Al-Shifa Hospital, Hamas’s Tunnels, and Israeli Propaganda

As the death toll in Gaza surpasses 13,000 Palestinians, including more than 5,500 children, the Israel Defense Forces propaganda machine has sought to use Al-Shifa Hospital as its main exhibit in justifying the unjustifiable. It is clear that the Israeli strategy centers on a belief that if the IDF can convince the world that Hamas used the hospital as a base of military operations, all of the carpet bombing — the attacks on refugee camps, schools, and hospitals — will retroactively be viewed as just acts of war against a terrorist enemy.

Both Israel and the White House, including President Joe Biden personally, have staked their credibility on the claim that there is a massive smoking gun lying below Al-Shifa Hospital. The U.S. said publicly it was not relying exclusively on Israel to back up its own assertions. Leaving aside the fact that both the U.S. and Israel have track records as long as the Gaza Strip of lying about the alleged crimes of their adversaries, the key question is not whether a tunnel or rooms exist under Al-Shifa, but whether they were being used for a clear military or combat purpose by Hamas, as the U.S. and Israel have alleged.

Since the October 7 raids led by Hamas in Israel that resulted in the deaths of more than 845 Israeli civilians, along with some 350 soldiers and police, and saw more than 240 people taken as hostages, the IDF has placed an intense focus on Hamas’s underground infrastructure. Israel’s allegation that Hamas’s main headquarters was housed in or under the sprawling Al-Shifa Hospital compound is not new. But the zealous focus on it is an indication that Israel wants to make it the central issue in its case to push back against critics of its indiscriminate campaign of civilian death and destruction in Gaza. Israel has sought to make Al-Shifa a Rorschach test in its narrative war, and Israel has accused journalists, the United Nations, doctors, and nurses of being part of the conspiracy to hide Hamas’s use of the hospital as a military command center from the world.

To date, this propaganda campaign has not gone well.

After initially claiming that Al-Shifa Hospital was effectively Hamas’s Pentagon — a narrative publicly bolstered by the Biden administration — the IDF released its first round of purported evidence, which more or less consisted of a smattering of automatic rifles, some nestled behind an MRI machine, and a conveniently placed combat vest with a Hamas logo on it. With the exception of Israel’s most die-hard supporters, this effort appeared to convince almost no one of the sweeping assertions about Al-Shifa’s importance to Hamas’s current operations. After all, the IDF had already shown the public a slick 3D video model purporting to be a depiction of an advanced underground command and control lair used by Hamas. So Israel’s first effort at selling the case fell flat.

Several other efforts to produce videos of what Israel claimed to be evidence of a significant Hamas base at hospitals have been met with widespread derision and skepticism, including from Western media outlets that historically report Israeli military assertions about its operations against Palestinians as fact. The IDF videos have been mocked across social media and compared to Geraldo Rivera’s much-hyped — and utterly disastrous — live 1986 nationally televised special promising to reveal the secrets hidden in Al Capone’s underground vault.

Al-Shifa staff, as well as a European doctor who worked there for years, vehemently deny that the hospital is used by Hamas for any military purpose. For what it’s worth, Hamas also denies it.

On Sunday, Israel released two new videos that it claimed document a 55-meter fortified tunnel 10 meters below Al-Shifa. The camera footage, presumably filmed using a remotely piloted vehicle, ends with what Israel said is a blast-proof door equipped with a shooting hole allowing Hamas to attack IDF forces should they seek to breach the purported Hamas command and control center. “The findings prove beyond all doubt that buildings in the hospital complex are used as infrastructure for the Hamas terror organization, for terror activity. This is further proof of the cynical use that the Hamas terror organization makes of the residents of the Gaza Strip as a human shield for its murderous terror activities,” the IDF said in a statement.

It’s no secret that Gaza houses extensive underground tunnels. Over the past two decades, Israel has repeatedly conducted operations aimed at destroying parts of the underground tunnel networks and has often boasted of its successes in doing so. Tunnels stretching from southern Gaza into Egypt served as smuggling lines for many years. Israel claimed their primary purpose was to move weapons, while other observers portrayed them as a lifeline to smuggle in food and other supplies to the blockaded population of Gaza. It’s likely that both assertions are true. In recent years, both Israel and Egypt have taken measures to block or flood tunnels that penetrated their territory, and Israel reportedly installed underground concrete walls and subterranean sensors around its border with Gaza to stop Hamas or other militants from using them to enter Israel to conduct operations. In 2006, Hamas operatives used such a tunnel to take IDF soldier Gilad Shalit back to Gaza after capturing him. Shalit was freed as part of a prisoner exchange in 2011.

