and warned by the Israeli military that they would be shot if they left the hospital without first receiving instructions to evacuate.

Eyewitnesses said medical personnel and other civilians were detained by Israeli troops.

Residents of the area around Al-Shifa told CNN there was heavy firing in the vicinity. One family said their home was shelled, and that children – some still alive – were buried under the rubble.

Targeting hospitals in wartime is prohibited under international law, but those standards change if enemy combatants are using the facility to attack an enemy.

One eyewitness said that, on the eve of the raid, they spotted hundreds of Hamas and Islamic Jihad members inside the hospital.

The eyewitness, who spoke to CNN on condition of anonymity for fear of reprisals, estimated about 400 to 500 Hamas and Islamic Jihad members and their families arrived at the hospital in mid-March. Some of them appeared to be members of Hamas’ political branch, while others were armed militants.

The eyewitness said some of the militants were carrying guns inside the hospital.

CNN is unable to independently verify the numbers due to lack of reporting access to the strip, and has asked the Gaza health ministry for comment.

Allegations of torture and abuse

More traumatic accounts have since emerged from people who have recently escaped Al-Shifa or are still trapped there.

A Palestinian paramedic who was detained by the Israeli military for three days at Al-Shifa claims he was stripped naked and left outside in the cold, an assertion made by other men who have been released from the area. He says he was also beaten and prevented from using the bathroom.

Mohammad Al Shawwa, in his 30s, told CNN he and his family were sheltering inside the hospital when they awoke to the sound of drones, bulldozers and heavy gunfire on March 18, as the Israeli military raided the complex.

“The army came to us and forced us out one by one. They stripped us naked and seated us in the yard. It was raining and unbelievably cold,” Al Shawwa told CNN, speaking in the courtyard of the nearby Al Ahli Baptist Hospital, on Thursday.

“They tied our hands and blindfolded us. They humiliated us and beat us,” Al Shawwa, in his 30s, alleged. “They bulldozed the cemetery in the yard and dug up all the graves, all the dead bodies of the martyrs were dug up.”

Al Shawwa claims that the IDF eventually told him to leave Al-Shifa, and he walked for two kilometers to Al Ahli Baptist Hospital, east of Gaza City. “I ran away with other guys between the vehicles, partly blindfolded and tied,” the paramedic said. CNN has previously asked the IDF about the movement of displaced people to Al Ahli Baptist Hospital.

Al Shawwa says he was forced to leave his relatives behind. He says the fate of his mother, a cancer patient, sister, wife and son is unknown – after the family was separated during their detention. He is especially worried about his father, aged 60, who, he says, “was taken by the army.” “I don’t know if they are alive or dead,” he told CNN. CNN has asked the IDF about Al Shawwa’s claims of mistreatment.

Meanwhile a doctor who cared for patients trapped inside Al-Shifa told CNN he fears two severely malnourished siblings will not survive due to lack of care and medication.

Dr Ali Alghaliz, an emergency doctor, treated Rafiq Dughmosh, 15, and his sister, Rafif Dughmosh, 13, at Al-Shifa Hospital, before the Israeli military laid siege to the complex on March 18. Alghaliz was not at the hospital when the raid began.

Both siblings had limbs amputated after surviving an Israeli airstrike on their home which killed their mother and 10 other relatives, according to the UK-based NGO Medical Aid for Palestinians (MAP). The IDF forced their uncle, Mahmoud, to evacuate the hospital, added MAP. They have been left without a guardian inside the hospital, said Alghaliz.

Alghaliz told CNN that he spoke to Rafiq on the phone on Monday night. The two children have been left without food, medication or wound dressing for more than one week, Alghaliz said in written messages on Wednesday and Thursday.

“Rafiq was crying,” added Alghaliz, after developing bed sores because of the lack of care and dressing. “I hope he will not be dead by the end of this siege. I have fears that he might get septic shock that will end his life.”

The Palestinian boy “feels desperate,” he said. “He told me, ‘Now look at me Dr Ali, the bed sores are getting worse, the bad odor is coming from the sores, and from my amputated limbs… I feel I’m going to die.’”

Alghaliz said he hopes both siblings will be evacuated. “I couldn’t hold my tears when he spoke to me, but what can I do?”

What is the international community saying?

World Health Organization (WHO) Director General Tedros Adhanom Ghebreyesus condemned the raid, saying “hospitals should never be battlegrounds.”

“We are terribly worried about the situation at Al-Shifa Hospital in northern #Gaza, which is endangering health workers, patients and civilians,” Ghebreyesus wrote March 18 on X. He also called for the protection of hospitals and a cessation of hostilities.

WHO and other humanitarian groups had been warning of an ever-nearing famine in northern Gaza.

Israel’s closest ally, the US, has repeatedly backed Israeli assessments that Hamas and other Gaza militants used Al-Shifa’s medical complex as a command hub, as well as to hold hostages and store weapons.

Asked about attack on Al-Shifa, US National Security Adviser Jake Sullivan on March 18 said that “Hamas came back into Shifa” after Israel had cleared the hospital of the militant group.

“Israel cleared Shifa once. Hamas came back into Shifa, which raises questions about how to ensure a sustainable campaign against Hamas so that it cannot regenerate, cannot retake territory,” Sullivan told reporters, adding that from the US perspective, the operation is “connecting Israel’s objective to a sustainable strategy… rather than have Israel go smash into Rafah.”

The US has been calling on Israel to find a way to protect civilians displaced in the southernmost city of Rafah, ahead of a planned Israeli incursion there.

On the day of the raid, the top US humanitarian aid official called a report warning that famine is set to break out in northern Gaza “a horrific milestone” and urged Israel to open more land routes to deliver aid into the enclave.

The “catastrophic levels of hunger and malnutrition” detailed in the report “should be unimaginable in the current era, but for hundreds of thousands of Palestinians in Gaza, this is the reality,” US Agency for International Development (USAID) Administrator Samantha Power said in a statement.

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CNN’s Benjamin Brown, Tim Lister, Kareem Khadder, Celine Alkhaldi and Ido Soen contributed reporting.