[News in War History] Gaza Strip Frontline, 'Al-Sifa Hospital'... Why It Became Hamas Headquarters

Israel "Al-Sifa Hospital, Hamas Operations Headquarters"
The 'Hospital Knights' Existing Since the Crusades

The conflict between Israel and the Palestinian armed group Hamas has exceeded 40 days. The Israeli military has taken control of most of Gaza City, the central city of the Gaza Strip, and entered the largest medical institution in the area, Al Shifa Hospital, sparking significant international controversy. Even during wartime, attacks on civilian medical facilities are prohibited under international law, yet international human rights organizations have strongly condemned the Israeli military for conducting indiscriminate attacks.

However, the Israeli military argues that an entrance connected to Hamas's underground tunnels was discovered inside Al Shifa Hospital, along with laptops containing information about a large cache of weapons and hostages, asserting that the hospital is not merely a medical facility. Given that it has long been used as Hamas's operational command center, they claim it was inevitably included in the ground operations.

On the 3rd (local time), a child injured in the Gaza Strip due to an Israeli airstrike is being transported to Al-Shifa Hospital. [Image source=AFP· Yonhap News]

In fact, hospitals in the Middle East have not been used solely as medical facilities for a long time. During the Crusades in the medieval period, there were even knight orders that used hospitals as bases, serving military functions as well. Especially, Al Shifa Hospital was built on a British military field base from the 19th century through World Wars I and II, making it geographically a strategic point, and suspicions have continuously been raised that Hamas has been repurposing it as a military facility.

This time, we will examine the controversy surrounding Al Shifa Hospital involving Israel, Hamas, and human rights organizations, as well as explore the history of hospitals that held a very unique status in the Middle East region.

◆News: Israel "Entrance to Hamas underground tunnel connected to Al Shifa Hospital discovered"

The weapons reportedly found inside Al-Shifa Hospital by the Israel Defense Forces (IDF) on the 15th (local time). [Image source=Reuters·Yonhap News]

First, let's look at the news. According to the Times of Israel on the 16th (local time), the Israel Defense Forces (IDF) announced that they found an entrance to Hamas's underground tunnel within the Al Shifa Hospital premises. Along with this, they discovered a pickup truck loaded with Hamas weapons inside the hospital and claimed to have found laptops containing information about hostages taken during Hamas's surprise operation on Israel on the 7th of last month.

The Israeli military asserts that it has been revealed that Al Shifa Hospital was not a simple civilian medical facility but was used as Hamas's operational command center, and that patients and medical staff inside the hospital were used as human shields. Until now, international human rights organizations have criticized the Israeli military's attack on Al Shifa Hospital, stating that no conclusive evidence has emerged that the hospital was used as Hamas's operational base.

Despite such criticism, the Israeli military insisted that Al Shifa Hospital was an operational area that must be subdued and eventually deployed ground forces into the hospital. Although international condemnation has continued, the U.S. government has accepted Israel's claims, and the Israeli military has taken control of the hospital facility.

Hamas and Al Shifa Hospital representatives have denied Israel's claims, calling them fabricated and asserting that Al Shifa Hospital was not used as Hamas's operational headquarters, continuing the controversy.

◆History 1: The 'Hospitaller Knights' active during the Crusades

A reenactment of the 'Order of Saint John' that ruled Malta Island in the 16th century. In the medieval era, the Order of Saint John was responsible for protecting and treating pilgrims traveling to the Holy Land of Jerusalem, earning them the name Hospitaller Knights or the Knights of the Hospital. [Image source=X (formerly Twitter)]

In fact, hospitals in the Middle East have a long history of being used not just as civilian medical facilities but also as military facilities. During the 11th-century Crusades, knight orders based in various hospitals continued expeditions around the Eastern Mediterranean, and many hospitals were repurposed as military facilities.

This knight order was originally called the "Order of St. John of Jerusalem," tasked during the Crusades with protecting pilgrims and civilians traveling to the holy city of Jerusalem and treating the sick. Hence, they earned the nickname "Hospitaller," meaning hospital or relief provider.

