Hamas Exploitation of Hospitals for Military-Terrorist Purposes Shifa Hospital as a test case

Overview^[1]

• Shifa Hospital is a government hospital which belongs to the Hamas-controlled ministry of health in the Gaza Strip and is the largest hospital in the Gaza Strip. It is located in the Rimal neighborhood in western Gaza City, and routinely provides medical services to hundreds of thousands of Gazans
• From the beginning of Operation Iron Swords, the hospital admitted the largest number of casualties of all the hospitals in the Gaza Strip, and also took in many residents for whom it served as a shelter. It received shipments of equipment and medical aid from the International Red Cross which included medical equipment for its operating and emergency rooms, and apparently received preferential treatment from international organizations because of its extensive activities. Shifa Hospital also received assistance from the State of Israel, which transferred significant quantities of medical equipment for the hospital’s use.
• As revealed by the IDF spokesperson, in addition to functioning as a medical institution, the hospital was clearly exploited by Hamas’ military-terrorist wing. The IDF forces entered the hospital and exposed its underground levels, which had tunnels, headquarters, control rooms and stockpiles of weapons. The evidence clearly proves that the hospital was used for extensive terrorist activity, exploiting the fact that IDF forces would not attack a civilian medical facility. Revealing that the hospital was exploited for military-terrorist purposes became a symbol of Hamas’s cynical use of the population and civilian facilities for its terrorist needs, including the use of medical facilities.
• It was not the first time the terrorist organizations in the Gaza Strip, especially Hamas, had been exposed as exploiting hospitals and other medical facilities for military-terrorist purposed. They knew the IDF would not attack hospitals, which provided their military-terrorist facilities with a kind of immunity. For the same reason, they exploit ambulances and vehicles belonging to humanitarian organizations for the transport of terrorist operatives and weapons from place to place. During Operation Protective Edge (2014) and Operation Cast Lead (2008-2009) there was evidence that hospitals, including Shifa Hospital, were exploited by Hamas for military-terrorist activities. Exploiting civilian facilities for military-terrorist purposes is a Hamas modus operandi, and to that end, they prepared a web of tunnels and stockpiles of weapons inside the hospitals in advance.

Evidence Found by the IDF in Shifa Hospital

• On the afternoon of October 27, 2023, during a briefing to the international media, the IDF spokesperson reported that according to intelligence information, Hamas headquarters were situated under Shifa Hospital. He also reported that inside the hospital there was a Hamas internal security control center staffed by a large number of armed terrorists in both routine and emergency situations. In addition, Hamas had located headquarters there, from which it directed rocket launchings and the activities of its forces in the field, and had stored weapons and ammunition (IDF website, October 27, 2023).

    
Right: Shifa Hospital. Left: The location of Hamas headquarters beneath the hospital
(IDF spokesperson, October 27, 2023)

• On the night of November 14, 2023, IDF forces initiated a maneuver in a specific location in the hospital compound where they had intelligence indicating the activity of Hamas terrorists. They began operations after the hospital management had been informed of the entry of the forces into the compound and an effort had been made to evacuate patients and sheltering residents s, for which the IDF opened a designated secure route. IDF forces also delivered medical equipment, incubators and baby food to the hospital (IDF spokesperson, November 15, 2023).

   
IDF soldiers bring humanitarian aid to Shifa Hospital (IDF spokesperson, November 15, 2023)

• The IDF activity at the site proved the suspicions had been correct and significant quantity of evidence was found to show that Hamas exploited the hospital for military-terrorist purposes. The forces located an operational headquarters, weapons and technological equipment in the hospital’s MRI building (IDF spokesperson, November 15, 2023).

   

   
Some of the weapons found in the hospital (IDF spokesperson, November 15, 2023)

• On November 19, 2023, after expanding IDF activity at the site, a tunnel opening was exposed. On November 22, 2023, IDF forces exposed the tunnel which was ten meters deep and 55 meters long, and its route passed under the hospital buildings. It contained a war room which was an air-conditioned hiding place, toilets and a kitchen, apparently intended for an extended stay. The forces also located a large number of weapons and evidence testifying to the presence of hostages (IDF website, November 22, 2023).

