United Nations investigators have accused Israel of deliberately targeting Gaza’s health facilities and killing medical personnel during its assaults on Gaza. 

Prior to the submission of the UN investigators’ full report to the General Assembly, Navi Pillay, Chair of the Commission of Inquiry, accused Israel of “committing war crimes and the crime against humanity of extermination with relentless and deliberate attacks on medical personnel and facilities” in its attacks on Gaza following Hamas’ cross-border attack on southern Israel on 7 October 2023.

The Report of the Independent International Commission of Inquiry on the Occupied Palestinian Territory, including East Jerusalem, and Israel was produced in accordance with UN Human Rights Council resolution S-30/1.

In the same UN statement, Pillay also said that children, in particular, “have borne the brunt of these attacks, suffering both directly and indirectly from the collapse of the health system.”

Israeli forces were also accused of deliberately killing and torturing medical personnel, targeting medical vehicles and restricting patients from leaving Gaza.

The independent Commission of Inquiry (COI) has previously alleged that both Israel and Hamas committed war crimes in the early stages of the Gaza conflict, and that Israel’s actions also constituted crimes against humanity because of the massive civilian deaths.

As of 13 October 2024, Gaza’s Health Ministry has supplied the following list of casualties:

• Killed: at least 42,227 people, including nearly 16,765 children;
• Injured: more than 98,464 people;
• Missing: more than 10,000.

However, according to a study published by the British journal The Lancet in July 2024, the true death toll at that time resulting from the accumulative effects of Israel’s assaults on Gaza was estimated to exceed 186,000 people.

The term ‘crimes against humanity’ is reserved for the most egregious international crimes committed as part of a widespread or systematic attack against civilians.

The International Court of Justice (ICJ) has determined that these systematic assaults by Israeli forces on civilians in Gaza plausibly constitute acts of genocide:

The ICJ’s order dated 26 January 2024, confirmed that “at least some of the rights claimed by South Africa under the Genocide Convention and for which it was seeking protection were plausible, namely the right of the Palestinians in Gaza to be protected from acts of genocide and related prohibited acts …”

Deliberate destruction of healthcare facilities

In referring to the deliberate destruction of Gaza’s healthcare facilities, Navi Pillay stated:

Israel must immediately stop its unprecedented wanton destruction of healthcare facilities in Gaza. By targeting healthcare facilities, Israel is targeting the right to health itself with significant long-term detrimental effects on the civilian population. Children in particular have borne the brunt of these attacks, suffering both directly and indirectly from the collapse of the health system.

UN investigators also found that Israeli forces have deliberately killed, detained and tortured medical personnel and targeted medical vehicles while tightening their siege on Gaza and restricted permits to leave the territory for medical treatment.

These actions were found to constitute the war crimes of wilful killing and mistreatment plus the destruction of protected civilian property and the crime against humanity of extermination.

One of the most horrific cases investigated by the COI involved the killing of five-year-old Hind Rajab, together with her extended family, and the shelling of a Palestinian Red Crescent ambulance which resulted in the death of two paramedics sent to rescue her. Shell fragments of an American-made M830A1 projectile were found at the site of the destroyed ambulance.

The COI found that the Israeli Army’s 162nd Division was responsible for killing Hind Rajab and six of her relatives, together with shelling the ambulance and killing the two paramedics inside. These atrocities constituted the war crimes of wilful killing and an attack against civilian objects.

Also, the COI found that the deliberate destruction of health infrastructure that provided sexual and reproductive healthcare, combined with the lack of access and availability to healthcare, was also a violation of women’s and girls’ reproductive rights and their right to life, health, human dignity and non-discrimination. The COI declared these atrocities to be crimes against humanity.

Detention of Palestinians in Israeli military camps and detention facilities

In relation to the detention of Palestinians in Israeli military camps and detention facilities, the COI found that thousands of child and adult detainees, many of whom were arbitrarily detained, have been subjected to widespread and systematic abuse, physical and psychological violence, and sexual and gender-based violence amounting to the war crime and crime against humanity of torture and the war crime of rape and other forms of sexual violence.

The investigation found that male detainees were subjected to rape, as well as attacks on their sexual and reproductive organs and forced to perform humiliating and strenuous acts while naked or stripped as a form of punishment or intimidation to extract information. The report found that the deaths of detainees as a result of abuse or neglect, amounted to the war crimes of wilful killing or murder and violations of the right to life.

Child detainees released by Israeli authorities who have returned to Gaza were reported to be severely traumatized, unaccompanied, with limited ability to locate or communicate with their families, if indeed their families were still alive.

The COI stated that the institutionalized mistreatment of Palestinian detainees, a longstanding practice by Israeli security forces, took place under direct orders from the Israeli Minister in charge of the prison system, ultranationalist settler leader Itamar Ben-Gvir, and was inflamed by Israeli government statements inciting violence and retribution.

Navi Pillay is quoted as saying:

The appalling acts of abuse committed against Palestinian detainees require accountability and reparations for the victims. The lack of accountability for actions ordered by senior Israeli authorities and carried out by individual members of Israeli security forces and the increasing acceptance of violence against Palestinians have allowed such conduct to continue uninterrupted, becoming systematic and institutionalized.

Root causes of the conflict

In addressing the root causes of the conflict, the Commission of Inquiry has called on the Israeli government to:

• Comply with the directions of the July 2024 Advisory Opinion of the International Court of Justice;
• End the unlawful occupation of Palestinian territory (Gaza Strip and the West Bank including East Jerusalem);
• Cease new settlement plans and activities;
• Evacuate all settlers and make reparations to victims;
• Comply with provisional measures ordered by the International Court of Justice to prevent the commission of all acts within the scope of Article II(a)-(d) of the Genocide Convention.

The COI’s report will be presented to the General Assembly’s 79th session on 30 October 2024 in New York.