Tens of thousands of displaced Palestinians across northern Gaza have been forced on a death march by the Israeli army since Monday, October 21. Northern Gaza is being emptied of its inhabitants, and one of Israel’s strategies in achieving this goal is to take out the area’s few remaining social institutions: hospitals.
As part of its ongoing offensive on northern Gaza, the Israeli army has been trying to clear out the entire area north of Gaza City for the past 18 days. At least 200,000 people continue to stay there, many of them fearing, according to local testimonies, that they will be targeted on the way south or in Israeli-designated “safe zones,” which have been consistently bombarded over recent months. The ongoing siege includes a second siege-within-the-siege on the Jabalia refugee camp, accompanied by a massive bombing and shelling campaign that is forcing tens of thousands of people to leave their homes. Many of them have headed to Beit Lahia, and particularly to Kamal Adwan Hospital. Over the past 18 days, the hospital has been issuing daily calls for help, warning of an imminent humanitarian catastrophe.
The Kamal Adwan Hospital in Beit Lahia is one of three functioning hospitals in the northern Gaza governorate. The hospital is the only fully functional medical center in the north, with a specialized neonatal section for newborns.
The two other hospitals in Gaza are barely functional. The Indonesian Hospital in the town of Sheikh Zayed went out of services last week after Israeli troops besieged it and invaded its surroundings. Al-Awda Hospital in Jabalia, smaller in size, has suspended most of its services and only functions at a limited capacity. On Tuesday, October 22, the al-Awda Hospital’s director, Bakr Abu Safiyeh, told al-Ghad TV that Israeli quadcopter drones were opening fire directly on the hospital.
Dr. Baker said that Israeli quadcopters were also opening fire on anybody moving in the streets, including ambulances. According to the hospital director, an Israeli strike targeted an ambulance carrying a mother who had just given birth. The mother was killed, Dr. Baker said, and the baby was later found alive by rescue teams and was taken to Kamal Adwan Hospital’s neonatal section.
Why targeting hospitals is the key to emptying northern Gaza
Named after Kamal Adwan, a Palestinian resistance leader assassinated by Israel in Beirut in 1973, the hospital has become a central destination for the wounded and the displaced. Like most other hospitals in Gaza over the past year of genocidal war, Kamal Adwan Hospital is the only remaining public space in northern Gaza that offers services and provides shelter, representing the backbone of Gazan civil society and social cohesion. That is why Israel is targeting it, with the aim of forcibly expelling the population in service of the Israeli plan to empty the north. This has now come to be called “the Generals’ Plan.”
Two weeks before Israel began the current siege, Netanyahu told Israeli lawmakers that he was considering the “Generals’ plan,” so named for the proposal put forward by senior Israeli army officials in early September based on the vision of retired Israeli general Giora Eiland, who wrote an Op-Ed a year ago explaining how northern Gaza should be emptied of the entire population through mass starvation and extermination.
The plan is an enhanced version of what Israel has already been doing for the past year, including targeting and forcibly evacuating hospitals. Israeli forces raided al-Shifa Hospital in Gaza City for the first time in November, when the compound and its surroundings were crowded with displaced families, and forced medics, patients, and displaced people to leave. But in February, when Israeli forces began to withdraw from parts of Gaza, including Gaza City, Palestinians returned to al-Shifa and began to operate parts of it again as displaced families began to take over its spaces once more.
Then, in April, Israeli forces invaded al-Shifa a second time in a raid that lasted several weeks with the purpose of accelerating social collapse in Gaza City. The Israeli army combed the hospital building by building and floor by floor, destroying equipment and, according to survivor testimonies gathered by Mondoweiss at the time, executing hundreds of civil government employees and separating people into differently-colored bracelet. At the end of the operation, Dr. Marwan Abu Saada, Deputy Director of al-Shifa, told UN News that the destruction of al-Shifa “took out the heart of the health system in the Gaza Strip,” adding that “al-Shifa is finished forever.”
In December 2023, two months into the Israeli genocide in Gaza, Israeli forces raided the Kamal Adwan hospital and forced medical staff, patients, and displaced civilians to evacuate. The hospital resumed partial services in July after joint efforts by the World Health Organization and other international parties, coupled with pressure on Israel to allow limited quantities of humanitarian aid into the north.
As Israel set its eyes on Gaza’s northernmost governorate to execute Eiland’s plan, Kamal Adwan Hospital is now the last bastion of Palestinian steadfastness in the north. This makes it a prime target in the ongoing Israeli offensive. Kamal Adwan came close to completely shutting down multiple times, mainly due to the lack of fuel for power generators, saved every time by intensified pressure by international parties on Israel to allow limited quantities of fuel to pass through
Kamal Adwan Hospital weathers siege and overcapacity
“We need blood units, shrouds for the dead, doctors, and food,” Dr. Husam Abu Safiyeh, director of Kamal Adwan hospital, told the media on Wednesday, October 23, signaling that Israeli forces had cut off internet services from the area.
The day before, on October 22, Dr. Abu Safiyeh told the media that the hospital had run out of blood units, had a shortage of medical staff, that the available staff was hungry and exhausted, and that the power generators were about to run out of fuel.
Dr. Abu Safiyeh also indicated that the hospital was treating 130 wounded, including 14 on ventilators, and that medics were unable to evacuate the wounded from the streets because of the risk of being targeted by Israeli quadcopter fire. He also called upon international entities to open a humanitarian route to evacuate the wounded, and described his hospital as “a mass grave.”
A week earlier, on October 16, Dr. Abu Safiyeh posted a video he took inside the Kamal Adwan Hospital’s newborn children’s section. The video showed babies inside incubators and Palestinian nurses caring for them. “These are children with difficult cases, and more cases are on the way, as we have scheduled cesarean births for tomorrow,” he said while filming.
“This baby girl here arrived after her family was targeted by [an Israeli] strike,” said Abu Safiyeh while filming one particular newborn. “Her mother and father were martyred, as well as her grandmother, and she is now alone with a wound to the head and a secondary inflammation,” he explained. “If fuel doesn’t arrive [for power generators] there will be a humanitarian catastrophe for these children,” he warned.
In the hospital’s sections, the medical staff described their working conditions. “There are cases of burning, internal bleeding, skull fractures, and limb amputations,” Dr. Ameen Abu Amshah, serving at Kamal Adwan, told Mondoweiss. “Out of every 10 to 15 wounded we receive at once, an average of seven are urgent cases for surgery. We just don’t have the capacity for all this, and we are forced to prioritize the cases that can be saved” said Dr. Abu Amshah.
“The occupation army has been ordering doctors to leave, including through phone calls,” said Abu Amshah.
This is an extermination. Northern Gaza is being exterminated, Jabalia is being exterminated, and Kamal Adwan hospital is being exterminated, but we will not leave.
Forced death march
On Tuesday, October 23, Israeli drones dropped leaflets and aired voice messages at Palestinians who remained in the surroundings of Kamal Adwan and inside its premises, ordering them to leave. Meanwhile, hundreds of Palestinians were being gathered and forced to move out of other shelters after arresting men among them. Thousands were left stranded in the street far away from the last standing public facilities and forced to take the road yet again at gunpoint, as shown by footage aired by the Israeli army.
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Dr. Abu Amshah at Kamal Adwan, however, told Mondoweiss that he knows one thing; that despite the lack of food, exhaustion, the siege, and Israeli drones,
we Palestinian doctors will not leave. We will stay for our people.
Qassam Muaddi is the Palestine Staff Writer for Mondoweiss.