Today, the word "hospital" shares the same etymology. Originally, this term referred to the hospitality shown by ancient Middle Eastern nomadic tribes when "hosts" (guests) arrived from outside. It encompassed the entire act of providing water, food, and treating wounds, which later evolved to mean a medical facility.

Ironically, one of the words sharing the same root as "hospital" is "hostile," meaning adversarial. This reflects that not all strangers or guests were friendly, and violent conflicts often occurred even in hospitality settings.

Starting from this etymology, the Hospitaller Knights originally aimed to provide relief and treatment to pilgrims, but as the Crusades intensified, they also engaged in frontline battles. Initially a group of monks centered around the Order of St. John, they gradually transformed into an armed organization as knights and mercenaries with combat experience joined. Subsequently, the hospitals and relief centers they established became military strongholds.

During the Crusades, the Hospitaller Knights operated based in Jerusalem but moved to Mediterranean islands such as Rhodes and Malta after the Crusades ended in failure in 1291. They developed a navy and became notorious for attacking and plundering various parts of Palestine and the Eastern Mediterranean. They also enslaved prisoners. Today, they are better known as the "Order of Malta," named after the island where they last resided.

◆History 2: Al Shifa Hospital built on a former British military barracks, controversy over Hamas operational headquarters

Marching scene of British troops deployed in the Gaza Strip area during World War I in 1917
[Image source: New Zealand History (nzhistory) website]

After the Crusades, from the 15th to 16th centuries, the Ottoman Turkish Empire, the predecessor of modern-day T?rkiye, dominated the Eastern Mediterranean, bringing a period of relative peace to the Middle East. However, from the 19th century during the era of imperialism, instability returned to the region. The Gaza Strip, including Al Shifa Hospital, entered a history of conflict starting from this period.

Al Shifa Hospital became an important military stronghold in Gaza City when Britain occupied the area in the 19th century and established barracks there. During World War I, fierce battles between British forces and the Ottoman Turkish Empire took place in the Gaza Strip, making it a hotly contested area. The hospital as it is known today was established in 1946 during the British Mandate of Palestine, named "Dar Al-Shifa," meaning "House of Healing" in Arabic.

After the Middle East wars, the Gaza Strip changed hands among Egypt, Israel, the Palestinian Authority (PA), and Hamas, with Al Shifa Hospital undergoing continuous expansion each time. As the largest hospital facility in Gaza City, it became a crucial facility regardless of who controlled the area amid intense conflict.

Since the 2000s, suspicions have been continuously raised that Hamas has been effectively exploiting the hospital as a military base. Foreign media have reported that Hamas has used the site to torture and kill opposition factions and Israeli collaborators within Gaza. However, Hamas continues to deny these allegations, claiming they are fabricated by Israel and the U.S., and insists that Al Shifa Hospital is a purely civilian medical institution.

◆Implication: Growing civilian casualties amid difficulties in distinguishing civilian and military facilities

Satellite image of the Al-Shifa Hospital area in Gaza City, the center of the Gaza Strip. [Image source=AFP·Yonhap News]

Concerns are growing that suspicions of Al Shifa Hospital being repurposed as a military facility will intensify as the conflict between Israel and Hamas prolongs. The Israeli military has stated it will not halt military operations until Hamas is completely eradicated, and as ground operations expand, the likelihood of more civilian facilities being attacked increases.

With the death toll in the Gaza Strip estimated to exceed 12,000, if Israeli attacks do not cease, far greater civilian casualties are expected. Especially, as Hamas faces setbacks in the war, it is anticipated that they will increasingly use civilian residential buildings as command centers, exploiting civilians as human shields.

Amid these offensive and defensive strategies by both sides, the number of innocent children victims is rising, and calls for a swift ceasefire are growing louder. We hope for peace to come to the Gaza Strip as soon as possible.