    
Right: The tunnel shaft in the hospital grounds. Left: An operational shaft located in the area of the hospital (IDF spokesperson, November 19, 2023)

• The tunnel had branches dozens of yards long which passed under the building, whose construction was financed by Qatar. Two other tunnel shafts were exposed near the hospital (IDF spokesperson, November 23, 2023).
• The findings show that Hamas used the hospital’s electricity and fuel to maintain its tunnel system, and operatives stored large quantities of weapons in and around the hospital. IDF forces detained the hospital director when he tried to move to the southern Gaza Strip (IDF spokesperson, November 23, 24, 2023). On November 26, 2023, correspondent Mahmoud Abu Salama reported from the hospital compound and said it was completely abandoned and neither patients nor sheltering residents were present (QudsN X account, November 26,  2023).

   
Right: A tunnel that was uncovered near the hospital (IDF website, November 22, 2023). Left: A tunnel shaft that was hidden 100 meters from the hospital (IDF website, November 22, 2023)

     
Tiled bathroom with a toilet and sink, and an air-conditioner in a room with tiled walls inside a tunnel (IDF website, November 22, 2023)

     
The route of the tunnel exposed under one of the hospital buildings
(IDF website, November 22, 2023)

  
Right: Solid steel fire door to the terrorist tunnel breached by IDF forces. Left: The continuation of the tunnel (IDF website, November 21, 2023)

• A vehicle similar to the vehicle used by Hamas terrorists in the attack on October 7, loaded with weapons, was also found in the hospital parking lot. IDF military vehicles seized by the terrorists were also brought to the hospital compound (IDF spokesperson, November 19, 2023).

    
Right: Terrorists’ vehicles at the entrance to the hospital. Left: An IDF vehicle driven to the hospital (IDF spokesperson’s website, November 19, 2023)

   
Hamas facilities at the hospital (IDF spokesperson, November 19, 2023)

• John Kirby, the spokesman for the United States’ national security council, said that in American assessment, Hamas used Shifa Hospital as a command center and possibly as a weapons storage facility, noting that they were confident of their intelligence and their assessments regarding Hamas activity in the hospital (Reuters, November 16, 2023).

Palestinian testimonies

• A conversation held with a source in the public health system in Gaza again revealed that Hamas kept fuel reserves in the hospital. The source stated that Hamas had stocks of more than half a million liters (about 132,000 gallons) of fuel under Shifa Hospital (IDF spokesperson, November 3, 2023). In response to the IDF spokesperson’s report, a spokesman for the ministry of health in Gaza claimed the accusations were false and the hospital complex was “open to everyone” (al-Jazeera Mubasher, November 3, 2023). Shehab claimed that the main generator at Shifa Hospital had stopped working due to lack of fuel, causing a blackout in some of the wards (Shehab, November 3, 2023).

