Israel’s massacre of Gaza paramedics was not an aberration

In a three-and-a-half-minute barrage of continuous gunfire, the Israeli military massacred 15 Palestinian first responders on 23 March in Rafah, southern Gaza. Eight of them were medical staff with the Palestine Red Crescent Society (PRCS).

I knew some of these men. We worked together last April and May when I was in Gaza to support the provision of trauma care as part of a small international emergency medical team.

The attack that killed them was not an aberration. Nor was it the result of “professional failures”, as the Israeli military investigation into itself has claimed. It was an extension of Israel’s spiralling strategy of targeted violence against healthcare and humanitarian workers, which I witnessed first-hand during my time in Palestine. It also forms another dimension of the mass atrocities Israel is perpetrating in the Gaza Strip, which threatens the permanent displacement and extermination of the Palestinian people in the enclave.

On the evening of 24 March, a friend working for PRCS messaged and asked if I had heard that 10 of his colleagues had gone missing while attempting to retrieve people injured by an Israeli strike in Rafah the previous morning. “I know them all. They are our colleagues. I hope they return safely for their families,” he wrote.

Over the following days, we continued to exchange messages and prayers, along with photos of the last time we had been together. Six days later, the messages changed: “Today, my colleagues were found, but unfortunately, they were all executed in cold blood. They were executed, brother, intentionally, not by chance.”

The photos he shared included the official PRCS announcement – an image with photos of the eight killed PRCS staff, all dressed in crisp PRCS uniforms, many smiling. The photograph that followed was of the body of one of these men inside a plastic body bag, still dressed in his bright red reflective uniform, the large PRCS emblem clearly visible on the back of his jacket. His clothes were covered in the soil he and the 14 others had been buried under in a mass grave by Israeli soldiers.

Available evidence now suggests many were killed at close range, with gunshot wounds to the head or chest.

Wanton destruction

At the time I was in Gaza last year, at least far exceeded the total number killed in 17 other countries that recorded violence against humanitarian workers during the same period.

At best, attacks on Palestinian healthcare and humanitarian workers have invoked momentary condemnation before being overshadowed by newer atrocities elsewhere. This pervasive impunity has allowed the killings to continue, with at least 418 now killed since October 2023. All bar eight have been Palestinian.

During my time in Gaza, the worst of Israel’s attacks on the city of Khan Younis had come to an end. Israeli soldiers had withdrawn from the city itself and were directing their attention towards the southern city of Rafah, which they would continue to besiege, attack, and subsequently occupy three weeks later.

This allowed me to visit healthcare facilities in Khan Younis, including Al-Amal Hospital, a once vibrant complex built and managed by PRCS, which had been decimated by repeated Israeli military attacks and put out of service.

The hospital director showed us bullet holes in his office; Hebrew graffiti etched into the walls by Israeli soldiers who had occupied the main building; the mangled generator, destroyed by an Israeli tank; a charred medical ward; and severed ultrasound probes, each of which had been meticulously cut to ensure the medical device could never be used again.

Before passing through the emergency department, we were shown the grave of Hedaya Hamad, the PRCS Director of Youth and Volunteers. She had been shot and killed by Israeli soldiers on 2 February 2024 as she tried to assist injured people seeking refuge at the PRCS headquarters adjacent to the hospital. Her colleagues had no option but to bury her in a shallow grave as it had been too dangerous to leave the hospital compound. Her grave was marked with her orange and white PRCS vest.

In the main courtyard, Israeli soldiers had destroyed every single one of the PRCS ambulances before burying them under tonnes of soil.

Israel has repeatedly claimed that healthcare facilities and ambulances have been used for military purposes. The accusations have never been conclusively or impartially substantiated. In fact, available evidence frequently contradicts Israeli claims. The meticulous destruction of ultrasound machines suggests another motive is at play: The systematic dismantling of the Palestinian healthcare system to render it inoperable. Why else would soldiers sabotage medical equipment that has no conceivable military use?

By undermining the ability of Palestinian healthcare and humanitarian workers to administer care and sustain life, Israel has created the conditions necessary to eliminate the population – either by ethnic cleansing or extermination – while dramatically amplifying the direct effects of its military violence.

Dedication of Palestinian Red Crescent workers

When I was in Gaza, many PRCS crews had been forced to relocate during Israel’s attacks on Khan Younis. One such team had established a trauma stabilisation point (TSP) on a tennis court in al-Mawasi, the coastal region Israeli unilaterally designated as a humanitarian zone so as to create the thinly veiled perception that it was adhering to its obligations under international humanitarian law.