A Palestinian person smuggles a sheep into the Gaza Strip through a tunnel under the Egypt–Gaza border at Rafah, Gaza Strip, on Dec. 5, 2008.

Al-Shifa’s Tunnels Were Built by Israel

It’s also well known that there are, in fact, tunnels and rooms under Al-Shifa. We know that because Israel admits that it built them in the early 1980s. According to Israeli media reports, the underground facilities were designed by Tel Aviv architects Gershon Zippor and Benjamin Idelson. “Israel renovated and expanded the hospital complex with American assistance, in a project that also included the excavation of an underground concrete floor,” according to Zvi Elhyani, founder of the Israel Architecture Archive, writing in Israel’s Ynetnews.

The underground infrastructure was part of a modernization and expansion effort at Al-Shifa commissioned by Israel’s Public Works Department. “The Israeli civil administration in the territories constructed the hospital complex’s Building Number 2, which has a large cement basement that housed the hospital’s laundry and various administrative services,” according to a report in the Israeli newspaper Haaretz. The room and tunnels under Al-Shifa were reportedly completed in 1983. Tablet magazine described the space as “a secure underground operating room and tunnel network.” Zippor’s son Barak, who began working at his father’s architecture firm in the 1990s, said that during the construction at Al-Shifa in the 1980s, the Israeli construction contractors hired Hamas to provide security guards to prevent attacks on the building site.

“You know, decades ago we were running the place, so we helped them — it was decades, many decades ago, probably four decades ago that we helped them to build these bunkers in order to enable more space for the operation of the hospital within the very limited size of this compound,” former Israeli Prime Minister Ehud Barak told a visibly stunned CNN host Christiane Amanpour.

Israel has claimed that following Hamas’s consolidation of power in Gaza in 2006, the group took over the Israeli-built facilities beneath Al-Shifa and modernized and expanded them into a full-fledged command and control operations center. During this period, some international journalists have described being called to meetings with Hamas officials on the hospital grounds, and Israel has long referred to it as a vital Hamas headquarters. During the 2014 war in Gaza, the Washington Post’s William Booth asserted that Al-Shifa “has become a de facto headquarters for Hamas leaders, who can be seen in the hallways and offices.” Assuming these claims are true, it is both shameful and logical that Hamas would choose to meet journalists at a civilian hospital given Israel’s well-known campaign to systematically assassinate them. Shameful as it may be, this is quite different than using a secret facility buried beneath the hospital as a military command and control center.

The fact that Israel built tunnels and rooms under Al-Shifa does not prove anything. Many modern hospitals, especially in war zones, have underground infrastructure, including Israeli hospitals. Nor do past reports about Hamas members being spotted inside the hospital. Israel will need to present much more convincing evidence, particularly to back up its claim that the site was of immense military and operational significance during this specific war.

The standard for such evidence should be extremely high, particularly because of the extent of civilian death and suffering caused by Israel’s operations. The Biden administration made allegations about Al-Shifa Hospital to offer preemptive cover for Israel to raid it, and the onus is on the administration to provide irrefutable, clear evidence to support its specific claims.

Dead bodies are seen on Nasir Street near the Al-Shifa Hospital after an Israeli attack on its 34th day in Gaza City, Gaza, on Nov. 9, 2023.

Propaganda vs. International Law

As Israel wages its propaganda war over Al-Shifa, it is simultaneously laying siege to yet another medical facility, the Indonesian Hospital, which is now the sole remaining medical facility in northern Gaza. Israeli artillery fire has killed at least 12 people at the hospital, according to local officials. Indonesia’s foreign minister, Retno Marsudi, has accused Israel of violating international law. “All countries, especially those that have close relations with Israel, must use all their influence and capabilities to urge Israel to stop its atrocities,” she said Monday.

International humanitarian law is clear that in case of any doubt as to whether the hospital is being used as a party to a conflict to “commit an act harmful to the enemy,” then it remains a protected site. Even if there were clear evidence that the hospital’s protected status had been abused, there are a range of rules governing any military action against the hospital — and the civilian patients would remain protected individuals.