Responses to the accusations

• Hamas strongly denied the IDF spokesperson’s report and claimed the report was false and “meant to pave the way to attack the central hospital, where there were thousands of wounded, sick and displaced persons” (Hamas Telegram channel, October 27, 2023). Even after the entry of the IDF forces and the presentation of the evidence, Hamas continued denying it, claiming that after Israel attacked the hospital it was lying about what it found there.
• Muneir al-Barsh, director general of the Hamas-controlled the ministry of health in the Gaza Strip, which is located in Shifa Hospital, claimed that the IDF had not proved Hamas had headquarters located in the hospital. He claimed the IDF had blown up “food stores” in the basement and carried out more excavations and explosions. He denied the hospital had received incubators from Israel and reported the death of a fourth premature baby in the hospital. He also claimed IDF soldiers had seized the bodies of 18 shaheeds (aljazeera.net, 17 November 2023).
• Senior Hamas terrorists said the following:
  • Senior terrorist Isma’il Haniyeh, head of Hamas’ political bureau, claimed it was a “brutal attack based on lies invented by the enemy about the compound.” He noted the situation of the “resistance” [terrorist organizations] in the Gaza Strip favorably and said that they had succeeded in foiling Israel’s plans to return the hostages by force. He called for the implementation of the decisions of the Arab-Islamic summit, noting that the presence of the Palestinian “resistance” [terrorist operatives] in the “fight against the occupation” had become “necessary” and was clearly in Arab-Muslim interests. He criticized the UN Security Council resolution, claiming it should have included a specific condemnation of the [alleged] “war crimes” committed by Israel in the Gaza Strip, Judea and Samaria (Hamas Telegram channel, November 16, 2023).
  • Senior terrorist Abu Obeida, spokesman for Hamas’ military-terrorist wing, claimed what the Israeli government looked for in the hospital was a “disgrace” to the international system and international law and that Israel was looking for proof that the hospitals were command centers. He called on “the [military-terrorist] wings of the Palestinian people’s “fighters in the West Bank” to escalate their attacks on Israel (Izz al-Din Qassam Brigades Telegram channel , November 17, 2023).
  • Senior Hamas terrorist Osama Hamdan claimed the attack on Shifa Hospital and invading it were “the greatest crime.” He claimed no command or control rooms or any of the hostages were found in the hospital. The forced evacuation of the hospital and turning it into a military camp was the height of moral and human degradation, a war crime and a crime against humanity (Palinfo, November 18, 2023; al-Jazeera YouTube channel, November 18, 2023).
  • The Palestinian Authority (PA) foreign ministry warned of Israeli publications about the discovery of weapons and a tunnel at Shifa Hospital. It claimed Israel planted the weapons in a hospital to justify its attack on the hospital. He also stated that all the reports about the presence of hostages inside the hospital were lies (PA foreign ministry Facebook page, November 18, 2023).

Bringing the hostages to the hospitals in the Gaza Strip

• The IDF spokesperson revealed that a number of hostages were brought to the hospital on October 7, 2023. One of the female soldiers who was kidnapped and whose body was found by the IDF forces and returned to Israel, had been brought to the hospital when she was wounded and murdered on hospital property. On November 16, 2023,the body of another hostage was found in the hospital area (IDF spokesperson, November 19, 2023).

    
Right: Israeli hostages brought to Shifa Hospital by Hamas terrorists. Left: Hamas operatives wait outside the room to which they brought the hostage
(IDF Spokesperson website, November 19, 2023)

• Hamas spokesmen referred to Israel’s accusation that signs of the presence of hostages were found at Shifa Hospital, claiming the hostages were brought to the hospital for “medical treatment:”
• Senior terrorist Zaher Jabarin, who holds the Hamas prisoner portfolio, claimed that Israel was falsifying the facts about the presence of Israeli hostages and the Hamas leadership in the tunnels under the Shifa medical complex. He claimed that before the IDF entered the hospital, Hamas had called for a visit by a neutral international committee to inspect it. He also referred to the testimonies of several foreign doctors and nurses who worked at the hospital, who told the international community that there were no tunnels or fighters in the hospital (al-Jazeera Mubasher website, November 20, 2023).
• Senior Hamas terrorist Osama Hamdan claimed operatives of the Hamas military[-terrorist] wing had taken some of the wounded hostages to the hospitals to be treated and had “risked their lives so that the captives would receive medical treatment” (Hamas Telegram channel, November 18, 2023).
• Senior terrorist Izzat al-Rishq, a member of Hamas’ political bureau and head of its central information bureau, also claimed that they transferred many Israeli hostages to hospitals for treatment and surgery, especially after some of them were [allegedly] injured by air force strikes. He claimed, [straight-faced], that they had risked their men to ensure the wounded hostages received “the best possible treatment” in the hospitals in the Gaza Strip. However, nevertheless, Israel’s leaders and the IDF spokesperson, with the help of the United States, “invented” explanations and reasons to attack Shifa and other hospitals (Khabarani website X account, November 18, 2023).