When fuel was allowed, PRCS ambulances were dispatched to respond to emergency calls throughout central and southern Gaza. During the Israeli siege of Khan Younis, between February and December 2023 and April 2024, this trauma point received a near-constant stream of wounded patients, all of whom were treated and dispatched with paramedics to hospitals in Rafah or Deir al-Balah.

As the intensity of the siege diminished in April last year, leaving behind a largely destroyed and depopulated city, the PRCS team continued to respond to Israeli airstrikes, gunfire from Israeli warships, the collapse of unstable buildings, and accidents on the main road.

Our small team of Palestinian and international medical staff worked alongside the PRCS team, and we spent several weeks treating patients together, learning from and teaching the medical and nursing students who volunteered every day at the clinic.

Many PRCS staff and their families had been displaced and were staying in tents along the beach road. When relatively safe, our closest colleague in the team returned to her neighbourhood in Khan Younis only to find graduation scarves, other sentimental items, and rubble strewn where her family’s home once stood.

Despite daily threats to their lives, repeated displacement, and the unending search for water, food, firewood, and shelter, PRCS teams worked 24/7 from the TSP. On 27 April, an Israeli warplane dropped a missile close to the medical tents, approximately 150 metres from where we were seeing patients, and right in the centre of the supposed humanitarian zone.

Appearing unfazed – and presumably knowing full well the “double tap” strategy deployed by the Israeli military, in which rescuers were often killed or injured by subsequent strikes – a crew was immediately dispatched in an ambulance in the direction of the smoke.

End impunity

Since October 2023, PRCS staff – and all first responders – have faced the unprecedented threat of Israeli violence, both in Gaza and the West Bank. With Israel’s massacre of the rescue crews in Rafah, 44 PRCS members have now been killed, 29 of whom were on duty, including two in the West Bank.

With each killing, UN agencies, humanitarian organisations, rights groups, and occasionally a handful of governments have offered some measure of denunciation.

In the wake of the Rafah killings, the International Committee of the Red Cross was “appalled” and Médecins Sans Frontières again condemned such attacks. The head of OCHA, the UN’s emergency aid coordinating body, demanded “answers and justice”, while UK Foreign Minister David Lammy attempted to deflect attention from the UK government’s continued support for Israel by stating that “those responsible must be held accountable”.

Israel’s attacks in Gaza and throughout Palestine cannot be explained away as the isolated mistakes of individual soldiers that can be corrected with greater awareness or more training.

These press releases and social media posts reveal a sector whose influence is largely limited to the recycling of language: We condemn; we demand accountability; we call for compliance; we mourn; and then we repeat.

While there is undoubtedly much closed-door lobbying that doesn’t feature in the curated social media posts of humanitarian organisations, the public facing image is of a sector entirely dependent on the very same belligerents whose violence renders humanitarian aid necessary in the first place, and on the multinational apparatuses that have functioned to enable such violence.

Meanwhile, over the past decade, advocacy to stop attacks on humanitarian and health responders has been animated by the belief that documenting the true scale and impact of attacks will provoke collective action. Breaches of international law are assumed to be matters of awareness and understanding, for which soldiers undergo training and are reminded of their obligations.

Yet Israel’s attacks in Gaza and throughout Palestine cannot be explained away as the isolated mistakes of individual soldiers that can be corrected with greater awareness or more training.

Palestinian humanitarian responders and medical staff have been targeted precisely because of the work they do. To administer care is to increase the likelihood that people can survive and remain in Gaza. Statements from Israeli and American politicians have made clear that Palestinians remaining and returning to their homes does not feature in their visions for a post-genocide Gaza.

Acknowledgement of Israel’s strategy of uninhibited violence, and the culture of deliberate impunity that enables it, demands a very different – and much more proactive – kind of response than documentation and reliance on the accountability mechanisms that have so far proved entirely ineffectual.

Only by ending their active and passive complicity – and by leveraging the full range of political, economic, and diplomatic measures at their disposal – will states be able to bring an end to Israel’s genocidal violence. As the situation in Gaza spirals to unimaginable new lows, such action is even more urgently needed to protect the Palestinian people from mass slaughter and permanent displacement.

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The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org.

</p> <p></p> <h2><span class=" ez-toc-section id="Key_Terms">Key Terms

• Palestinian humanitarian workers
• Israeli violence
• Healthcare system dismantling
• Impunity
• Genocidal violence

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