“Even if the building loses its special protection, all the people inside retain theirs,” said Adil Haque, the Judge Jon O. Newman scholar at Rutgers Law School, in an interview with the Washington Post. “Anything that the attacking force can do to allow the humanitarian functions of that hospital to continue, they’re obligated to do, even if there’s some office somewhere in the building where there is maybe a fighter holed up.”

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The staff at Al-Shifa have directly accused Israel of causing the deaths of civilians at the hospital, including several babies in the neonatal intensive care unit whose incubators were rendered useless after electricity was severely restricted as a result of the Israeli siege. On November 18, a U.N. humanitarian team led by the World Health Organization visited Al-Shifa. According to the WHO, its staff on the delegation described the hospital as a “death zone,” saying in a statement, “Signs of shelling and gunfire were evident. The team saw a mass grave at the entrance of the hospital and were told more than 80 people were buried there.”

Palestinian medics prepare premature babies, evacuated from Gaza City’s Al-Shifa Hospital, for transfer from a hospital in Rafah in the southern Gaza Strip to Egypt on Nov. 20, 2023.

Israel has also released what it says is CCTV footage from within Al-Shifa recorded in the immediate aftermath of the October 7 Hamas raid into Israel. It claims that the video depicts armed fighters entering the hospital with two international hostages, one Thai and one Nepali. The footage shows one of the alleged hostages injured on a stretcher.

Assuming that this footage is genuine and armed Hamas militants brought a wounded hostage in for treatment, what does Israel believe the hospital staff should have done in this case? Doctors have an ethical obligation to treat all wounded individuals, and it is not their job to serve as police or intelligence operatives.

“Given what the Israeli occupation reported, this confirms that the hospitals of the Ministry of Health provide their medical services to everyone who deserves them, regardless of their gender and race,” Gaza’s Ministry of Health said in a statement after the videos were released. The ministry added that it could not verify the videos. Hamas spokesperson Izzat Al-Rishq said that Hamas had previously acknowledged that it had taken wounded hostages to Al-Shifa on October 7. “We have released images of all that and the [Israeli] army spokesman is acting as if he has discovered something incredible,” he said. Rishq also claimed some of the hostages Hamas took to Al-Shifa had been wounded in Israeli strikes. Israel has also claimed, without evidence, that some hostages were murdered by Hamas inside the hospital grounds, though the IDF’s own maps indicate their bodies were recovered from locations outside Al-Shifa’s campus.

The onus is on both the Israeli government and its sponsors in the Biden administration to prove the sweeping claims about Hamas’s alleged use of Al-Shifa Hospital. This evidence should be strong enough to irrefutably prove that all of the suffering and death inflicted on the patients, doctors, and nurses at Al-Shifa was justifiable under the law, as well as basic principles of proportionality and morality. Such a conclusion is unfathomable when placed in the context of the civilian suffering caused by Israel’s siege on the hospital.

If Hamas is decisively proven to have intentionally abused the hospital’s protected status and did, in fact, actively operate a command center hidden beneath it, then it should face war crimes charges for having done so. Hamas, not innocent civilians, should be held accountable for these actions.

At the same time, if it is proven that Israel perpetrated fraud in its relentless campaign to portray the most important hospital in Gaza as a secret Hamas military base, then the world should hold Israeli officials accountable for this grave and lethal propaganda. So, too, should the Biden administration — including the president himself — be made to answer for the U.S. role.

Israel is seeking to justify its industrial-scale killing of civilians in Gaza with accusations that Hamas is hiding among civilians and using them as shields. Yet Israel’s leading human rights group B’Tselem has documented how the IDF has engaged in this very activity for decades. “Since the beginning of the occupation in 1967, Israeli security forces have repeatedly used Palestinians in the West Bank and in the Gaza Strip as human shields, ordering them to perform military tasks that risked their lives,” according to a 2017 report. 

In the bigger picture, the controversy around Hamas and Al-Shifa has served mostly as a distraction from the overarching, indisputable facts about Israel’s war against Gaza: Using U.S. weapons, financing, and political support, Israel has waged a campaign of violent collective punishment against the civilians of Gaza.