Other Examples of Hamas’ Exploitation of Medical Facilities

The Indonesian Hospital in the northern Gaza Strip

• Another example of the exploitation of hospitals by Hamas is the Indonesian Hospital, located in Beit Lahia in the northern Gaza Strip. The hospital was constructed by the Indonesian government and cost $32 million. It was inaugurated in January 2016, and has 110 beds. The IDF exposed that rocket launch pits and a terrorist tunnel shaft located near the hospital (IDF spokesperson, November 5, 2023).

Al-Rantisi Hospital

• On November 13, 2023, the IDF spokesperson revealed evidence that al-Rantisi Children’s Hospital, located in the north of Gaza City,^[2] was used by Hamas for military-terrorist purposes. He reported that a Hamas command center operated in the hospital basement and a large quantity of weapons and devices were found, including explosive belts; a terrorist tunnel was also found in the compound. Evidence was found there indicating that some of the hostages may have been in the hospital basement. A motorcycle that used by the kidnappers on the day of the terrorist attack, diapers, a pacifier and a baby bottle, apparently for the kidnapped babies, were also found (IDF spokesperson’s website,  November 13, 2023).

   
Right: A photograph clarifying the positions of Hamas facilities in al-Rantisi Hospital. Left: Weapons found in the hospital basement (IDF spokesperson’s website, November 13, 2023)

   
Diapers, a pacifier and a baby bottle. On the box is the symbol of the World Health Organization (IDF spokesperson’s website, November 13, 2023)

• Senior Hamas terrorists denied the claims attributed to al-Rantisi Hospital and called for an international commission to come to the Gaza Strip and inspect the hospitals. Hamas commented as follows:
  • The Hamas government media information office claimed that they were lies, part of psychological warfare against them, and intended to legitimize attacks on hospitals and medical staff. Furthermore, the office [falsely] claimed that in the past it had “already been proven” that tunnel openings reported by the IDF were actually water and fuel storage pits. The bureau blamed Israel for any harm to the medical staff and residents sheltered in the hospitals (Hamas media information bureau Facebook page, November 13, 2023). .
  • Senior terrorist Khalil al-Haya, a member of Hamas’ political bureau, claimed that Israel showed unidentified weapons and it was illogical for their fighters to leave their weapons in the hospital. As for the tunnel, he claimed that it was found outside the hospital and not inside (al-Jazeera, November 13, 2023).
  • Senior Hamas terrorist Bassem Na’im said Hamas was ready for an international committee to check if the hospitals in Gaza were free of military activity (al-Jazeera, November 13, 2023).

Previous Military-Terrorist Exploitation of Hospitals

• The recent exposure of exploitation, especially by Hamas, of Gazan hospitals for military-terrorist use was not the first one. The terrorist organizations consider the hospitals “safe” because they know the IDF will not attack medical facilities, which grants “immunity” to the terrorist facilities located in them. For the same reason, the terrorist organizations exploit ambulances and vehicles belonging to humanitarian aid organizations to transfer operatives and weapons from place to place.
• During Operation Cast Lead (2008-2009) much evidence was found of Hamas’ exploitation of Shifa Hospital, including through intelligence information and an IDF investigation. For instance:
• Senior Hamas terrorist operatives remained in the hospital throughout the operation. They turned some of the wings into closed areas guarded by armed operatives and thoroughly examined everyone present in the hospital. Mahmoud al-Zahar and Said Siam were mentioned as finding shelter in Shifa Hospital. Ismail Haniyeh, who at the time was head of the Hamas administration in the Gaza Strip, also established his headquarters in the hospital’s burn unit (according to another version, below the maternity ward).
• A Hamas operative captured by the IDF stated during questioning that senior Hamas operatives took control of a large bunker located under Shifa Hospital and were hiding there.
  • Terrorist operatives positioned themselves near Shifa Hospital to launch mortar shells.
  • The staff training complex at the hospital, adjacent to the new maternity ward, was used as a residence for Hamas operatives.
  • Hamas moved weapons to the buildings next to Shifa Hospital.
  • A tunnel was dug under the mosque near the hospital, which served as a direct escape route from the mosque to the hospital. The tunnel opening and a hidden room were located under the maternity floor.
  • A man suspected of collaborating with Israel was executed in the hospital.
• Fatah operatives and the PA also testified about military uses made at Shifa Hospital:
  • Sources in Fatah said Hamas prepared the ground floor of the radiation department at Shifa Hospital as a prison and interrogation facility after the prison in the Shati refugee camp in western Gaza City had been completely destroyed by Israeli Air Force attacks. The radiation department, its devices and equipment, were moved to the first floor and to the hospital reception hall (al-‘Ahed, a Fatah-affiliated website, January 21, 2009).
  • The ministry of health in Ramallah accused the Hamas security forces of converting medical centers into prisons and interrogation facilities during and after Operation Cast Lead. The ministry said the Palestinian people and the entire world were surprised that after the operation, Hamas’ security forces took over Shifa Hospital, especially the oncology wards and a new building which was supposed to be an outpatient center for specialists. According to the ministry of health in Ramallah, converting medical facilities into interrogation facilities was done while distancing members of the medical staff, who responded to the call of the ministry of health in Ramallah in the Fayad government and returned to their places of work because of the IDF operations in the Gaza Strip (Ma’an, February 7, 2009).
  • An article in the Italian newspaper Corriere della Sera on January 22, 2008, included a report from a Gazan who said Hamas had arranged a room in the Shifa Hospital basement as an interrogation room for Fatah prisoners. The report was given by Magah al-Rachman, who said he had heard it from terrorist operatives of the Democratic Front for the Liberation of Palestine (DFLP).
• Later, the hospital was used by Hamas during the Operation Protective Edge (July – August 2014):
• According to an article in The Washington Post (July 15, 2014) written by Booth William, reporting from Gaza:

“At Shifa Hospital in Gaza City, crowds gathered to throw shoes and eggs at the Palestinian Authority’s health minister, who represents the crumbling “unity government” in the West Bank city of Ramallah. The minister was turned away before he reached the hospital, which has become a de facto headquarters for Hamas leaders, who can be seen in the hallways and offices.”

• During Operation Protective Edge, Nick Casey, a correspondent for The Wall Street Journal, tweeted that Hamas used Shifa Hospital as a safe place to meet with media representatives.^[3]
• In December 2016, Bilal al-Razina, a 24-year-old Gazan, was detained after crossing the security fence into Israeli territory. He was an operative in the Izz al-Din Qassam Brigades, Hamas’ military-terrorist wing, and involved in activities including sniper training, digging tunnels and guarding facilities. He also served as an escort for his brother Mustafa al-Razina, the head of Hamas’s internal security apparatus in the northern Gaza Strip. During questioning he revealed that during Operation Protective Edge his brother and other senior Hamas terrorists hid in Kamal Adwan Hospital, in Beit Lahia in the northern Gaza Strip, and conducted the fighting from there. Bilal al-Razina said that during the operation he liaised between his brother and senior Hamas terrorists. He also revealed that senior terrorists in Hamas’ internal security force conducted the fighting from civilian homes (Israeli Security Agency website, December 28, 2016). Apparently, the location of the hospital in the north of the Gaza Strip and its proximity to Israel made it a convenient site for Hamas to conduct the fighting against Israel and for other military-terrorist uses.

Hamas Exploitation of Ambulances

• The ministry of health in Gaza claimed the IDF attacked dozens of ambulances throughout the Gaza Strip since the beginning of Operation Iron Swords. An investigation of Hamas terrorists currently held by the IDF revealed that Hamas exploits ambulances to transfer terrorist operatives and weapons from area to area. The exploitation of medial vehicles is also not new and was carried out during both Operation Protective Edge and Operation Cast Lead. Hamas uses ambulances and vehicles belonging to international organizations to transfer its military-terrorist operatives between the various combat arenas and to transfer rockets and other weapons. Using ambulances and vehicles of international organizations during combat is meant to bypass inspections and exploit the freedom of movement, which the IDF grants to these vehicles. For example:

Operation Cast Lead

• An IDF investigation carried out after Operation Cast Lead (April 6, 2009) revealed that Hamas made military use of ambulances some of which y belong to the civil defense mechanism operating on behalf of the Hamas internal security system. In addition, Hamas “ordered” rides in vehicles which were marked as ambulances. According to the investigation, ambulances were used mainly to transfer field operatives and senior terrorists from place to place, rescuing operatives from combat zones and patrolling. An IDF Brigadier General testified that during Operation Cast Lead, at least three instances were unequivocally identified in which armed Hamas terrorist operatives sat next to rescue teams in ambulances.
• Other examples based on intelligence information include:
  • Hamas operatives used ambulances to transport rockets. Several times Hamas operatives were seen unloading rockets from ambulances.
  • Hamas sent ambulances to various sites to collect operatives and to rescue operatives from combat sites, including by having them pretend to be wounded.
• The use of ambulances during Operation Cast Lead was reported in the Australian The Sydney Morning Herald on January 26, 2009. Jason Koutsoukis, the newspaper’s correspondent in the Gaza Strip, interviewed Muhammad Sharitah, a Gazan ambulance driver, who was involved in evacuating the wounded from the fighting zones during the operation. He told the correspondent that almost every time the wounded had to be evacuated it could be coordinated with the IDF forces, which made sure that no shots were fired at the ambulances during the evacuation. He said the greater threat to the safety of the ambulances was from Hamas operatives. The Hamas operatives “would lure the ambulances into the heart of battle to transport fighters [terrorists] to safety.”
• Sharitah related an incident that occurred in the second week of Operation Cast Lead. He drove to a house in Jabaliya to which he had been urgently summoned. When he entered the house, he saw three Hamas operatives taking shelter inside the house, about half of which had already been destroyed. The operatives, who were very scared and nervous, ordered him to take them out of the house, put them in the ambulance and evacuate them from the area. Muhammad Sharitah refused to comply because, he said, he knew that if the IDF forces saw him evacuating fighters and not the wounded, they would kill him. One of the terrorists threatened him with a gun, but he refused. In the end, they allowed him to drive away without them. He added that during Operation Cast Lead Hamas operatives tried several times to take over ambulances belonging to al-Quds Hospital (situated in the Tel al-Hawa neighborhood Gaza City). The hospital employees usually received early warnings of Hamas’ plans and removed all the ambulances from the hospital area to make it seem they were not available. The ambulances were returned to the hospital only after the Hamas operatives went away.

• The reports of the IDF and the ambulance driver were supported by Israeli intelligence information. From the statements of Hamas operatives during Operation Cast Lead, ambulances were used to transport operatives and weapons. It was reported that Izz al-Din Qassam Brigades terrorist operatives conducted ambulance and motorcycle patrols at night. Additional examples of the use of ambulances to evacuate military-terrorist operatives and weapons:
  • On January 1, 2009, when the Khalifa Mosque in Jabaliya was attacked from the air, there were several secondary explosions, evidence of large quantities of weapons inside the building. Shortly after the attack, a number of ambulances were seen arriving at the mosque and evacuating terrorists who had not been harmed in the attack and functional weapons.
• On January 4, 2009, a rocket launching squad operating in northern Gaza City was attacked. Immediately after the attack several ambulances arrived and evacuated the victims and the weapons that had not been damaged.
• On January 6, 2009, after the IDF warned that it was about to attack a building in the Gaza Strip, dozens of armed activists were seen being evacuated from the building by several ambulances.
• Ambulances were also used for the escape of senior Hamas officials out of the Strip. During the fighting a delegation of senior Hamas terrorists went to Egypt for talks with Omar Suleiman, at the time the head of Egyptian General Intelligence, leaving the Gaza Strip in ambulances. Two members of the delegation, Jamal Abu Hashem and Ayman Taha, hid inside an ambulance to protect themselves from an IDF attack. Eyewitnesses testified that they saw two other senior officials who rode in another ambulance (Egyptian TV website from a Hamas police source, January 9, 2009).

      
UNRWA ambulance evacuates wounded and terrorist operatives from a combat zone
(Israeli Channel 10, May 11, 2004)

Operation Protective Edge

• There was also evidence of the use of ambulances in Operation Protective Edge. The IDF spokesperson reported that during the operation, the IDF identified two Palestinian terrorists using an ambulance to move around the Gaza Strip (IDF spokesperson, July 22, 2014). The two were seen getting into the ambulance and using it as a transport vehicle and the ambulance driver was seen wearing a white coat. The IDF did not attack the ambulance out of concern that there were civilians in it. The incident was announced by the IDF spokesperson in a YouTube video.

Appendix

The history of Shifa Hospital

• Shifa Hospital (“recovery”) is a government hospital located in the Rimal neighborhood in western Gaza City. It is considered the most important hospital in the Gaza Strip and belongs to the Hamas-controlled the ministry of health. It was established in 1946 during the British Mandate on the territory of a British military base as a hospital dedicated to the treatment of high-fever diseases and for quarantined patients.

• The occupation of the Gaza Strip by Egypt in 1948, made it possible to turn it into a central hospital. After a short time, a hospital for internal medicine, a surgical wing, units for pediatrics and ophthalmology were established. After Operation Kadesh in 1956 the hospital was expanded and upgraded by order of Gamal Abdel Nasser, the Egyptian president. At that time, health services in the Gaza Strip were provided by the Bandar Gaza organization, which established clinics in densely populated areas operated by hospital doctors who worked in shifts.
• After the Six-Day War in 1967, and the IDF occupation of the Gaza Strip, the hospital was managed by an Israeli doctor, who served as head of the Gaza public health system. In the 1980s, the State of Israel renovated and expanded the hospital with American assistance. In 1990, when the hospital in Bureij was closed, Shifa Hospital became even more active.
• During the first intifada (1987-1993), the hospital treated many Gazans wounded in the riots and became a focus of interest for the international community. In some cases, the hospital was attacked by rock-throwing Palestinian mobs because it was a symbol of the Israeli government. In one of the difficult weeks during the intifada, IDF forces raided the hospital six times to pursue terrorists and lawbreakers inside it. During the years of Israeli rule over the hospital, Israeli doctors handed over the names of Palestinian doctors who were suspected of being in contact with terrorist organizations, which the Palestinians regarded as “political interference” in the hospital management.
• After the Oslo accords in 1993, when Israel disengaged from the Gaza Strip, the management of the hospital returned to the Palestinians.
• In the 1980s Israel’s department of public works received responsibility for the establishment of a medical infrastructure in the Gaza Strip, later Shifa Hospital. The two architects, Gershon Zippor and Benjamin Idelson, who developed expertise in hospital and medical center design, designed Shifa Hospital. Initially, the hospital had 320 beds and served approximately 210,000 residents of Gaza City. The goal was approximately 900 beds in an extensive campus of 50 dunams, which would serve the residents of the entire Strip, while demolishing old buildings in favor of new high-risers equipped with advanced technology. The renovation phase of the 1990s also included concrete basement floors from which the Hamas leadership operated while hiding in the hospital.

    
Shifa Hospital in the 1980s (Gershon Zippor Collection, Israel Architecture Archive undated)

 
Drawing of the hospital by Israeli architects
(Gershon Zippor Collection, Israel Architecture Archives, July 28, 2014)

^[1] Click https://www.terrorism-info.org.il/en to subscribe and receive the ITIC's daily updates as well as its other publications. ↑
^[2] The hospital, located in northwestern Gaza City is named after senior Hamas terrorist Dr. Abd al-Aziz Rantisi, who was a pediatrician and killed in a targeted attack by the Israeli Air Force in April 2004. Its construction began in 2003 and it was inaugurated for full operation in 2008. The hospital has 45 beds and can accommodate up to 100 beds. The hospital complex covers an area of 2,500 square meters. ↑
^[3] For further information, see the July 2014 ITIC report, "Hamas and the Other Terrorist Organizations in the Gaza Strip Use Medical Facilities and Ambulances for Military-Terrorist Purposes." ↑

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